Human mercury exposure associated with small-scale gold mining in Burkina Faso

Public health assessment of Kenyan ASGM communities using multi-element biomonitoring, dietary and environmental evaluation

The Kakamega gold belt's natural geological enrichment and artisanal and small-scale gold mining (ASGM) have resulted in food and environmental pollution, human exposure, and subsequent risks to health. This study aimed to characterise exposure pathways and risks among ASGM communities. Human hair, nails, urine, water, and staple food crops were collected and analysed from 144 ASGM miners and 25 people from the ASGM associated communities. Exposure to PHEs was predominantly via drinking water from mine shafts, springs and shallow-wells (for As>Pb>Cr>Al), with up to 366 µg L-1 arsenic measured in shaft waters consumed by miners. Additional exposure was via consumption of locally grown crops (for As>Ni>Pb>Cr>Cd>Hg>Al) besides inhalation of Hg vapour and dust, and direct dermal contact with Hg. Urinary elemental concentrations for both ASGM workers and wider ASGM communities were in nearly all cases above bioequivalents and reference upper thresholds for As, Cr, Hg, Ni, Pb and Sb, with median concentrations of 12.3, 0.4, 1.6, 5.1, 0.7 and 0.15 µg L-1, respectively. Urinary As concentrations showed a strong positive correlation (0.958) with As in drinking water. This study highlighted the importance of a multidisciplinary approach in integrating environmental, dietary, and public health investigations to better characterise the hazards and risks associated with ASGM and better understand the trade-offs associated with ASGM activities relating to public health and environmental sustainability. Further research is crucial, and study results have been shared with Public Health and Environmental authorities to inform mitigation efforts.

Artisanal gold mining in Kakamega and Vihiga counties, Kenya: potential human exposure and health risk

Artisanal and small-scale gold mining (ASGM) represents 20% of gold supply and 90% of gold mining workforce globally, which operates in highly informal setups. Pollutants from mined ores and chemicals introduced during gold processing pose occupational and inadvertent health risks to the extent that has not been well elucidated in Africa. Trace and major elements were analysed using inductively coupled plasma mass spectrometry in soil, sediment and water samples from 19 ASGM villages in Kakamega and Vihiga counties. Associated health risks for residents and ASGM workers were assessed. This paper focuses on As, Cd, Cr, Hg, Ni and Pb for which 96% of soil samples from mining and ore processing sites had As concentrations up to 7937 times higher than the US EPA 12 mg kg-1 standard for residential soils. Soil Cr, Hg and Ni concentrations in 98%, 49% and 68% of the samples exceeded respective USEPA and CCME standards, with 1-72% bioaccessibility. Twenty-five percentage of community drinking water sources were higher than the WHO 10 µg L-1 drinking water guideline. Pollution indices indicated significant enrichment and pollution of soils, sediment and water in decreasing order of As > Cr > Hg > Ni > Pb > Cd. The study revealed increased risks of non-cancer health effects (98.6) and cancer in adults (4.93 × 10-2) and children (1.75 × 10-1). The findings will help environment managers and public health authorities better understand the potential health risks in ASGM and support evidence-based interventions in ASGM processes, industrial hygiene and formulation of public health policy to protect residents and ASGM workers' health in Kenya.

An examination of mercury levels in the coastal environment and fish of Cote d'Ivoire

Artisanal and small-scale gold mining (ASGM), energy production and other industrial inputs are a major source of anthropogenic mercury (Hg) to the aquatic environment globally, and these inputs have led to environmental contamination and human exposure. While studies have documented the effects of Hg inputs to rivers and marine waters of the West African region, estuarine waters of Cote d'Ivoire have been understudied, besides the waters surrounding Abidjan. To fill this gap, and to examine the potential for human exposure to methylmercury (MeHg), we measured the concentrations of total Hg, MeHg, and ancillary parameters in water (dissolved and particulate phases), sediment and fish to determine the extent of environmental impact and the potential for MeHg exposure for people consuming these fish. Levels of Hg and MeHg in sediment were elevated in the vicinity of the urban environment (up to 0.3 ng/g dry weight (dw) MeHg and 623 ng/g dw total Hg) and lowest in the more remote estuarine environments. Measurements of Hg in tuna and other larger pelagic coastal species indicated that levels were elevated but comparable to other North Atlantic regions. However, levels of Hg in fish, even smaller estuarine species, were such that the rural and urban populations are potentially being exposed to unsafe levels of MeHg, primarily as a result of the relatively high fish consumption in Cote d'Ivoire compared to other countries. Overall, both local point sources and the transport of Hg used in interior ASGM activities are the sources for Hg contamination to these coastal waters.

A preliminary study on health impacts of Mexican mercury mining workers in a context of precarious employment

Mercury mining is one of the main sources of mercury (Hg) release into the environment, causing serious impacts on human health and the environment. Workers in these mines are employed informally and precariously and therefore lack labor rights such as social security. The objective of the study is to make visible the exposure to environmental contaminants and the health of workers in mercury mines. An environmental assessment was conducted to determine workers' exposure to contaminants; urine samples were obtained to measure exposure to mercury and arsenic, and blood samples were obtained for lead and cadmium. Clinical parameters were also evaluated. Concentrations of Hg, As and Pb were determined in soil, 279.4 mg/kg (24.4-788.5), 14.7 mg/kg (9.5-20.3) and 1.4 mg/kg (1-2.8), respectively. The exposure results for mercury were 551 μg/g creatinine, for arsenic 50 μg/L and for lead 4.7 μg/dL. Cd-B was not found. In addition, 17.6 % of the workers had diabetes and 17.6 % had renal disorders. Principal Component Regression was performed obtaining an r2 of 0.86 for glomerular filtration rate and 0.54 for albumin creatinine ratio using clinical, occupational, and metal exposure variables. Exposure to Hg in this type of mine is not exclusive, so there is a cumulative risk of chronic exposure to different environmental pollutants directly impacting the health of workers. It is necessary to implement health strategies and different work opportunities for these workers.

