Conducting a mini field study on a nearby farm/gasoline station/bazaar to quantify environmental stressors and design evidence-based guidelines that prevent heat illness/AKI, cold injuries/neuropathies, and UV-related skin/eye disease (exposure assessment, prevention planning, behavior-change protocol writing, patient education materials development):
A Comprehensive study.
1. Dr.Turusbekova Akshoola Kozmanbetovna
2. Vishnu Saini
(Teacher, International Medical Faculty, Osh state university, Kyrgyzstan
Student, International Medical Faculty, Osh state university, Kyrgyzstan)
Abstract
Outdoor occupational environments present a dangerous convergence of thermal, chemical, and physical stressors that are frequently underestimated by generalized meteorological data. This report quantifies these risks across three specific microclimates: high-intensity agriculture, gasoline service stations, and urban bazaars. By utilizing advanced metrics such as the Wet Bulb Globe Temperature (WBGT) and the Universal Thermal Climate Index (UTCI), the study identifies critical physiological thresholds for the prevention of heat-related Acute Kidney Injury (AKI), Chronic Kidney Disease of unknown etiology (CKDu), and Non-Freezing Cold Injury (NFCI). New research highlights the synergy between thermal stress and carcinogenic benzene vaporization at industrial retail sites, as well as the psychiatric impact of chronic noise pollution in informal commerce. Mitigation is addressed through evidence-based guidelines, including strict work-rest cycles and personal protective equipment (PPE) compliance as defined by ANSI Z87.1-2020. The framework incorporates the Health Belief Model (HBM) and the Capability, Opportunity, Motivation, and Behavior (COM-B) model to drive sustainable safety behaviors in vulnerable workforces.
Keywords: Occupational Health, Acute Kidney Injury (AKI), Benzene Toxicity, Pterygium, Noise Pollution, Universal Thermal Climate Index (UTCI), ANSI Z87.1-2020, Health Belief Model (HBM).
Characterization and Quantification of Environmental Stressors
A rigorous exposure assessment requires moving beyond ambient thermometers to integrated sensors that reflect the body's actual thermal load.1 Regional weather reports are often insufficient for occupational safety because they are measured in the shade and fail to account for the radiant energy absorbed and re-radiated by asphalt or metallic stalls.
The Superiority of the Wet Bulb Globe Temperature (WBGT)
The WBGT is the global standard for assessing heat stress because it factors in temperature, humidity, wind speed, and radiant heat.2 The black globe thermometer is critical for workers standing on sun-heated surfaces at gasoline stations or urban markets.1
● Outdoor Sunlight Formula: WBGT = (0.7 x Natural Wet Bulb Temp) + (0.2 x Globe Temp) + (0.1 x Dry Bulb Temp).
● Shaded/Indoor Formula: WBGT = (0.7 x Natural Wet Bulb Temp) + (0.3 x Globe Temp).
Readings over 90 degrees Fahrenheit are considered dangerous for strenuous activity and require immediate administrative controls.5
Microclimate Variations: The "Crop Row Effect"
Agricultural stressors vary significantly within the same field. Inside tall-growing crops like tobacco or sugarcane, WBGT levels in the center of rows are substantially higher than at the field edges due to reduced airflow and increased humidity from plant transpiration.6 Greenhouses present even higher risks, with internal conditions often exceeding outside temperatures by several degrees.
Industrial and Urban Retail Stressors
● Gasoline Station Chemical Synergy: Fueling attendants face a dual threat of heat and chemical exposure. Benzene, a Group 1 carcinogen, vaporizes more rapidly in high ambient temperatures.7 Inhalation risk is highest during car refueling, with concentrations reaching up to 85 micrograms per cubic meter.7 Clusters of gas stations can create cumulative risk areas for nearby workers and residents.10
● Urban Heat Island (UHI) and Noise: City centers can be up to 12 degrees Celsius warmer than rural areas.11 Beyond heat, bazaar vendors are exposed to chronic noise levels exceeding 70-85 decibels. Such noise pollution is an uncontrollable environmental stressor that raises urine cortisol levels and increases the odds of psychological distress by 2.34 times.
