A Rest-Shade-Hydration-Hygiene program reduces acute kidney injury and increases production at a sugar mill in Nicaragua, an economic analysis.

Background: Occupational heat stress mediated acute kidney injury (AKI) has been linked to the development of chronic kidney disease of non-traditional causes (CKDnt) in agriculture workers. Rest-shade-hydration-hygiene (RSHH) programs are promising interventions for preventing CKDnt. An obstacle to the implementation of RSHH programs is the concern that the reduced work time associated with these programs may reduce productivity and earnings.