Strenuous work in hot environments is associated with negative impacts on biomarkers of kidney function over the workday and over five months. Appropriate access to water, rest and shade during work offers relief from high levels of heat stress and reduces effects on kidney function.Affiliation: University of Massachusetts Lowell, 7 Camden Place, Cambridge, MA 02138, USA. david_wegman@uml.eduThe following article refers to this text: 2018;44(1):1-2