Pathophysiology of Environmental and Chemical Injuries
Heat-Induced Acute Kidney Injury and CKDu
A critical emerging public health crisis is the high prevalence of CKDu in agricultural workers, often described as a tubulointerstitial nephritis triggered by chronic heat strain.
● Renal Mechanism: Intense labor in heat diverts blood flow away from the kidneys to the skin for cooling, causing renal ischemia and tubular damage.
● AKI Incidence: Up to 43 percent of workers in certain high-heat cohorts experience an AKI incident during a single shift.12
● Piece-Rate Risk: Workers paid by output are 3 to 4 times more likely to suffer AKI because economic incentives lead them to ignore thirst and skip mandated rest breaks.14
Cold-Induced Injuries and Vaso-neuropathies
Workers in damp, cool climates (0 to 15 degrees Celsius) are at risk for Non-Freezing Cold Injury (NFCI), such as "trench foot".15
● Vaso-neuropathy: NFCI involves damage to microvascular endothelium and peripheral nerves, often passing through a "hyperemic stage" of intense burning pain and swelling.15
● Conduction Velocity: Nerve signals slow by roughly 2 meters per second for every 1 degree Celsius drop in temperature, exacerbating symptoms of numbness and tingling in workers with pre-existing damage.
UV-Related Pathologies
Ultraviolet radiation (UVR) is a primary factor in both dermal and ocular diseases.
● Pterygium: This blindness-causing tissue growth is highly prevalent (12% global mean) among outdoor workers due to long-term sunlight exposure.
● Skin Cancer: UVA penetrates deep into the tissue while UVB causes immediate burns; together they significantly increase the risk of melanoma and squamous-cell carcinoma.
Evidence-Based Prevention Guidelines
Hydration and Work-Rest Cycles
● Volume Standards: Workers should drink 1 cup (8 oz) of water every 15-20 minutes, totaling approximately 32 oz (1 quart) per hour.19
● Limits: Intake should not exceed 48 oz (1.5 quarts) per hour to prevent hyponatremia.22
● Electrolytes: For work lasting more than 2 hours, electrolyte-replacement beverages are recommended to replace salts lost through sweating.
● Thresholds: Under "Extreme Risk" (90+ degrees F WBGT), heavy labor requires a 10/50 work-rest cycle.20
Cold Protection and Wind Chill
Guidelines must be based on the Wind Chill Temperature (WCT) Index.21
● PPE Triggers: Gloves are mandated for sedentary work below 60.8 degrees Fahrenheit and moderate work below 19.4 degrees Fahrenheit.21
● Acclimatization: New workers should start at 20-25% exposure on Day 1, increasing by 20% daily over a 14-day period to build cold tolerance.
Eye and Face Protection: ANSI Z87.1-2020
Eyewear must be "matched to the hazard" using permanent markings.26
● U Scale (UV): Marked from U2 to U6; U6 blocks 99.9% of harmful rays.28
● L Scale (Light): L1 to L3 are for low light; L5 to L6 are necessary for high-intensity sunlight.28
● Impact Rating (+): A "Z87+" mark indicates high-velocity impact protection, essential for agricultural tasks.26
Behavior-Change Protocol and Education
Behavioral Theory: COM-B and HBM
Adherence to safety protocols depends on Capability, Opportunity, and Motivation.
● Psychological Capability: Workers must know how to fit-test a respirator or recognize early AKI signs.31
● Physical Opportunity: Shade structures and cool water (50-60 degrees F) must be accessible within a short walk of the work area.
● Health Belief Model (HBM): Interventions must address "perceived severity" (e.g., the permanence of kidney failure) and provide "cues to action" such as automated hydration reminders.
Education Materials Development
Materials must be evaluated for Understandability and Actionability using the PEMAT tool.34
● Plain Language: Use "kidney damage" instead of "nephropathy" and "low blood flow" instead of "ischemia".
● Visual Distinction: Infographics must clearly contrast "Heat Exhaustion" (heavy sweating, nausea) with "Heat Stroke" (lack of sweat, confusion).36
● Small Group Activity Method (SGAM): Hands-on simulations and participatory risk mapping are more effective than passive lectures for knowledge acquisition.
