Occupational Heat Exposure and Kidney Stone Risk in High-Risk Workers: A Systematic Review
Abstract
Background: Kidney stone disease (KSD) or Nephrolithiasis is an escalating occupational health challenge in high-heat environments, including military, mining, agricultural, and construction sites. Existing evidence remains fragmented regarding how occupational heat stress interacts with lifestyle determinants and metabolic conditions in high-risk workers. Objective: This systematic review evaluated the combined effects of occupational heat exposure, dehydration, dietary patterns, physical activity, and obesity on KSD incidence and recurrence. Methods: Guided by PRISMA 2020 protocols, comprehensive searches were conducted across Scopus, PubMed, Web of Science, and Embase for studies published from 2021 to 2026. Original peer-reviewed studies examining urolithiasis among adult workers ( years) across high-risk sectors (military, mining, agriculture, and construction) met inclusion criteria. After removing duplicates and completing independent screening, data were systematically extracted and thematic analysis was applied to evaluate the combined impact of workplace heat stress, hydration behaviors, and off-shift lifestyle factors. Results: Synthesis of 12 included studies identified occupational heat exposure and repeated dehydration as the primary, consistent drivers of KSD. Prolonged heat stress induces excessive sweating, leading to oliguria and elevated urinary supersaturation. Lifestyle risk factors including low fluid intake, obesity, high sodium consumption, and sedentary off-shift behavior substantially amplified lithogenic risk. Conclusion: Occupational heat stress and chronic dehydration are major determinants of KSD among high-risk workers, exacerbated by unhealthy lifestyle and metabolic factors. Prospective cohort studies employing standardized objective measures for real-time hydration (e.g., urinary osmolality) and thermal load (WBGT index) are recommended. Workplace intervention trials assessing structured hydration schedules, cooling shelters, and nutritional counseling are needed to mitigate long-term renal risks.