Mercury Exposure and Its Health Effects in Workers in the Artisanal and Small-Scale Gold Mining (ASGM) Sector—A Systematic Review

Gold is one of the most valuable materials but is frequently extracted under circumstances that are hazardous to artisanal and small-scale gold miners’ health. A common gold extraction method uses liquid mercury, leading to a high exposure in workers. Therefore, a systematic review according to the PRISMA criteria was conducted in order to examine the health effects of occupational mercury exposure. Researching the databases PubMed^®, EMBASE^® and Web of Science^TM yielded in a total of 10,589 results, which were screened by two independent reviewers. We included 19 studies in this review. According to the quantitative assessment, occupational mercury exposure may cause a great variety of signs and symptoms, in particular in the field of neuro-psychological disorders, such as ataxia, tremor or memory problems. However, many reported symptoms were largely unspecific, such as hair loss or pain. Most of the included studies had a low methodological quality with an overall high risk of bias rating. The results demonstrate that occupational mercury exposure seriously affects miners’ health and well-being.

Assessment of biomarkers of early kidney damage and exposure to pollutants in artisanal mercury mining workers from Mexico

Artisanal mercury mining (AMM) is an informal economic activity that employs low technology and limited protection, and poses a risk to workers and their families; due to the extraction process, these scenarios involve exposure to complex mixtures of pollutants that synergistically aggravate the health of miners and people living near the site. Although mercury is the predominant pollutant, there are others such as polycyclic aromatic hydrocarbons (PAHs), toluene, arsenic, and lead which have been classified as nephrotoxic pollutants. Therefore, the purpose of this research was to evaluate the association between exposure to a complex mixture of pollutants (mercury, lead, arsenic, PAHs, and toluene) and kidney damage in artisanal Hg mining workers through early kidney damage proteins (KIM-1, OPN, RBP-4, NGAL, and Cys-C). The results demonstrate the presence of OH-PAHs at concentrations of 9.21 (6.57-80.63) μg/L, hippuric acid as a biomarker of exposure to toluene, As and Pb (655. 1 (203.8-1231) mg/L, 24.05 (1.24-42.98) g/g creatinine, and 4.74 (2.71-8.14) g/dL, respectively), and urinary Hg (503.4 (177.9-878.7) g/g creatinine) in the study population. As well as biomarkers of kidney damage, NGAL and RPB-4 were found in 100% of the samples, KIM-1 and Cys-C in 44.1%, and OPN in 41% of the miners. Significant correlations were found between several of the evaluated pollutants and early kidney damage proteins. Our results demonstrate the application of the early kidney damage biomarkers for the assessment of damage caused by the exposure to mixtures of pollutants and, therefore, the urgent need for monitoring in AMM areas.

Working in a risky environment: Coping and Risk Handling Strategies among Small-scale Miners in Ghana

Background

It is estimated that about 13 million artisanal and small-scale miners carry out their activities under harsh, precarious, unfriendly, and risky conditions. Yet, our understanding of the extent to which these workers use personal protective equipment (PPE) and navigate through the various risks and hazards they face is still limited. This article has two main objectives. First, it explores the extent of usage of PPE among artisanal and small-scale miners for the prevention of hazards and risks. Second, it examines the coping strategies used by these miners as a response to experiences of occupational injuries and risks

Methods

A cross-sectional survey of small-scale miners was conducted in six communities across three districts in Ghana, West Africa. The mixed methods approach was adopted. A total of 148 small-scale miners participated in the study. Six focus group discussions (FGDs) were held across the six communities. The data were analysed using descriptive statistics. Chi-square tests were used to analyse the relationship between some socio-demographic characteristics (sex, age, and educational background) and the usage of PPE. Open-ended questions and responses from FGDs were analysed based on the content and verbatim quotations from miners.

Results

Findings suggest that 78% of the miners interviewed do not use the appropriate PPE citing reasons such as cost, and their personal discomfort associated with use of PPE. There was no significant relationship between socio-demographic characteristics (i.e., sex, age, education and major mining activity) and the usage of PPE. The study further revealed four main coping strategies used by miners to handle the risks. These are rest, taking unprescribed medication and hard drugs, registration with health insurance scheme and savings and investments.

Conclusion

This study shows that very few artisanal miners use PPE despite the significant hazards and risks to which they are exposed. The study recommends to the government to put in place measures to ensure that miners adhere to health and safety regulations before undertaking mining activities. This means that health and safety plans and use of PPE should be linked to the license acquisition process for miners.

