Evidence map›Paper›PMID 41856596›Full record

ArticleBMJ open2026

Experiences of heat stress and adapting practices among farmworkers in northwest Nicaragua: a qualitative study.

Ana L Pineda Reyes, Andres Jaime, Aurora Aragón, Indiana López-Bonilla, Neil Pearce, Ben Caplin, Marvin González-Quiroz

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors.

Ana L Pineda ReyesDepartment of Environmental and Occupational Health, Kate Marmion School of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA.ORCID http://orcid.org/0009-0007-8748-1044
Andres JaimeOffice of Research and Partnerships, Kate Marmion School of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA.
Aurora AragónWuku' Kawoq Maya Health Alliance, Chimaltenango, Guatemala.
Indiana López-BonillaWuku' Kawoq Maya Health Alliance, Chimaltenango, Guatemala.
Neil PearceDepartment of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK.ORCID http://orcid.org/0000-0002-9938-7852
Ben CaplinBladder and Kidney Centre, University College London, London, UK.ORCID http://orcid.org/0000-0001-9544-164X
Marvin González-QuirozDepartment of Environmental and Occupational Health, Kate Marmion School of Public Health, The University of Texas at San Antonio, San Antonio, Texas, USA gonzalezquir@uthscsa.edu.ORCID http://orcid.org/0000-0002-0093-6357

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesChronic heat stress and recurrent dehydration from strenuous labour in hot environments are recognised drivers of acute kidney injury among agricultural workers in Mesoamerica and may contribute to Chronic Kidney Disease of Unknown Aetiology (CKDu). This study explored how members of a long-term community-based cohort in northwest Nicaragua perceive, experience and adapt to extreme heat, within the broader context of environmental and labour changes.

designThis qualitative study used focus group discussions with participants from a community-based cohort followed for over a decade and community members. Transcripts were analysed thematically using an interpretative approach, with trustworthiness ensured through peer debriefing, audit trails, triangulation and achievement of thematic saturation. SETTINGS: Rural agricultural communities in northwest Nicaragua participating in a long-term community-based cohort.

participantsParticipants were purposively sampled from a prospective community-based cohort and community members were invited to participate. Men and women across different age groups were invited. In total, 91 adults aged ≥18 years participated in 11 face-to-face focus groups, each comprising 8-11 men or women. OUTCOMES: Themes describing experiences of heat stress, occupational risk and adaptive responses among agricultural workers.

resultsParticipants described worsening heat linked to deforestation, unsafe and inadequate water access and unrealistic production targets that prioritised output over health. In response, workers reported adaptive practices including self-paced labour, hydration routines and peer monitoring. Community solidarity and mutual aid emerged as key sources of resilience despite structural constraints.

conclusionHeat stress amplifies occupational hazards and exacerbates health inequities among marginalised agricultural workers. Integrating climate adaptation and equity into labour protections-ensuring access to clean water, adequate shade and fair workloads-can strengthen resilience in agricultural communities facing rising heat-related health risks.

Indexed as

Adaptation, PhysiologicalFarmersHeat Stress DisordersAdultAgricultureChronic Kidney Diseases of Uncertain EtiologyDehydrationFemaleFocus GroupsHot TemperatureHumansMaleMiddle AgedNicaraguaOccupational ExposureProspective StudiesAcute renal failureChronic renal failureEnvironmental IllnessEPIDEMIOLOGY

Identifiers

PMID41856596
PMCPMC13007072

What Socratic holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.