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

Biomonitoring of Mercury and Lead Levels in the Blood of Children Living near a Tropical River Impacted by Artisanal and Small-Scale Gold Mining in Colombia

(1) Background: Mercury and lead contamination resulting from various anthropogenic activities represents a global environmental problem and a considerable risk to the health of the human population. (2) Methods: The objective of this research was to evaluate the concentrations of mercury (Hg) and Lead (Pb) in the blood of the child population in the municipalities in the Atrato River basin using a direct Hg analyzer and graphite furnace atomic absorption spectrometry. (3) Results: In total, 171 children (5-14 years of age) were taken into account, and 18.71% (32) of the children had concentrations of Hg and Pb above the permissible values established by the WHO. In the municipality of UN, 19 children had blood Hg concentrations between 5.29 and 17.71 μg/L. In CA, two children had concentrations of 5.03 and 8.43 μg/L, separately. In the case of Pb, seven children showed concentrations between 3.60 and 4.83 μg/dL in the municipality of RQ, three in UN (3.59, 3.61, and 4.60 μg/dL), and one in Carmen de Atrato (5.47 μg/dL). (4) Conclusions: The levels of Hg and Pb in the blood of children living in the riparian areas of the Atrato River basin are related to gold mining activities in the basin and the consumption of contaminated fish.

Field method for preservation of total mercury in waters, including those associated with artisanal scale gold mining

Analysis of mercury (Hg) in natural water samples has routinely been impractical in many environments, for example, artisanal and small-scale gold mines (ASGM), where difficult conditions make monitoring of harmful elements and chemicals used in the processes highly challenging. Current sampling methods require the use of hazardous or expensive materials, and so difficulties in sample collection and transport are elevated. To solve this problem, a solid-phase extraction-based method was developed for the sampling and preservation of dissolved Hg in natural water samples, particularly those found around ASGM sites. Recoveries of 85% ± 10% total Hg were obtained during 4 weeks of storage in refrigerated (4 °C, dark) and unrefrigerated (16 °C, dark) conditions, and from a representative river water spiked to 1 μg L-1 Hg2+, 94% ± 1% Hg recovery was obtained. Solid-phase extraction loading flow rates were tested at 2, 5, and 10 mL min-1 with no breakthrough of Hg, and sorbent stability showed no breakthrough of Hg up to 2 weeks after functionalisation. The method was deployed across five artisanal gold mines in Kakamega gold belt, Kenya, to assess Hg concentrations in mine shaft water, ore washing ponds, and river and stream water, including drinking water sources. In all waters, Hg concentrations were below the WHO guideline limit value of 6 μg L-1, but drinking water sources contained trace concentrations of up to 0.35 μg L-1 total Hg, which may result in negative health effects from long-term exposure. The SPE method developed and deployed here is a robust sampling method that can therefore be applied in future Hg monitoring, toxicology, and environmental work to provide improved data that is representative of total dissolved Hg in water samples.

Serum levels of inflammatory cytokines in mercury mining workers in a precarious situation: A preliminary study

Mercury is a ubiquitous environmental xenobiotic; the primary sources of exposure to this metal are artisanal gold mining and the direct production of mercury. In Mexico, artisanal mercury mining continues to be an important activity in different regions of the country. Exposure to mercury vapors releases can have severe health impacts, including immunotoxic effects such as alterations in cytokine profiling. Therefore, in the present work, we evaluated the inflammatory cytokines profile in the blood serum of miners exposed to mercury. A cross-sectional observational study was performed on 27 mining workers (exposed group) and 20 control subjects (nonexposed group) from central Mexico. The mercury urine concentration (U-Hg) was determined by atomic absorption spectrometry, and IL-2, IL-6, IL-8, IL-10, and TNF-α were measured using a Multiplex Assay. The results showed that the U-Hg in the miners had a median value of 552.70 μg/g creatinine. All cytokines showed a significant increase in the miner group compared with the control group, except for TNF-α. In addition, we observed a positive correlation between U-Hg concentration and cytokine levels. In conclusion, mercury exposure correlated with cytokine levels (considered acute inflammatory marker) in miners; therefore, workers exposed to this metal show an acute systemic inflammation that could lead to alterations in other organs and systems.