References -
1. Heat Hazard Recognition | Occupational Safety and Health Administration - OSHA, accessed January 12, 2026, https://www.osha.gov/heat-exposure/hazards
2. Heat stress in agriculture: safeguarding farm workers and sustaining productivity, accessed January 12, 2026, https://gillinstruments.com/industries-applications/heat-stress-in-agriculture-safeguarding-farm-workers-and-sustaining-productivity/
3. Here Comes the Heat: How Summer Puts Critical Industries at Risk - Baron Weather, accessed January 12, 2026, https://baronweather.com/extreme-weather/summer-puts-industries-at-risk
4. Hot Environments - Control Measures - Canadian Centre for Occupational Health and Safety, accessed January 12, 2026, https://www.ccohs.ca/oshanswers/phys_agents/heat/heat_control.pdf
5. Heat Injury and Illness Prevention in Outdoor and Indoor ... - OSHA, accessed January 12, 2026, https://www.osha.gov/sites/default/files/Heat_Regulatory_Framework_8_21_2023.pdf
6. How Dangerous Is Heat Stress in the Agricultural Industry?, accessed January 12, 2026, https://heatstress.com/blog/how-dangerous-is-heat-stress-in-the-agricultural-industry
7. Risk Assessment on Benzene Exposure among Gasoline Station Workers - PMC, accessed January 12, 2026, https://pmc.ncbi.nlm.nih.gov/articles/PMC6678808/
8. Benzene Exposure in Gas Stations across the World: A Systematic Review | ACS Chemical Health & Safety, accessed January 12, 2026, https://pubs.acs.org/doi/10.1021/acs.chas.5c00041
9. Assessment and prediction of exposure to benzene of filling station employees | Request PDF - ResearchGate, accessed January 12, 2026, https://www.researchgate.net/publication/223813220_Assessment_and_prediction_of_exposure_to_benzene_of_filling_station_employees
10. Benzene emissions from gas station clusters: a new framework for estimating lifetime cancer risk - PMC - PubMed Central, accessed January 12, 2026, https://pmc.ncbi.nlm.nih.gov/articles/PMC8172828/
11. Assessment of Outdoor Thermal Comfort in Urban Public Space, during the Hottest Period in Annaba City, Algeria - MDPI, accessed January 12, 2026, https://www.mdpi.com/2071-1050/15/15/11763
12. Heat‐induced kidney disease: Understanding the impact - PMC, accessed January 12, 2026, https://pmc.ncbi.nlm.nih.gov/articles/PMC11636433/
13. Heat Stress and Determinants of Kidney Health Among Agricultural Workers in the United States: An Integrative Review - PubMed Central, accessed January 12, 2026, https://pmc.ncbi.nlm.nih.gov/articles/PMC12386589/
14. Investigating the Impact of Heat Exposure Among Agricultural Communities in a CKDu Hotspot - Indian Journal of Nephrology, accessed January 12, 2026, https://indianjnephrol.org/investigating-the-impact-of-heat-exposure-among-agricultural-communities-in-a-ckdu-hotspot/
15. Non-freezing cold injury - Wikipedia, accessed January 12, 2026, https://en.wikipedia.org/wiki/Non-freezing_cold_injury
16. Nonfreezing Cold-Induced Injuries - DTIC, accessed January 12, 2026, https://apps.dtic.mil/sti/tr/pdf/ADA558999.pdf
17. Trench Foot or Non-Freezing Cold Injury As a Painful Vaso-Neuropathy: Clinical and Skin Biopsy Assessments - Frontiers, accessed January 12, 2026, https://www.frontiersin.org/journals/neurology/articles/10.3389/fneur.2017.00514/full
18. Nonfreezing Tissue Injuries - Injuries; Poisoning - Merck Manual Professional Edition, accessed January 12, 2026, https://www.merckmanuals.com/professional/injuries-poisoning/cold-injury/nonfreezing-tissue-injuries
19. QUENCH THE THIRST! - Prevent Heat-Related Illness Among Outdoor Workers - NJ.gov, accessed January 12, 2026, https://www.nj.gov/health/workplacehealthandsafety/occupational-health-surveillance/Quench%20The%20Thirst%20(English).pdf