Transdisciplinary Online Health Assessment of an Artisanal and Small-Scale Gold Mining Community during the COVID-19 Pandemic in the Mandalay Region of Myanmar

Artisanal and small-scale gold mining (ASGM) has a known negative effect on the community's health; therefore, assessment to monitor community health is essential to detect any issues and enable early treatment. Because ASGM-related health issues are complex and cannot be addressed effectively with a traditional one-time health assessment alone, both long-term and regular health assessments using a transdisciplinary approach should be considered. In response to this need, we designed an online health assessment tool as a reference for a future long-term health assessment system. An online video interview was conducted with 54 respondents living in the ASGM area of Chaung Gyi Village, Thabeikkyin Township, Mandalay Region, Myanmar, via a social networking service application. The tool was used to evaluate community health during the coronavirus 2019 pandemic, including mercury intoxication symptoms, mining-related diseases, and other diseases. Results show that persons working in mining versus non-mining occupations had a greater prevalence of pulmonary diseases, such as pulmonary tuberculosis, silicosis, and bronchial asthma, in addition to malaria. Based on these findings, online health assessment using a transdisciplinary approach can be recommended as an effective tool for sustainable and long-term health assessment of ASGM-related disease and should be performed regularly following physical health surveys.

Heavy metals in urinary stones in the Democratic Republic of Congo

Background

The Democratic Republic of Congo has been a country of intensive mining activities for centuries, but the data on the presence of heavy metals in stones are lacking. This study aimed to identify different heavy metals in urinary tract stones and to investigate their association with the main components of urinary stones.

Methods

Thirty-six stones from urolithiasis patients (n = 36) followed in 10 hospitals in the Democratic Republic of Congo between January 2016 and September 2019 were analyzed by Fourier transform infrared spectrophotometry. Further analysis using X-ray fluorescence was conducted at the Laboratory of Solids Physics.

Results

Eight heavy metals were detected in all the stones analyzed. The average (SD) number of heavy metals detected by stone was 5 (1.2). Iron and strontium were detected in all the stones analyzed. Other heavy metals detected included zinc, copper, bromine, rubidium, lead and nickel. Rubidium had the highest concentration in the stones regardless of the sampling site. There was no statistically significant association between the content of heavy metals at the center level and at the crown level of the stones. Rubidium had more affinity with phosphates and purines (p ˂ 0.001). Iron and strontium exhibited a high affinity with weddellite than with whewellite.

Conclusion

Iron and Strontium were present in all stones analyzed. The presence of heavy metals in stones analyzed might suggest environmental pollution rather than crystalline induction factors.

Characterization of inhalation exposure to gaseous elemental mercury during artisanal gold mining and e-waste recycling through combined stationary and personal passive sampling

While occupational inhalation exposure to gaseous elemental mercury (GEM) has decreased in many workplaces as mercury is being removed from most products and processes, it continues to be a concern for those engaged in artisanal and small-scale gold mining or in recycling mercury-containing products. Recently, stationary and personal passive air samplers based on activated carbon sorbents and radial diffusive barriers have been shown to be suitable for measuring GEM concentrations across the range relevant for chronic health effects. Here, we used a combination of stationary and personal passive samplers to characterize the inhalation exposure to GEM of individuals living and working in two Ghanaian gold mining communities and working at a Norwegian e-waste recycling facility. Exposure concentrations ranging from <7 ng m^-3 to >500 μg m^-3 were observed, with the higher end of the range occurring in one gold mining community. Large differences in the GEM exposure averaged over the length of a workday between individuals can be rationalized by their activity and proximity to mercury sources. In each of the three settings, the measured exposure of the highest exposed individuals exceeded the highest concentration recorded with a stationary sampler, presumably because those individuals were engaged in an activity that generated or involved GEM vapors. High day-to-day variability in exposure for those who participated on more than one day, suggests the need for sampling over multiple days for reliable exposure characterization. Overall, a combination of personal and stationary passive sampling is a cost-effective approach that cannot only provide information on exposure levels relative to regulatory thresholds, but also can identify emission hotspots and therefore guide mitigation measures.

Health Impact Assessment of Artisanal and Small-Scale Gold Mining Area in Myanmar, Mandalay Region: Preliminary Research

Increasing artisanal and small-scale gold mining (ASGM) in developing countries has raised health concerns in mining communities. A preliminary health survey was conducted in Thabeikkyin Township, Mandalay Region, Myanmar, in February 2020 to assess the health conditions of an ASGM community. Respiratory function and other clinical assessments were evaluated in miners and non-miners, and participants’ hair was analyzed for heavy metals. Respiratory function of miners was similar to that of non-miners. However, miners’ respiratory function declined with longer mining activity duration. In total, 3 out of 18 miners showed neurological signs and symptoms of chronic mercury intoxication. The median concentration of the hair mercury was significantly higher in miners than non-miners (P = 0.01), and 9 out of 18 miners and 2 out of 11 non-miners showed the warning level of mercury. We found that, despite an association between declining respiratory function and length of time mining, only a minority of miners showed clinical features of chronic mercury intoxication. Further clinical surveys with a larger sample size are necessary to determine the broader health status of this community. In addition, clinical indicators such as pulmonary function tests are recommended as additional criteria for the diagnosis of mercury intoxication.

Mercury Exposure Among Artisanal and Small-Scale Gold Miners in Four Regions in Uganda

BACKGROUND

Artisanal and small-scale gold mining is a human health concern, especially in low-income countries like Uganda due to the use of mercury (Hg) in the mining process.