Temporal changes of blood mercury concentrations in Chinese newborns and the general public from 1980s to 2020s

Mercury (Hg) is a global pollutant that threatens the environment and human health. As a major producer, emitter and consumer of Hg, China is currently taking different measures to curb mercury pollution in accordance with the requirements of the Minamata Convention on Mercury. Blood Hg can reflect the human body's recent exposure to Hg. This review summarized the temporal changes in blood Hg concentrations in newborns and the general public in China from 1980 s to 2020 s. It was shown that the blood Hg concentrations of newborns showed the downward trend, although it was not significant. The general public Hg concentrations showed a trend of first increase and then decrease trend. Most of the cord blood Hg and venous blood Hg concentrations in China were lower than the USEPA reference concentration of 5.8 µg/L. Since low-dose prenatal Hg exposure can affect fetal and neonatal development, continuous attention needs to be paid to reduce maternal and neonatal Hg exposure. The information provided in this review may lay a basis for the effectiveness evaluation on the implementation of Minamata Convention on Mercury.

The dynamics of mercury around an artisanal and small-scale gold mining area, Camarines Norte, Philippines

To elucidate the dynamics of mercury emitted and released by artisanal and small-scale gold mining (ASGM) activity and to estimate its impact on the ecosystems of the bay, the distribution of mercury in the atmosphere, soil, water, and sediment around Mambulao Bay, Camarines Norte, Philippines, was investigated. The ASGM operations use mercury to extract gold from ore and are located on the east shore side of the bay. Samplings were conducted in August 2017 and September 2018. The samples were used for determination of total mercury (T-Hg) and organic mercury (org-Hg) concentrations, total organic carbon (TOC) content, and chemical composition. The atmospheric mercury concentration on the east shore side, 6.1-25.8 ng m^-3, was significantly higher than the value of 1.4-9.9 ng m^-3 observed on the west shore side. The average concentrations of T-Hg in the forest soils of the west shore side and those of the east shore side were 0.081 ± 0.028 mg kg^-1 and 0.496 ± 0.439 mg kg^-1, respectively. In the vertical distribution of T-Hg in the soil of the east shore side, a higher concentration was observed near the surface. For the vertical variations in T-Hg in the marine sediment, higher values were observed near the estuary, and the vertical variations in core samples showed an increase in mercury concentration toward the surface. The highest concentration of T-Hg in sediment, 9.5 mg kg^-1, which was 2 orders of magnitude higher than the background levels of this area, was found near the river mouth. The T-Hg, org-Hg, and TOC levels showed a positive correlation, suggesting that the rivers are the main sources of T-Hg and org-Hg in the bay. Although the fish sample containing a mercury content higher than the regulatory level for fish and shellfish of 0.4 mg kg^-1 in Japan was only one of 42 samples, the percentage of org-Hg in fish samples was 91 ± 18%. Mercury released into the surroundings by the ASGM activities can be converted into methylmercury and affect the bay's ecosystem.

Adverse Health Effects and Mercury Exposure in a Colombian Artisanal and Small-Scale Gold Mining Community

The aim of this study was, first of all, to associate the mercury (Hg) concentrations and respiratory functions of the gold miners in the artisanal small-scale gold mining (ASGM) environment in San Martín de Loba, Colombia. We carried out a cross-sectional study using a survey whereby we collected basic demographic information, occupational medical history, and applied two validated questionnaires (Q16 and SF36). We measured Hg levels in all volunteers using direct thermal decomposition-atomic absorption spectrometry. Univariate and bivariate statistical analyses were carried out for all variables, performing logistic regression to assess the effect of ASGM on health outcomes. Volunteers enrolled (n = 124) were between the ages of 20 and 84 years (84% miners and 79% males). No changes were found in the systolic blood pressure, diastolic blood pressure, and heart rate from the ASGM miners, in crude and adjusted statistical analyses. ASGM miners increased 8.91 (95% confidence interval, 1.55-95.70) times the risk of having these than of having neurotoxic effects. Concentrations of total whole blood mercury (T-Hg) in all participants ranged from 0.6 to 82.5 with a median of 6.0 μg/L. Miners had higher T-Hg concentrations than non-miners (p-value = 0.011). Normal and abnormal respiratory spirometry patterns showed significant differences with the physical role and physical function of quality-of-life scales (the (p-value was 0.012 and 0.004, respectively). The spirometry test was carried out in 87 male miners, with 25% of these miners reporting abnormalities. Out of these, 73% presented a restrictive spirometry pattern, and 27%, an obstructive spirometry pattern. The ASGM population had higher Hg concentrations and worse neurotoxic symptomatology than non-miners of the same community.

