International Total Worker Health®

Improving farm worker health through a holistic approach to health and safety.

We have partnered with the ColoradoSPH Center for Global Health and two of the largest agricultural enterprises in Central America to better understand the health risks agricultural workers face and determine the most effective, feasible solutions to improve their health, safety, and well-being. Global temperatures are on the rise and as a result, these workers face greater health risks. As part of the University of Colorado Consortium on Climate Change and Health, a group of CU scientists researching the impact of climate on human health, we are working to understand how climate affects workers.   

We are studying the health of sugarcane and banana agricultural workers and evaluating the health and safety programs provided by their employers. Based on our findings, we will offer recommendations to these businesses, emphasizing a Total Worker Health approach to protect workers from safety hazards and support their health and well-being. Since launching this research in 2015, we have conducted health screenings on thousands of workers. ​​​

Current Research

Particulate Exposure and Kidney Health. (March 2021 – December 2026)

Investigators: John Adgate, PhD, MSPH, Lee Newman, MD, MA, Joshua Schaeffer, PhD, Co-Principal Investigators (PI). Funded by: NIH (National Institutes of Health), National Institute for Environmental Health Sciences (NIEHS)

Women's airborne exposure and kidney health in Guatemala. (May 2021 – April 2024)

Investigators: Jaime Butler-Dawson, PhD, MPH, Principal Investigator (PI). Funded by: NIH/NIEHS

Individual and household determinants of renal insufficiency among agricultural workers: A Total Worker Health Approach. (September 1, 2022 – August 31, 2023)

Investigators: Lyndsay Krisher, MS, Principal Investigator (PI). Funded by: CDC/NIOSH Center of Excellence for TWH, Pilot Project

Air pollutants, heat exposure, and kidney health: A longitudinal study in women in Central America

This study aims to contribute to the understanding of the causes, mechanisms, and potential strategies for the prevention of the international epidemic of chronic kidney disease of unknown origin (CKDu). Our central hypothesis is that exposure to high concentrations of airborne contaminants will be associated with kidney injury and inflammation in females at-risk for CKDu in Guatemala and Nicaragua.

Investigators: Lee Newman, MD, MA, Principal Investigator (PI). Funded by: NIEHS

Total Worker Health® Training for Occupational Health and Safety Professionals

A team of recognized experts in leadership training and organizational psychology from the University of Colorado will deliver two weeklong Total Worker Health trainings for occupational professionals at the Instituto Mexicano de Seguro Social (IMSS). The team will examine theories of organizational change and evidence-based ways that workplaces and occupational professionals can implement evidence-based practices.

Investigators: Lee Newman, MD, MA, Principal Investigator (PI). Funded by: Instituto Mexicano de Seguro Social (IMSS)


Total Worker Health® is a registered trademark of the U.S. Department of Health and Human Services (HHS). Participation by the Center for Health, Work & Environment does not imply endorsement by HHS, the Centers for Disease Control and Prevention, or the National Institute for Occupational Safety and Health.

Center for Health, Work & Environment

Colorado School of Public Health

CU Anschutz

Fitzsimons Building

13001 East 17th Place

Suite W3111

Mail Stop B119

Aurora, CO 80045

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