OBJECTIVE

The aim of the present study was to assess Hg exposure among artisanal and small-scale gold miners in Uganda through biologic monitoring parameters and Hg-related clinical manifestations.

METHODS

A cross-sectional study was conducted from June to July 2018 among 183 miners from Ibanda (Western region), Mubende (Central region), Amudat (Karamoja region) and Busia (Eastern region) in Uganda. An interviewer-administered questionnaire and health assessment were used to collect socio-demographic, exposure and self-reported Hg poisoning symptoms. In addition, 41 urine, 41 blood and 26 environment samples were assessed. Descriptive statistics, Kruskal-Wallis test and Wilcoxon signed-rank test for comparison of Hg levels in urine and blood among miners were performed while logistic regression was used to assess associations between exposure and Hg poisoning-related symptoms.

RESULTS

The miners ranged from 15 to 65 years old and were primarily male (72.6%). The majority (73.3%) had worked directly with Hg for an average duration of 5.3 years. Symptoms associated with working directly with Hg included chest pain (odds ratio (OR)=9.0, confidence interval (CI)=3.3 to 24.6), numbness (OR=8.5, CI=2.1 to 34.4), back pain (OR=6.2, CI= 2.2 to 17.5), fatigue and stress (OR=5.4, 2.0 to CI=14.9), headache (OR=4.7, CI=1.9 to 11.3), dizziness (OR=3.8, CI=1.5 to 9.7) joint pain (OR=3.2, CI=1.3 to 8.3) and respiratory problems (3.2, 1.0 to 10.1). Statistically significant differences in Hg levels with p-values less than 0.05 were observed across district, gender and type of work. Mubende had the highest blood and urine levels (136 μg/l and 105.5 μg/l) in comparison with Busia (60 μg/l and 70.6 μg/l) and Ibanda (43 μg/l and 58 μg/l). Females (84.7 μg/l), panners (109 μg/l) and those with knowledge of occupational health and safety measures (95.6 μg/l) reported higher levels of Hg in urine. The average levels of Hg in water and soil samples were 23.79 μg/l and 0.21 μg/l, respectively.

CONCLUSIONS

Variation in Hg levels were attributed to varied duration of exposure across geographical sites. There was considerable exposure to Hg as indicated by both clinical manifestations and biologic parameters among miners in Uganda with Hg in urine exceeding the recommended thresholds.

PARTICIPANT CONSENT

Obtained.

ETHICS APPROVAL

Ethical approval was obtained from the Makerere University School of Health Science Institutional Review Board (reference number SHSREC REF 2018-2019) and Uganda National Council for Science and Technology (reference number SS 4577).

COMPETING INTERESTS

The authors declare no competing financial interests.

Review of stable mercury isotopes in ecology and biogeochemistry

Due to the advent of cold vapor-multicollector-inductively coupled plasma mass spectrometry (CV-MC-ICP-MS) in the past two decades, many research groups studying mercury (Hg) biogeochemistry have integrated stable Hg isotopes into their research. Currently, >200 studies using this technique have been published and this has greatly enhanced our understanding of the Hg biogeochemical cycle beyond what Hg concentration and speciation analyses alone can provide. These studies are largely divided into two groups: (i) controlled experiments investigating fractionation of Hg isotopes and refining tools of isotopic analyses, and (ii) studies of natural variations of Hg isotopes. It is now known that Hg isotopes undergo both mass dependent fractionation (MDF; reported as the ratio of mass ²⁰²Hg to ¹⁹⁸Hg) and mass independent fractionation (MIF), with MIF occurring at odd masses (¹⁹⁹Hg, ²⁰¹Hg) to a larger magnitude and at even masses (²⁰⁰Hg, ²⁰⁴Hg) to a much smaller magnitude. The two types of MIF are controlled by different photochemical processes. The range of isotopic variations of MDF, odd-MIF, and even-MIF are now well documented in a diverse set of environmental samples, and researchers are continuing to explore how the field of Hg isotope biogeochemistry can be further developed and taken to the next level of understanding. One application that has received considerable attention is the use of Hg isotopes to examine the environmental controls on the production and degradation of methylmercury (MeHg), the most toxic and bioaccumulative form of Hg. Since MeHg is efficiently assimilated and biomagnified along food chains, MeHg has the potential to be a robust ecological tracer. In this review, we give an updated overview of the field of Hg isotopes and focus on how Hg isotopes of MeHg can be used to address fundamental ecological questions, including energy transfer across ecosystem interfaces and as a tracer for animal movements.

Human health risk assessment of exposure to indoor mercury vapour in a Ghanaian artisanal small-scale gold mining community

People living or working in and around artisanal small-scale gold mining communities can be exposed to mercury vapour, which may negatively affect their health. In this study, the human exposure to air borne mercury in an artisanal mining community in the Upper East region of Ghana was investigated using Lumex RA 915 M mercury analyser, an active sampler. The concentration of mercury in air was measured inside and outside households and was related to human health risk standards. For each household, one measurement was taken from outside and three from inside at different positions. About 91% of the households where amalgam burning was reported had concentrations higher than the USEPA reference dose of 300 ng m^-3 whereas 64% of the households where amalgam burning was not reported exceeded the reference dose above. The maximal (upper) instrumental limit (50,000 ng m^-3) was passed for the highest concentrations, so, the upper 97.5% concentration was estimated, using censored statistics, to exceed 800,000 ng m^-3 for the fireplaces. This exceeds any reported indoor household air concentration of Hg, identified by the literature review in this paper. Estimated hazard quotients were found to range from <1 to 108 within the households that are reported not to burn amalgam. In the households where amalgam burning reportedly takes place, the hazard quotient had a range of 0.01-160. Mercury concentrations measured in households with reported amalgam burning are approximately ten times higher than those households with no reported burning of amalgam. The censored data predicted hazard quotients up to 966. The results indicate that both miners and non-miners of the community are at risk of adverse health effects resulting from inhalation of mercury vapour.