Mercury Exposure in Artisanal Mining: Assessing the Effect of Occupational Activities on Blood Mercury Levels Among Artisanal and Small-Scale Goldminers in Ghana

A cross-sectional survey of 425 male artisanal and small-scale goldminers (ASGM) was conducted to examine the relationship between the occupational activities of the miners and their blood mercury levels while controlling for relevant biosocial and socio-cultural factors. The data was subjected to descriptive and inferential statistics. Initial findings showed that 43.29% of the ASGM miners had blood mercury levels above the occupational exposure threshold. Among the occupational factors, ASGM miners who amalgamate gold, burn amalgam, and ASGM miners who smelt gold were 2.260, 1.881, and 2.094 times respectively more likely to have high blood mercury levels as compared to ASGM miners who did not carry out these activities. Also, ASGM miners who suck excess mercury with their mouth (OR = 0.197, p < 0.001) were less likely to have high blood mercury levels. For the biosocial and socio-cultural attributes, high blood mercury levels was less likely among older ASGM miners (OR = 0.507, p < 0.05). Inversely, high blood mercury levels was more likely among ASGM miners who are married (OR = 1.627, p < 0.05), ASGM miners with junior (OR = 2.240, p < 0.001) and senior (OR = 1.575, p < 0.05) high school education, and ASGM miners who have 6-10 years (OR = 3.802, p < 0.001) and above 10 years (OR = 2.591, p < 0.001) work experience. ASGM miners who amalgamate gold, burn amalgam, and smelt gold are exposed to mercury and are at risk of mercury poisoning. This could, however, be minimized with the right capturing devices and personal protective equipment. This notwithstanding, unsafe, and unsustainable occupational practices such as working in mercury contaminated water and sucking excess mercury with the mouth should be discouraged.

Reducing disease and death from Artisanal and Small-Scale Mining (ASM) - the urgent need for responsible mining in the context of growing global demand for minerals and metals for climate change mitigation

Artisanal and small-scale mining (ASM) takes place under extreme conditions with a lack of occupational health and safety. As the demand for metals is increasing due in part to their extensive use in 'green technologies' for climate change mitigation, the negative environmental and occupational consequences of mining practices are disproportionately felt in low- and middle-income countries. The Collegium Ramazzini statement on ASM presents updated information on its neglected health hazards that include multiple toxic hazards, most notably mercury, lead, cyanide, arsenic, cadmium, and cobalt, as well as physical hazards, most notably airborne dust and noise, and the high risk of infectious diseases. These hazards affect both miners and mining communities as working and living spaces are rarely separated. The impact on children and women is often severe, including hazardous exposures during the child-bearing age and pregnancies, and the risk of child labor. We suggest strategies for the mitigation of these hazards and classify those according to primordial, primary, secondary, and tertiary prevention. Further, we identify knowledge gaps and issue recommendations for international, national, and local governments, metal purchasers, and employers are given. With this statement, the Collegium Ramazzini calls for the extension of efforts to minimize all hazards that confront ASM miners and their families.

