India Faces Surge in Kidney Disease Linked to Heat Stress and Labor Conditions
New Delhi – A growing epidemic of chronic kidney disease of unknown etiology (CKDu) is disproportionately impacting vulnerable workers in India, wiht heat stress and inadequate workplace protections identified as key drivers, according to recent research and public health officials.The crisis threatens to overwhelm already strained healthcare systems and exacerbate existing inequalities.
While kidney disease is typically associated with older populations, doctors are observing a disturbing trend: increasingly younger individuals, even in their early 30s, presenting with severe kidney damage. “Out of the occupational setting, you won’t see people in their early 30s, or even younger, with destroyed kidneys en masse,” explains Dr.Richard Glaser, highlighting the link to specific work environments.
The issue is especially acute in labor-intensive sectors like agriculture and salt production, where workers face prolonged exposure to extreme heat.However, heat alone isn’t the sole culprit. A lack of basic workplace safeguards - including access to drinking water, shaded rest areas, and clean bathroom facilities – significantly contributes to the problem. In some cases, particularly among women working in salt pans, the absence of restroom access leads workers to limit fluid intake during work hours, increasing dehydration and kidney strain.
Dr. glaser’s research demonstrates a clear benefit to preventative measures. Published findings show that providing agricultural workers at risk of CKDu with rest, shade, and hydration not only boosts productivity but also yields a positive return on investment for employers. “Governments certainly would too,” he states, emphasizing the financial burden of dialysis. “state-funded health systems cannot afford dialysis.”
India currently offers free dialysis to poor patients, but these services are insufficient to meet the escalating demand. The country lacks universal health coverage, leaving most medical expenses to be borne by patients and their families, compounding the financial hardship when workers become unable to earn a living.
Public health experts warn that if left unaddressed, CKDu will become an even larger public health crisis in the coming decades. Dr. Vivekanand Jha stresses that the issue is rooted in inequity, with communities lacking access to healthcare being the most vulnerable.”It’s a vicious cycle,” she says. “From birth, they have limited access to basic services, which increases their risk of getting sick. Once they do, they frequently enough miss out on early diagnosis and preventive care, allowing the disease to progress faster. Without access to treatment, they face worse outcomes and develop kidney diseases at least a decade earlier than those in more privileged sections of society.”
Solutions center on preventative measures. Experts like Dr. Venugopal advocate for simple interventions: hourly hydration, rest breaks, and access to shade. “Water means hydrating yourself every hour,” says Venugopal.”Rest means taking a break every hour. Shade is also critically important. Even if workers are given five to ten minutes of rest in a cooler place each hour, with access to water, it would make a huge difference.”