Environmental Health Research in Africa: Important Progress and Promising Opportunities

The World Health Organization in 2016 estimated that over 20% of the global disease burden and deaths were attributed to modifiable environmental factors. However, data clearly characterizing the impact of environmental exposures and health endpoints in African populations is limited. To describe recent progress and identify important research gaps, we reviewed literature on environmental health research in African populations over the last decade, as well as research incorporating both genomic and environmental factors. We queried PubMed for peer-reviewed research articles, reviews, or books examining environmental exposures and health outcomes in human populations in Africa. Searches utilized medical subheading (MeSH) terms for environmental exposure categories listed in the March 2018 US National Report on Human Exposure to Environmental Chemicals, which includes chemicals with worldwide distributions. Our search strategy retrieved 540 relevant publications, with studies evaluating health impacts of ambient air pollution (n=105), indoor air pollution (n = 166), heavy metals (n = 130), pesticides (n = 95), dietary mold (n = 61), indoor mold (n = 9), per- and polyfluoroalkyl substances (PFASs, n = 0), electronic waste (n = 9), environmental phenols (n = 4), flame retardants (n = 8), and phthalates (n = 3), where publications could belong to more than one exposure category. Only 23 publications characterized both environmental and genomic risk factors. Cardiovascular and respiratory health endpoints impacted by air pollution were comparable to observations in other countries. Air pollution exposures unique to Africa and some other resource limited settings were dust and specific occupational exposures. Literature describing harmful health effects of metals, pesticides, and dietary mold represented a context unique to Africa. Studies of exposures to phthalates, PFASs, phenols, and flame retardants were very limited. These results underscore the need for further focus on current and emerging environmental and chemical health risks as well as better integration of genomic and environmental factors in African research studies. Environmental exposures with distinct routes of exposure, unique co-exposures and co-morbidities, combined with the extensive genomic diversity in Africa may lead to the identification of novel mechanisms underlying complex disease and promising potential for translation to global public health.

The Clinical Importance of the Mercury Problem in Artisanal Small-Scale Gold Mining

Artisanal small-scale mining is widely operated in various countries serving as a livelihood to many rural communities. However, it is a significant source of environmental mercury contamination which affects human health. Amalgamation and amalgam smelting, two significant steps in the artisanal small-scale mining operations generate lots of mercury vapors, leading to chronic exposure among miners. Thus, this article seeks to provide a topical review of recent findings on organ damage and metabolic disorders among mercury-exposed artisanal small-scale miners with emphasis on the contributing factors such as personal protective equipment usage and artisanal small-scale gold mining-specific occupational activities. Also, insights into the effect of mercury intoxication and mechanisms of action on organ and metabolic systems among exposed individuals are provided.

An assessment of the impact of artisanal and commercial gold mining on mercury and methylmercury levels in the environment and fish in Cote d'Ivoire

Artisanal and small-scale gold mining (ASGM) activities are an important source of mercury (Hg) to the atmosphere globally, and in most countries in West Africa, where gold production has increased dramatically in the last decade from both commercial and ASGM activities. This study focused on examining the concentrations of Hg and methylmercury (MeHg) in water, sediments and fish in four regions associated with gold mining activities in Cote d'Ivoire to assess the potential exposure of the local communities to MeHg from fish consumption. Concentrations of dissolved total Hg and MeHg in water and sediment were elevated at some locations sample and were indicative of local contamination. Several locations had sediment total Hg above 100 ng g^-1 and sediment %MeHg ranged from 0.03 to 4.4%. Fish concentrations exceeded 0.3 μg/ g wet wt., especially for carnivores and fish caught in the western region of the country. Bioaccumulation factors, relative to dissolved MeHg, were higher for carnivores than omnivores and varied with region, suggesting other factors besides MeHg concentration alone were impacting uptake and trophic transfer. Given that people in Cote d'Ivoire consume fish at a higher level than other countries, the levels in fish were sufficient to exceed the US EPA's guidance criteria even at average consumption levels, and particularly for people consuming fish at a higher rate. Overall, this study provides compelling evidence that ASGM activities in Cote d'Ivoire are leading to elevated exposure and likely impacting the health of the local populations in regions where such activity is occurring.