Artisanal and Small-Scale Gold Mining (ASGM): Management and Socioenvironmental Impacts in the Northern Amazon of Ecuador

Mining is one of the oldest economic activities of mankind. Within this activity, artisanal and small-scale gold mining (ASGM) is one of the most studied sectors due to its high level of environmental contamination and the social problems it causes. In recent years, ASGM in the northern Amazon of Ecuador has increased significantly, and studies that describe its current situation and impact are scarce. In this sense, the present study aimed to analyze the current status and socioenvironmental impacts caused by ASGM gold mining activities in the Cascales canton in the province of Sucumbíos in northeastern Ecuador. The methodological tools used in the present study were a literature review of scientific and gray literature, field visits to assess perceived impacts and an expert judgment to discuss the results and establish challenges. The main results indicate that illegal and informal activities continue to be carried out in the upper zone of the Cascales and Duvino rivers; 90% of local miners still use mercury in this activity, although it is legally prohibited. Among the main impacts evidenced are the contamination of water bodies, soil and atmosphere due to the use of mercury and disturbance to flora and fauna due to the use of machinery in the exploration process. Finally, the government should focus efforts on strengthening public policies to socialize the importance of good environmental practices in ASGM and the effects of the impacts on human health and environmental issues, all this with the support of social actors, such as ministries, universities, NGOs, ASGM associations and private enterprise.

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.

Cupriavidus metallidurans CH34 Possesses Aromatic Catabolic Versatility and Degrades Benzene in the Presence of Mercury and Cadmium

Heavy metal co-contamination in crude oil-polluted environments may inhibit microbial bioremediation of hydrocarbons. The model heavy metal-resistant bacterium Cupriavidus metallidurans CH34 possesses cadmium and mercury resistance, as well as genes related to the catabolism of hazardous BTEX aromatic hydrocarbons. The aims of this study were to analyze the aromatic catabolic potential of C. metallidurans CH34 and to determine the functionality of the predicted benzene catabolic pathway and the influence of cadmium and mercury on benzene degradation. Three chromosome-encoded bacterial multicomponent monooxygenases (BMMs) are involved in benzene catabolic pathways. Growth assessment, intermediates identification, and gene expression analysis indicate the functionality of the benzene catabolic pathway. Strain CH34 degraded benzene via phenol and 2-hydroxymuconic semialdehyde. Transcriptional analyses revealed a transition from the expression of catechol 2,3-dioxygenase (tomB) in the early exponential phase to catechol 1,2-dioxygenase (catA1 and catA2) in the late exponential phase. The minimum inhibitory concentration to Hg (II) and Cd (II) was significantly lower in the presence of benzene, demonstrating the effect of co-contamination on bacterial growth. Notably, this study showed that C. metallidurans CH34 degraded benzene in the presence of Hg (II) or Cd (II).

Does mercury emission from small-scale gold mining cause widespread soil pollution in Ghana?

The use of mercury in small-scale gold mining is globally the largest anthropogenic source of mercury in the environment. In countries like Ghana, where small-scale gold mining is a highly important economic sector, the activity is also expected to cause local pollution. This study is based on a hypothesis that the mining activity in Ghana is causing more widespread soil pollution also outside active mining sites, and that the main part of regional differences in soil concentrations of mercury might come from pollution. Little systematic and dependable data has been collected to assess the extent of mercury contamination of soils in areas outside active mining areas. The regional aspect of mercury pollution from mining has not been studied in Ghana or other countries with a large small-scale gold mining sector. Systematic collection of soil samples on a 25 × 25 km² net covering the entire country was carried out to ensure the representativeness of data and to allow calculation of spatial trends. The soil concentrations found in one-third of the country, where most intensive mining takes place, are three times higher than concentrations in the rest of the country. This difference cannot be explained by sources of natural variation in mercury concentrations but can be explained by decades of atmospheric deposition. It is therefore likely that the mining activity has caused a more widespread increase in soil concentrations, also outside active mining sites. The mercury concentrations found are on average 0.024 mg kg^-1, which is low compared to published studies from other countries and regions and estimated world averages. All measured concentrations are well below soil quality criteria for human health. The build-up of soil concentrations in the mining area is still problematic because mercury is a hazardous substance in the environment.

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.

