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There is a need for access to clean potable water worldwide. However, almost every source of surface water in Guatemala is contaminated. This study assesses the potential exposure to water contaminants in proximity to Medecins Sans Frontieres's (MSF) chronic kidney disease clinic population in La Gomera, Guatemala during wet and dry seasons. Five municipal wells and four artisanal wells (servicing approximately 18.9% of La Gomera) were selected for their proximity to MSF La Gomera clinic to determine the presence of coliforms, physicochemical parameters, heavy metals, and pesticide residues. Water samples were collected over 3 consecutive days during La Gomera's wet season and again during the dry season. Wet season 2022: Total coliforms and Escherichia coli exceeded the acceptable limits for several artisanal wells but were not detected in municipal wells. Mercury and arsenic were detected in all wells during at least one sampling period. Dry season 2023: Total coliforms exceeded the acceptable limits for all wells and E. coli was detected in all four artisanal wells. Lead and arsenic were detected in all wells. Our results suggest that water from artisanal wells does not meet COGUANOR or WHO microbiological criteria for human consumption. HIGHLIGHTS No information on water quality in La Gomera, Guatemala.; Comprehensive assessment of water quality in region.; Assess public and private water sources.; Relationship between water quality and health.; Timeseries of water quality.;

Objectives. To determine the prevalence of kidney disease of unknown etiology in banana, melon, and tomato workers in north-eastern Guatemala, and to evaluate the usefulness of a cystatin C blood test for early detection of renal disease. Methods. This was a cross-sectional, farm-based study of 462 agricultural workers conducted from June to September 2021. Epidemiological and demographic characteristics of the workers were collected through a self-administered questionnaire. Blood samples were obtained to determine glucose, creatinine and cystatin C levels. Anthropometric and clinical data were also recorded. Results. The prevalence of kidney disease of unknown etiology was 3.03% (95% confidence interval (CI): 1.36–4.70%) based on glomerular filtration rate (GFR-EPI) < 60 mL/min/1.73 m2, with a significantly higher prevalence in banana workers (5.67%; 95% CI: 2.16–9.18%) than melon workers (p = 0.009) and tomato workers (p = 0.044). Ten workers (2.16%) had reduced kidney function (GFR-EPI 60–90 mL/min/1.73 m2). The levels of cystatin C showed less variability (coefficient of variation 46.4%) than those of creatinine (coefficient of variation 67.0%), and cystatin C levels in cases with abnormal and reduced kidney function were significantly different from cases with normal kidney function (p < 0.001). Conclusions. Surveillance of the health of active farm workers and improvement of working conditions, such as sun protection, adequate hydration, and sufficient breaks, are recommended. The significant differences in cystatin C levels between cases with abnormal and reduced kidney function and those with normal kidney function suggest that cystatin C could be a useful measure for early detection of renal disease.