Assessing occupational mercury exposures and behaviours of artisanal and small-scale gold miners in Burkina Faso using passive mercury vapour badges

Artisanal and small-scale gold mining (ASGM) is a crucial economic activity in Burkina Faso, however it is associated with significant mercury exposure and health concerns. The aim of the present study was to assess the level of mercury (Hg) vapour exposures and occupational behaviours at a representative site using Hg vapour monitor badges and questionnaires. To our knowledge this is the first time that personal exposure to Hg vapour during ASGM activities has been reported. The study population were ASGM workers who completed a questionnaire (n=100) or participated with an occupational exposure assessment using commercially available passive Hg vapour samplers (n=44). Occupational exposure to Hg was high during open-air burn events with a time weighted average (TWA) exposure of 7026±6857µg/m³ for burners, and 1412±2870µg/m³ for bystanders. Most (82%) of the people present at the burn exceeded the Permissible Exposure Limit (PEL) of 100µg/m³, and 11% exceeded the level considered to be Immediately Dangerous to Life and Health (IDLH) of 10,000µg/m³. Even control workers who were not present at the burn exceeded the PEL (24%), likely due to legacy Hg contamination producing latent Hg releases to the atmosphere. Similarly, 86% of the miners at the burn and 59% of control workers had an 8-h TWA that exceeded the Recommended Exposures Limit (REL). Several occupational behaviours that may contribute to Hg exposures were documented. This study corroborates previous studies suggesting that Hg exposure during amalgam burning is very high, and demonstrates the plausibility of using passive vapour monitoring badges rather than costly and logistically difficult biomonitoring methods. Mercury reduction and elimination interventions are strongly needed to reduce Hg exposure in ASGM communities, particularly as countries come into compliance with the Minamata Convention.

Exposure of Small-Scale Gold Miners in Prestea to Mercury, Ghana, 2012

Introduction

Small-scale gold miners in Ghana have been using mercury to amalgamate gold for many years. Mercury is toxic even at low concentration. We assessed occupational exposure of small-scale gold miners to mercury in Prestea, a gold mining town in Ghana.

Methods

We conducted a cross-sectional study in which we collected morning urine samples from 343 small-scale gold miners and tested for elemental mercury. Data on small-scale gold miner's socio-demographics, adverse health effects and occupational factors for mercury exposure were obtained and analyzed using SPSS Version 16 to determine frequency and percentage. Bivariate analysis was used to determine occupational factors associated with mercury exposure at 95% confidence level.

Results

The mean age of the small-scale gold miners was 29.5 ±9.6 years, and 323(94.20%) were males. One hundred and sixty (46.65%) of the small-scale gold miners had urine mercury above the recommended exposure limit (<5.0ug/L). Complaints of numbness were significantly associated with mercury exposure among those who have previously worked at other small-scale gold mines (χ²=4.96, p=0.03). The use of personal protective equipment among the small-scale gold miners was low. Retorts, which are globally recommended for burning amalgam, were not found at mining sites.

Conclusion

A large proportion of small-scale gold miners in Prestea were having mercury exposure in excess of occupational exposure limits, and are at risk of experiencing adverse health related complications. Ghana Environmental Protection Agency should organize training for the miners.

Essential Indicators Identifying Chronic Inorganic Mercury Intoxication: Pooled Analysis across Multiple Cross-Sectional Studies

Background

The continuous exposure to inorganic mercury vapour in artisanal small-scale gold mining (ASGM) areas leads to chronic health problems. It is therefore essential to have a quick, but reliable risk assessing tool to diagnose chronic inorganic mercury intoxication. This study re-evaluates the state-of-the-art toolkit to diagnose chronic inorganic mercury intoxication by analysing data from multiple pooled cross-sectional studies. The primary research question aims to reduce the currently used set of indicators without affecting essentially the capability to diagnose chronic inorganic mercury intoxication. In addition, a sensitivity analysis is performed on established biomonitoring exposure limits for mercury in blood, hair, urine and urine adjusted by creatinine, where the biomonitoring exposure limits are compared to thresholds most associated with chronic inorganic mercury intoxication in artisanal small-scale gold mining.

Methods

Health data from miners and community members in Indonesia, Tanzania and Zimbabwe were obtained as part of the Global Mercury Project and pooled into one dataset together with their biomarkers mercury in urine, blood and hair. The individual prognostic impact of the indicators on the diagnosis of mercury intoxication is quantified using logistic regression models. The selection is performed by a stepwise forward/backward selection. Different models are compared based on the Bayesian information criterion (BIC) and Cohen`s kappa is used to evaluate the level of agreement between the diagnosis of mercury intoxication based on the currently used set of indicators and the result based on our reduced set of indicators. The sensitivity analysis of biomarker exposure limits of mercury is based on a sequence of chi square tests.

Results

The variable selection in logistic regression reduced the number of medical indicators from thirteen to ten in addition to the biomarkers. The estimated level of agreement using ten of thirteen medical indicators and all four biomarkers to diagnose chronic inorganic mercury intoxication yields a Cohen`s Kappa of 0.87. While in an additional stepwise selection the biomarker blood was not selected, the level of agreement based on ten medical indicators and only the three biomarkers urine, urine/creatinine and hair reduced Cohen`s Kappa to 0.46. The optimal cut-point for the biomarkers blood, hair, urine and urine/creatinine were estimated at 11. 6 μg/l, 3.84 μg/g, 24.4 μg/l and 4.26 μg/g, respectively.

Conclusion

The results show that a reduction down to only ten indicators still allows a reliable diagnosis of chronic inorganic mercury intoxication. This reduction of indicators will simplify health assessments in artisanal small-scale gold mining areas.