Neurotoxicity of mercury: an old issue with contemporary significance

Mercury exerts a variety of toxic effects, depending on the specific compound and route of exposure. However, neurotoxicity in virtue of its consequence to health causes the greatest concern for toxicologists. This is particularly true regarding fetal development, where neurotoxic effects are much more severe than in adults, and the toxicity threshold is lower. Here, we review the major concepts regarding the neurotoxicity of mercury compounds (mercury vapor; methylmercury and ethylmercury), from exposure routes to toxicokinetic particularities leading to brain deposition and the development of neurotoxic effects. Albeit research on the neurotoxicity of mercury compounds has significantly advanced from the second half of the twentieth century onwards, several grey areas regarding the mechanism of toxicity still exist. Thus, we emphasize research advances during the last two decades concerning the molecular interactions of mercury which cause neurotoxic effects. Highlights include the disruption of glutamate signaling and excitotoxicity resulting from exposure to mercury and the interaction with redox active residues such as cysteines and selenocysteines which are the premise accounting for the disruption of redox homeostasis caused by mercurials. We also address how immunotoxic effects at the CNS, namely microglia and astrocyte activation modulate developmental neurotoxicity, a major topic in contemporary research.

Exposure to environmental neurotoxic substances and neurodevelopment in children from Latin America and the Caribbean

Environmental (and occupational) exposure to neurotoxic substances is a worldwide problem that can affect children's neurodevelopment (ND). In Latin American and Caribbean (LAC) countries there are over 300 million children living under the threat of neurodevelopmental delays due to toxic environmental exposure. Large industrial centers, intense mining and agricultural activities, along with changing complex ecosystems constitute a mosaic that drives contamination of air, water and the food chain. Neurotoxic contaminants such as pesticides (organochlorines, organophosphates, carbamates, pyrethroids, neonicotinoids, and manganese fungicides), chemicals of industrial use (phthalates), and metals (Hg, Pb, Al, As, F, Cd, Mo, Mn) are at the center of environmental exposure studies. Exposure to neurotoxic substances singly or in combination with other compounds or socioeconomic stressors (maternal education, socio-economic and nutritional status) intertwined with occupational and para-occupational exposure can affect ND (motor, cognition, behavior) of children. Significant negative effects of pesticides and neurotoxic elements on ND were found in all studied countries, affecting especially the less-privileged children from laboring families. Studies showed that exposures to the neurotoxicants in human milk are secondary to their more lasting effects during prenatal exposure. This review integrates exposure (prenatal and breastfeeding), metabolism, and ND effects of neurotoxicants. It highlights the overwhelming evidence showing that current levels of exposures are hazardous and detrimental to children's ND in LAC countries. The evidence indicates that a reduction in neurotoxicant exposure is essential to protect children's ND. Therefore, it is urgent to adopt policies and actions that prevent and remediate region-specific children's ND issues.

Urinary Mercury Levels and Predictors of Exposure among a Group of Italian Children

Urinary mercury (Hg) levels are suitable to assess long-term exposure to both elemental and inorganic Hg. In this study, the urinary Hg levels of 250 children (aged 6–11 years) from three areas with different anthropogenic impacts in the Rieti province, central Italy, were assessed. The Hg concentrations were in the range of 0.04–2.18 µg L⁻¹ with a geometric mean equal to 0.18 µg L⁻¹ [95% confidence interval (CI), 0.17–0.20 µg L⁻¹] or 0.21 µg g⁻¹ creatinine (95% CI, 0.19–0.23 µg g⁻¹ creatinine), and a reference value calculated as 95th percentile of 0.53 µg L⁻¹ (95% CI, 0.44–0.73 µg L⁻¹) or 0.55 µg g⁻¹ creatinine (95% CI, 0.50–0.83 µg g⁻¹ creatinine). In all cases, urinary Hg data were below the HBM-I values (7 µg L⁻¹ or 5 µg g⁻¹ creatinine) established for urine, while the 95th percentile was above the German Human Biomonitoring Commission’s RV95 (0.4 µg L⁻¹) set for children without amalgam fillings. A significant correlation (p < 0.05) was found between creatinine-corrected results and residence area, with higher urinary Hg levels in children living in the industrial area. Multiple linear regression analysis showed that creatinine was the main predictor of urinary Hg.

