How to prove relative dehydration in a 1500 worker population?

[DwayneEMTP]

My desire stems from a couple of places.

The first, that we see a lot of symptoms in this population that I've attributed to dehydration and as a person I don't like to see them suffer from ignorance of a simple cause. Particularly when I know that the management that's charge with caring for them is hardly more educated on the issue than the local population.

Second, though most don't and I'm almost never expected to, as a lone medic and highest level of care on site I consider it part of my responsibility to do my best to keep the entire population as healthy and fit as possible. Not only to fulfill their responsibilities for the company, but so that they are more able to enjoy their time home. So in my mind resolving the relative dehydration isn't really any different than organizing malaria/hand washing/STD/general hygiene educational campaigns.

If a truck driver believed that I was going to get run over, I would hope that he would tell me to move. If the kitchen staff had reason to believe that there were issues with the water, I again would hope that they would tell me not to drink it until they were certain. And as their medical provider I would hope that those that I care for would have the expectation that if I believed that I could prevent them from becoming ill, or cause them to be healthier, that I would do so. (There is Local National medical staff also, but they are in not much better of a position to recognize these issues than management.)

Wendy does have a great point though. At least for me the real balancing act is to try and bring education and create a positive change in behaviors without insulting or alienating those that I'm supposed to care for. It's an interesting challenge, as I promise you that the day that I man a campaign that states as fact that demons/curses don't cause disease, I'll forever be impotent as a provider due to the local populations instant belief that if I can be so ignorant of such an obvious fact then following my advice on any issues would be foolish.

Anyway, I took the advice here and again tried to reorder the urine dips, but also created a spread sheet that tracks b/p, pulse, s/s, pt age, ultimate diagnosis, # of bottles of water consumed during a 12hr shift, and the reason for that number, as well as some location specific information to see if the issue is general or localized to certain parts of the site.

I've also put together an educational campaign explaining that according to most medical bodies that I could Google that 2L is a decent amount of water for an average sized man (which I blindly defined as 80kg for the purposes of this population) during a day at rest. Along with the PP presentation to be dispersed I suggested that each crew member that works outside be given 5 bottles of water at the beginning of shift and to have the full and empty bottles returned at end of shift (without supervisors comment) as a weak, but possible way to track effectiveness of training and changes in attitude.

We'll see. It went up the chain just before I left or my rotation home. I'm confident that the results will be pretty telling as to the companies attitudes regarding worker health because though it will be an expensive intervention, compared to the multimillion dollar daily operating expenses it should be doable I think.

Thanks all for your interest and comments!