Occupational Metallic Mercury Poisoning in Gilders

Occupational exposure to elemental mercury vapor usually occurs through inhalation during its utilizations. This leads to a variety of adverse health effects. In some Islamic cities, this type of poisoning may occur during gilding of shrines using elemental mercury with gold. Herein, we report on three male patients aged 20-53 years, who were diagnosed with occupational metallic mercury poisoning due to gilding of a shrine. All patients presented with neuro-psychiatric disorders such as anxiety, loss of memory and concentration, and sleep disorders with high urinary mercury concentrations of 326-760 μg/L upon referring, 3-10 days after cessation of elemental mercury exposure. Following chelating therapy, the patients recovered clinically and their mercury concentrations declined to non-toxic level (<25 μg/L). Health, environmental and labor authorities, as well as the gilders should be aware of the toxicity risk of exposure to metalic mercury during gilding in closed environments and act accordingly.

Mercury health effects among the workers extracting gold from carpets and dusted clays through amalgamation and roasting processes

Mercury (Hg) is a highly toxic metal which can cause serious health effects. The aim of this research was to determine the concentrations of total Hg (T-Hg), methyl Hg (Me-Hg), and inorganic Hg (I-Hg) in the biological samples (plasma, red blood cells (RBCs), urine, hair, and nails) of the exposed goldsmith workers. This is the first study that determines the detailed Hg concentrations in the biological samples (plasma, RBCs, urine, hair, and nails) of the exposed goldsmith workers and correlates them with the diseases noted among the workers in a single paper. Biological samples were collected from goldsmith workers (n = 40) and analyzed for T-Hg, Me-Hg, and I-Hg using atomic absorption spectrometer equipped with mercury hydride system. The mean T-Hg concentration in RBCs (33 μg L(-1)), plasma (11.8 μg L(-1)), urine (167 μg L(-1)), hair (4.21 μg g(-1)), and nails (5.91 μg g(-1)) were higher than the control RBCs (1.64 μg L(-1)), plasma (0.55 μg L(-1)), urine (2.72 μg L(-1)), hair (0.35 μg g(-1)), and nails (0.51 μg g(-1)). All workers participated in this study were suffering from physical and mental diseases. The concentration of Hg was found higher among the workers suffering from mental diseases as compared to those suffering from physical diseases. Among the physical diseases, the most serious diseases were sexual dysfunction, skin diseases, and fatigue because the workers suffering from these diseases had higher concentration of Hg than the workers with other diseases. The occurrence of physical diseases (88%) was greater than the mental diseases (53%) among the workers. The correlations of physical and mental diseases with experience (years of work) and exposure time were significant (p < 0.05), while nonsignificant (p > 0.05) correlation was observed between demographic parameters and Hg concentrations in the biological samples of the workers. The burning process of amalgamated gold is a significant source of Hg exposure to goldsmith workers; therefore, awareness and precautionary measures are needed to provide protection to them.

The burden of chronic mercury intoxication in artisanal small-scale gold mining in Zimbabwe: data availability and preliminary estimates

BACKGROUND

Artisanal small-scale gold mining (ASGM) is a poverty-driven activity practiced in over 70 countries worldwide. Zimbabwe is amongst the top ten countries using large quantities of mercury to extract gold from ore. This analysis was performed to check data availability and derive a preliminary estimate of disability-adjusted life years (DALYs) due to mercury use in ASGM in Zimbabwe.

METHODS

Cases of chronic mercury intoxication were identified following an algorithm using mercury-related health effects and mercury in human specimens. The sample prevalence amongst miners and controls (surveyed by the United Nations Industrial Development Organization in 2004 and the University of Munich in 2006) was determined and extrapolated to the entire population of Zimbabwe. Further epidemiological and demographic data were taken from the literature and missing data modeled with DisMod II to quantify DALYs using the methods from the Global Burden of Disease (GBD) 2004 update published by the World Health Organization (WHO). While there was no disability weight (DW) available indicating the relative disease severity of chronic mercury intoxication, the DW of a comparable disease was assigned by following the criteria 1) chronic condition, 2) triggered by a substance, and 3) causing similar health symptoms.

RESULTS

Miners showed a sample prevalence of 72% while controls showed no cases of chronic mercury intoxication. Data availability is very limited why it was necessary to model data and make assumptions about the number of exposed population, the definition of chronic mercury intoxication, DW, and epidemiology. If these assumptions hold, the extrapolation would result in around 95,400 DALYs in Zimbabwe's total population in 2004.

CONCLUSIONS

This analysis provides a preliminary quantification of the mercury-related health burden from ASGM based on the limited data available. If the determined assumptions hold, chronic mercury intoxication is likely to have been one of the top 20 hazards for population health in Zimbabwe in 2004 when comparing with more than 130 categories of diseases and injuries quantified in the WHO's GBD 2004 update. Improving data quality would allow more accurate estimates. However, the results highlight the need to reduce a burden which could be entirely avoided.

Mercury exposure and health impacts among individuals in the artisanal and small-scale gold mining community: a comprehensive review

BACKGROUND

Mercury (Hg) is used in gold mining to extract gold from ore by forming "amalgam"-a mixture composed of approximately equal parts mercury and gold. Approximately 15 million people, including approximately 3 million women and children, participate in artisanal small-scale gold mining (ASGM) in developing countries. Thirty-seven percent of global air emissions of Hg are produced by ASGM. The recently adopted Minamata Convention calls for nations to gather health data, train health-care workers, and raise awareness in regard to ASGM activity.

OBJECTIVE

The purpose of our review was to evaluate the current literature regarding the health effects of Hg among those working and/or living in or near ASGM communities.