Personalized Prevention in Mercury-Induced Amyotrophic Lateral Sclerosis: A Case Report

Chronic exposure to low levels of mercury is involved in the development of motor neuron diseases (MND). Genetic alterations may have a crucial role in the onset and progression. We presented a case of a TANK-binding kinase 1 (TBK1)-mutated 54-year-old male worker who developed a MND due to chronic mercury exposure at work. He was employed in a chlor-alkali plant in Central Italy. After two years of employment he had acute mercury intoxication with suggestive neurological symptoms and a high urinary level of the metal. Through years, many episodes of intoxication occurred, but he continued to perform the same job and be exposed to mercury. After yet another episode of intoxication in 2013, he showed fasciculations of the upper limbs and trunk, and electromyographic activity patterns were consistent with amyotrophic lateral sclerosis (ALS). In 2016, a genetic test revealed a mutation of TBK1, an ALS-related gene. This case highlights the important role of genetics in personalized occupational medicine. Occupational physicians should use genetic tests to identify conditions of individual susceptibility in workers with documented frequent episodes of mercury intoxication recorded during health surveillance programs to customize prevention measures in the workplace and act before damage appears.

How Occupational Mercury Neurotoxicity Is Affected by Genetic Factors. A Systematic Review

Occupational exposure to elemental mercury still represents a significant risk in the workplace. The sensitivity of the exposed subjects varies considerably. This study aims to summarize the literature on the role of genetic factors in occupationally exposed cohorts. A systematic search of the literature was carried out on PubMed Central (PMC), MEDLINE, and Google Scholar databases in accordance with the “Preferred Reporting Items for Systematic reviews and Meta-Analyses” (PRISMA) guidelines, from 1946 to July 2020. Ten cross-sectional studies were included in the review. All studies referred to the polymorphisms that can favour some neurotoxic effects of the metal in occupational cohorts. Some genetic variants may be associated with an increase in the occupational effects of mercury. Given the limited evidence, genetic screening of all mercury-exposed workers is not recommended. However, a personalized search for polymorphisms could be taken into consideration if exposed workers report early neurotoxic symptoms.

Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study

Background

In Zimbabwe, an estimated 500,000 people work in the sector of artisanal and small-scale gold mining (ASGM). Two million Zimbabweans are dependent on this sector. Using mercury is common to extract gold from ore. Long term exposure to mercury can cause various adverse health conditions including chronic mercury intoxication. The influence of these adverse health effects on the health-related quality of life (HRQoL) is still unknown. The aim of this study is to assess the HRQoL of people who identify themselves as miners, and to analyze potential influencing factors, such as age, years of working with mercury and health conditions caused by mercury exposure.

Methods

This cross-sectional study assessed the HRQoL using the standardized EQ-5D + C (3 L) questionnaire and collected human specimens (blood, urine) of people living and possibly working in ASGM areas in Zimbabwe. Factors such as age, years of working with mercury and adverse health conditions possibly caused by mercury exposure were analyzed with regards to their influence on the HRQoL.

Results

The 207 participants (82% male, mean age 38 years) reported 40 different health states. Of the study participants 42.5% reported to be in complete good health while 57.5% reported being unwell in different ways. Nine participants (4.3%) were identified with chronic mercury intoxication, whereas 92 participants (33.3%) had mercury levels above the “Alert” threshold in at least one specimen. Having chronic mercury intoxication has a significant negative influence on the HRQoL, when taking into account age, gender and years of working with mercury. Cognitive problems were the most reported in the questionnaire, however, the association between this domain separately and the HRQoL was not verified.

Conclusion

This study shows that adverse health effects caused by chronic exposure to mercury, have a negative influence on the HRQoL among people living in ASGM areas.

