Abstract
Background
Healthcare workers (HCWs) in rural maternity wards are particularly exposed, and thus vulnerable to, extreme heat due to heat-inept infrastructure, with insufficient ventilation and suboptimal access to safe water. These conditions can lead to excessive sweating and dehydration, impairing health outcomes, and job performance. Research demonstrates that occupational heat stress elevates urine specific gravity (USG) in outdoor workers. This study investigates the hydration status of HCWs in high-temperature maternity wards in rural Zimbabwe, a group whose hydration status remains largely unexplored.
Methods
The study was conducted during the hotter season (September–December 2023) with indoor temperatures averaging 30°C, and the cooler season (May–July 2024) with temperatures averaging 17.5 °C. We recruited 44 HCWs from maternity wards to assess intra-individual changes across both seasons. HCWs self-collected urine samples after their shifts, which varied in duration: most shifts lasted 8 hours (08:00 to 16:00, 07:00 to 15:00, and 12:00 to 20:00), while the 19:00 to 07:00 shift lasted 12 hours. A refractometer measured USG ≥1.020 as the dehydration marker. We analysed dehydration differences between seasons using Stata.
Results
Of the 44 women assessed in both the warmer and cooler seasons, 33 (75%) and 26 (59%) showed to have signs of dehydration, respectively. This difference in hydration classifications (hydrated vs. dehydrated) between the seasons, did not reach statistical significance (McNemar’s test; P=0.065). In warmer months, median USG was 1.024 (IQR=1.019-1.029), while in cooler months this was 1.022 (IQR=1.016-1.026). A paired t-test revealed a statistically significant difference in mean USG between seasons (P=0.032).
Discussion
Our results show that dehydration levels are very common with more than half the healthcare workers objectively assessed as having dehydration, and this was the case in both the warmer and cooler seasons. Although we assessed a small group of HCWs, there was a tendency towards more dehydration during the warmer months. Key heat adaptation interventions should be considered, and could include hydration protocols, such as scheduled water breaks and improved access to potable water. Additionally, workplace modifications like installing air conditioning could replicate winter conditions in summer to enhance hydration. Future research should focus on larger, longitudinal cohorts with diverse variables to validate these findings and refine intervention strategies.
Healthcare workers (HCWs) in rural maternity wards are particularly exposed, and thus vulnerable to, extreme heat due to heat-inept infrastructure, with insufficient ventilation and suboptimal access to safe water. These conditions can lead to excessive sweating and dehydration, impairing health outcomes, and job performance. Research demonstrates that occupational heat stress elevates urine specific gravity (USG) in outdoor workers. This study investigates the hydration status of HCWs in high-temperature maternity wards in rural Zimbabwe, a group whose hydration status remains largely unexplored.
Methods
The study was conducted during the hotter season (September–December 2023) with indoor temperatures averaging 30°C, and the cooler season (May–July 2024) with temperatures averaging 17.5 °C. We recruited 44 HCWs from maternity wards to assess intra-individual changes across both seasons. HCWs self-collected urine samples after their shifts, which varied in duration: most shifts lasted 8 hours (08:00 to 16:00, 07:00 to 15:00, and 12:00 to 20:00), while the 19:00 to 07:00 shift lasted 12 hours. A refractometer measured USG ≥1.020 as the dehydration marker. We analysed dehydration differences between seasons using Stata.
Results
Of the 44 women assessed in both the warmer and cooler seasons, 33 (75%) and 26 (59%) showed to have signs of dehydration, respectively. This difference in hydration classifications (hydrated vs. dehydrated) between the seasons, did not reach statistical significance (McNemar’s test; P=0.065). In warmer months, median USG was 1.024 (IQR=1.019-1.029), while in cooler months this was 1.022 (IQR=1.016-1.026). A paired t-test revealed a statistically significant difference in mean USG between seasons (P=0.032).
Discussion
Our results show that dehydration levels are very common with more than half the healthcare workers objectively assessed as having dehydration, and this was the case in both the warmer and cooler seasons. Although we assessed a small group of HCWs, there was a tendency towards more dehydration during the warmer months. Key heat adaptation interventions should be considered, and could include hydration protocols, such as scheduled water breaks and improved access to potable water. Additionally, workplace modifications like installing air conditioning could replicate winter conditions in summer to enhance hydration. Future research should focus on larger, longitudinal cohorts with diverse variables to validate these findings and refine intervention strategies.
| Original language | English |
|---|---|
| Pages | 29-30 |
| Number of pages | 176 |
| Publication status | Published - Oct 2024 |
| Event | Climate and Health Africa Conference: Cultivating Resilience in Health: Towards Unified Equitable Strategies for Climate Adaptation and Mitigation in Africa - Cresta Lodge Hotel , Harare, Zimbabwe Duration: 29 Oct 2024 → 31 Oct 2024 Conference number: 528 https://www.climatehealthconf.africa/abstract-book/ |
Conference
| Conference | Climate and Health Africa Conference |
|---|---|
| Abbreviated title | CHAC 2024 |
| Country/Territory | Zimbabwe |
| City | Harare |
| Period | 29/10/24 → 31/10/24 |
| Internet address |
Keywords
- Occupational heat stress
- Dehydration
- Urine specific gravity
- Healthcare workers
- Maternity care
- Extreme heat
- Longitudinal observational study
- Climate and health
- Zimbabwe
- Climate Resilient Health Systems
- health workforce
Themes
- Climate Health
- Community Health and Resilient Health Systems