20. Develop a heat and air quality safety plan for your farm workers ..., accessed January 12, 2026, https://extension.umn.edu/climate-resilience-resources-vegetable-growers-minnesota/heat-and-air-quality-safety-plan
21. Employer Guidance: Protecting Outdoor Workers from Extreme Cold ..., accessed January 12, 2026, https://dol.ny.gov/system/files/documents/2025/01/p196-cold-weather-guidance.pdf
22. Keeping Workers Well-Hydrated - OSHA, accessed January 12, 2026, https://www.osha.gov/sites/default/files/publications/OSHA4372.pdf
23. Heat Stress: Hydration - CDC, accessed January 12, 2026, https://www.cdc.gov/niosh/mining/UserFiles/works/products/training/keepingcool/2017-126_hydration.pdf
24. Heat Stress: Work/Rest Schedules - CDC, accessed January 12, 2026, https://www.cdc.gov/niosh/docs/mining/UserFiles/works/pdfs/2017-127.pdf
25. Cold Environments - Control Measures - CCOHS, accessed January 12, 2026, https://www.ccohs.ca/oshanswers/phys_agents/cold/cold_working.html
26. What Does ANSI Z87.1 Certified Mean? - Safety Glasses USA, accessed January 12, 2026, https://safetyglassesusa.com/blogs/news/what-does-ansi-z871-certified-mean
27. ANSI-certified safety glasses, accessed January 12, 2026, https://rx-safety.com/product-category/master-safety-glasses/general-safety-products/
28. U, R, L for UV Protection Safety Goggles under ANSI Z87.1 - Ningbo Toprise, accessed January 12, 2026, https://toprisesafety.com/u-r-l-for-uv-protection-safety-goggles-under-ansi-z87-1/
29. Skullerz AEGIR-AFAS Anti-Scratch & Enhanced Anti-Fog Safety Glasses, Sunglasses, accessed January 12, 2026, https://www.ergodyne.com/skullerz-aegir-anti-fog-anti-scratch-safety-glasses-sunglasses
30. UV Protection Safety Glasses Ergodyne Skullerz SAGA Frameless Safety Glasses - UV Protection ANSI Z87.1 Work Safety Eyewear - Avalon Fire Protection, accessed January 12, 2026, https://avalonfire.com/Safety-Glasses-UV-Protection-ANSI-Z87-498215
31. COM-B Framework Guide: Change Cyber Behavior at Scale - OutThink, accessed January 12, 2026, https://outthink.io/community/thought-leadership/blog/practical-guide-to-com-b/
32. The COM-B Model - Habit Weekly, accessed January 12, 2026, https://www.habitweekly.com/models-frameworks/the-com-b-model
33. Applying the COM-B behaviour model and behaviour change wheel to develop an intervention to improve hearing-aid use in adult aud, accessed January 12, 2026, https://www.tandfonline.com/doi/pdf/10.3109/14992027.2015.1120894
34. Assessing the Understandability and Actionability of Education Materials for Agricultural Workers' Health - CHW Central, accessed January 12, 2026, https://chwcentral.org/wp-content/uploads/Assessing-the-Understandability-and-Actionability-of-Education-Materials-for-Agricultural-Workers-Health.pdf
35. Full article: Assessing the Understandability and Actionability of Education Materials for Agricultural Workers' Health - Taylor & Francis Online, accessed January 12, 2026, https://www.tandfonline.com/doi/full/10.1080/1059924X.2025.2474130
36. Heat Stroke vs. Stroke Infographic, accessed January 12, 2026, https://www.stroke.org/en/professionals/stroke-resource-library/prevention/heat-stroke-vs-stroke
37. Know the Symptoms of Heat-Related Illnesses Infographic | US EPA, accessed January 12, 2026, https://www.epa.gov/emergencies-iaq/know-symptoms-heat-related-illnesses-infographic
38. Heat Stroke vs Heat Exhaustion - Piktochart, accessed January 12, 2026, https://piktochart.com/templates/infographics/3788-heat-stroke-vs-heat-exhaustion/