Artisanal and small-scale gold mining: A cross-sectional assessment of occupational mercury exposure and exposure risk factors in Kadoma and Shurugwi, Zimbabwe

In artisanal and small-scale gold mining (ASGM) the toxic metal mercury is used for gold extraction. The objective of this cross-sectional study was to assess mercury concentrations in urine and blood and mercury-related symptoms of participants identifying themselves as miners from Kadoma and Shurugwi, Zimbabwe. Moreover, we aimed to explore possible risk factors influencing mercury body burden. In 2019, urine and blood samples of 207 participants were collected and analyzed for mercury using atomic absorption spectroscopy. All participants answered questions regarding their exposure risks. The median urine mercury value was 4.75 μg/L with a maximum of 612 μg/L. Median mercury concentration in creatinine corrected urine values was 3.98 μg/g with a maximum value of 478 μg/g. The median blood mercury value was 2.70 μg/L with a maximum of 167 μg/L. Correlations between exposure risks factors such as the lack of retort use and elevated mercury values were demonstrated. ASGM is very common in Zimbabwe. Thus, mercury exposure is a major occupational health risk for miners. Moreover, this study emphasizes the impact of exposure risk factors on the mercury body burden.

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.

Sensor-as-a-Service: Convergence of Sensor Analytic Point Solutions (SNAPS) and Pay-A-Penny-Per-Use (PAPPU) Paradigm as a Catalyst for Democratization of Healthcare in Underserved Communities

In this manuscript, we discuss relevant socioeconomic factors for developing and implementing sensor analytic point solutions (SNAPS) as point-of-care tools to serve impoverished communities. The distinct economic, environmental, cultural, and ethical paradigms that affect economically disadvantaged users add complexity to the process of technology development and deployment beyond the science and engineering issues. We begin by contextualizing the environmental burden of disease in select low-income regions around the world, including environmental hazards at work, home, and the broader community environment, where SNAPS may be helpful in the prevention and mitigation of human exposure to harmful biological vectors and chemical agents. We offer examples of SNAPS designed for economically disadvantaged users, specifically for supporting decision-making in cases of tuberculosis (TB) infection and mercury exposure. We follow-up by discussing the economic challenges that are involved in the phased implementation of diagnostic tools in low-income markets and describe a micropayment-based systems-as-a-service approach (pay-a-penny-per-use-PAPPU), which may be catalytic for the adoption of low-end, low-margin, low-research, and the development SNAPS. Finally, we provide some insights into the social and ethical considerations for the assimilation of SNAPS to improve health outcomes in marginalized communities.

Environmental impacts of the life cycle of alluvial gold mining in the Peruvian Amazon rainforest

Alluvial gold mining activities in the Peruvian Amazon rainforest are responsible for mercury emissions and deforestation. To understand related environmental impacts, specifically toxicity and climate change, this study uses Life Cycle Assessment methodology. Four predominant extraction systems were selected and modelled and three scenarios that reflect currently available gold recovery systems were modelled: amalgamation, amalgamation with mercury recovery through retort system and gravimetric tables. The USEtox and IPCC life cycle impact assessment methods were used to assess the environmental impacts in term of human toxicity, freshwater ecotoxicity and climate change. Results show that for all systems, human toxicity values are governed by mercury emissions in gold recovery activities (ca. 80%). However, the use of retort significantly lowers these impacts (ca. 90%). Machines and diesel use for ore extraction and freighting activities drive freshwater ecotoxicity. Moreover, deforestation has a major contribution on the environmental impacts related to climate change. However, these impacts are dependent on the type of extraction system. Although human toxicity, freshwater ecotoxicity and climate change are frequently studied separately, a direct relationship between them has been identified in this system. Finally, beyond the environmental burdens related to alluvial gold mining, there are impacts affecting the social, cultural, and economic dimensions that will need to be analyzed to ensure a comprehensive understanding of the system.

An overview of worldwide and regional time trends in total mercury levels in human blood and breast milk from 1966 to 2015 and their associations with health effects

BACKGROUND

Mercury is a pollutant of global concern. To protect human health and environment from mercury pollution, the Minamata Convention on mercury entered into force in 2017.

