Hemoglobin Levels Among Male Agricultural Workers

In rural areas of Ethiopia, India, Lesotho, and Senegal, men working in agriculture have modestly lower hemoglobin levels than men with other occupations. One explanation could be lower kidney function, due to undetected chronic kidney disease, among agricultural workers. More population-based surveys could consider adding kidney function assessments by occupation. Objective Estimate agricultural work's effect on hemoglobin (Hgb) level in men. A negative effect may indicate presence of chronic kidney disease of uncertain etiology. Methods We use Demographic and Health Surveys data from seven African and Asian countries and use matching to control for seven confounders. Results On average, Hgb levels were 0.09 g/dL lower among agricultural workers compared with matched controls. Significant effects were observed in Ethiopia, India, Lesotho, and Senegal, with effects from 0.07 to 0.30 g/dL lower Hgb level among agricultural workers. The findings were robust to multiple control groups and a modest amount of unmeasured confounding. Conclusions Men engaged in agricultural work in four of the seven countries studied have modestly lower Hgb levels. Our data support integrating kidney function assessments within Demographic and Health Surveys and other population-based surveys.