METHODS

We searched PubMed, ScienceDirect, and Google Scholar for studies relating to health effects and biomarkers of Hg exposure in ASGM communities. Articles published from 1990 through December 2012 were evaluated for relevance.

DISCUSSION

Studies reporting health assessments, kidney dysfunction, neurological disorders and symptoms, and immunotoxicity/autoimmune dysfunction in individuals living in or near an ASGM community were identified. More than 60 studies that measured biomarkers of Hg exposure in individuals living in or near ASGM communities were also identified. These studies, conducted in 19 different countries in South America, Asia, and Africa, demonstrated that hair and urine concentrations are well above World Health Organization health guidance values in ASGM communities.

CONCLUSIONS

ASGM workers and their families are exposed to Hg vapor, and workers, workers' families, and residents of nearby and downstream communities are consuming fish heavily contaminated with methylmercury.

A review of mercury exposure among artisanal small-scale gold miners in developing countries

PURPOSE

Extraction of gold using mercury has been a way out of poverty for millions of people in developing countries. Artisanal small-scale gold mining (ASGM) has expanded during the last decades and is often carried out under primitive conditions. Thus, workers in this industry may be exposed to high levels of mercury and suffer from toxic effects from mercury exposure. The objective of this review was to provide an outline of the studies available on elemental mercury exposure among artisanal small-scale gold miners.

METHODS

Searching the PubMed and Embase databases, 26 studies with a total of 3,005 exposed subjects and 442 controls across 14 different developing countries were found. Urine mercury levels were used as biomarkers of exposure.

RESULTS

In general, the urine mercury levels were elevated and a considerable proportion of workers had urine mercury levels above existing guidelines. Exposed subjects were stratified into residents, miners, millers, smelters, and refiners, who by work task content were expected to be increasingly exposed to mercury. This group order did show a clear trend of increasing mercury levels. Mercury levels differed substantially between studies. Possible explanations include dissimilarities in gold extraction methods, use of protective devices, and selection of participants.

CONCLUSIONS

This review provides evidence that artisanal gold miners and residents of the mining sites are exposed to mercury vapour to an extent where acute and long-term toxic effects of mercury are likely. Interventions aimed at reducing exposure and emission of mercury from ASGM are needed.

Characterization, mapping, and mitigation of mercury vapour emissions from artisanal mining gold shops

Artisanal miners sell their gold to shops that are usually located in the urban core, where the mercury-gold amalgam is burned to evaporate the mercury that was added during ore processing. People living and working near these gold shops are exposed to intermittent and extreme concentrations of mercury vapour. In the urban centres of Segovia, Colombia, and Andacollo, Chile, the average concentrations measured by mobile mercury vapour analyzer transects taken repeatedly over several weeks were 1.26 and 0.338μgm(-3), respectively. By World Health Organization standards, these towns are exposed to significant health hazard, and globally, the millions of miners, as well as non-miners who live near gold shops, are at serious risk of neurological and renal deficits. Measurements taken in Suriname, Ecuador and Peru reveal this to be a widespread phenomenon with unique regional variations and myriad attempts at remediation. Maps of average mercury concentrations show the spatial distribution of the hazard in relation to residential buildings and schools. Measurements from towers show the temporal variability of mercury concentrations, and suggest that large quantities of mercury are available for long-range atmospheric transport. Mercury mapping in Segovia in 2011 suggest a 10% reduction in airborne mercury concentrations over 2010, despite a 30% increase in gold production. This is attributable to the adoption of retorts by miners and regulations banning new processing centres to the rural periphery. This is the first full description of artisanal mining gold shop practices and of the character, quantity, and remediation of mercury emissions within urban mining centres.

Mercury contamination from artisanal gold mining in Antioquia, Colombia: The world's highest per capita mercury pollution

The artisanal gold mining sector in Colombia has 200,000 miners officially producing 30tonnes Au/a. In the Northeast of the Department of Antioquia, there are 17 mining towns and between 15,000 and 30,000 artisanal gold miners. Guerrillas and paramilitary activities in the rural areas of Antioquia pushed miners to bring their gold ores to the towns to be processed in Processing Centers or entables. These Centers operate in the urban areas amalgamating the whole ore, i.e. without previous concentration, and later burn gold amalgam without any filtering/condensing system. Based on mercury mass balance in 15 entables, 50% of the mercury added to small ball mills (cocos) is lost: 46% with tailings and 4% when amalgam is burned. In just 5 cities of Antioquia, with a total of 150,000 inhabitants: Segovia, Remedios, Zaragoza, El Bagre, and Nechí, there are 323 entables producing 10-20tonnes Au/a. Considering the average levels of mercury consumption estimated by mass balance and interviews of entables owners, the mercury consumed (and lost) in these 5 municipalities must be around 93tonnes/a. Urban air mercury levels range from 300ng Hg/m(3) (background) to 1million ng Hg/m(3) (inside gold shops) with 10,000ng Hg/m(3) being common in residential areas. The WHO limit for public exposure is 1000ng/m(3). The total mercury release/emissions to the Colombian environment can be as high as 150tonnes/a giving this country the shameful first position as the world's largest mercury polluter per capita from artisanal gold mining. One necessary government intervention is to cut the supply of mercury to the entables. In 2009, eleven companies in Colombia legally imported 130tonnes of metallic mercury, much of it flowing to artisanal gold mines. Entables must be removed from urban centers and technical assistance is badly needed to improve their technology and reduce emissions.