OBJECTIVES

To support a future effectiveness evaluation of the convention, this study assesses worldwide and regional time trends of total mercury levels in human blood and breast milk across different population sub-groups in the last half-century prior to entry-into-force of the Minamata Convention. This study also provides an overview of the epidemiological literature showing evidence of associations between mercury exposure (in terms of total mercury levels in whole blood, cord blood, and breast milk) and human health.

METHODS

We searched electronic databases to identify articles published prior to June 14, 2017 and reported total mercury levels in any of three biological matrices (whole blood, cord blood, or breast milk) and/or associations with human health. Temporal trends of total mercury levels in the selected biological matrices across different population sub-groups were estimated using a linear fit of the log-transformed data. In parallel, statistical methods were employed to assess any possible effect of sources of inhomogeneity (i.e. study and population characteristics such as age, sex, ethnicity, source of exposure, sampling period, and geographical region) in the collected studies. Furthermore, a summary of significant and relevant associations between mercury exposure and human health conditions in children and adults was prepared.

FINDINGS

We found significant declines in total mercury levels in whole blood, cord blood, and breast milk between 1966 and 2015. A regional overview of total mercury levels in whole blood, cord blood, and breast milk suggests the highest levels in South America, followed by Africa or Asia whereas the population groups from Europe or North America displayed the lowest levels of total mercury in the selected biological matrices. We observed conclusive consistent associations of mercury exposure with selected health conditions, especially neurodevelopment and neurotoxicity in children and adults. For several other health conditions, reported findings in the collected studies do not support conclusive associations. We also found that several studies demonstrated significant associations between mercury exposure below the USEPA reference level and various health conditions.

CONCLUSIONS

This study provides a worldwide and regional overview of trends in total mercury levels in human blood and breast milk and associated health risks prior to entry-into-force of the Minamata Convention and calls for further epidemiological investigations from across the globe to fully understand the health implications of mercury exposure.

Knowledge and awareness of health effects related to the use of mercury in artisanal and small-scale gold mining in Suriname

BACKGROUND

The use of mercury in artisanal and small-scale gold mining has negative effects on human health and the environment. In Suriname, the current gold rush resulted in estimated mercury emissions up to 63t per year. To reduce the use of mercury and the subsequent health impact to gold miners and local inhabitants, knowledge and awareness in the community should be increased.

METHODS

This study evaluated the effects of a health education programme (HEP) on the levels of knowledge and awareness among local inhabitants and small-scale gold miners in active gold mining areas in the interior of Suriname, South-America. Baseline knowledge levels were assessed with a survey prior to the implementation of the HEP. Thereafter, the exact same questions were asked to evaluate the effects. A total of 959 local inhabitants and 140 gold miners completed the survey including five topics: general knowledge on mercury, potential routes of exposure, health risks for children versus adults, mercury related health effects, and reproductive risks. Additionally, participants were asked in a separate survey (n = 107) about potential exposure reduction techniques and their willingness to be involved in a future human biomonitoring programme.

RESULTS

The HEP influenced knowledge on exposure routes of mercury (increase from 64% to 78% of respondents who could name the relevant exposure routes) and on health effects attributed to mercury (increase from 48% to 70% of respondents who were able to list the correct health effects). After the HEP, 70% of the respondents affirmed the higher sensitivity of children, while knowledge on reproductive health effects increased from 39% to 63%. Self-estimated levels of knowledge also increased, indicating lower anxiety regarding potential risks of mercury. Gold miners reported to be willing to improve their work procedures (e.g. burning amalgam with a retort), although suitable tools were not always available. Consistent results were found for individuals included in both surveys, before and after the health education programme. Almost all respondents in the separate survey reported to be willing to give consent for participation in a future human biomonitoring programme, for themselves and their children.

CONCLUSION

The implementation of a health education programme within an existing local healthcare structure proved effective and levels of knowledge and awareness improved. Most improved was the knowledge on health effects attributable to mercury, more specifically reproductive health effects.

Repeated Exposition to Mercury (II) Chloride Enhances Susceptibility to S. schenckii sensu stricto Infection in Mice

Sporotrichosis is a subcutaneous mycosis that has re-emerged in several tropical and subtropical regions over the last decades. Growing findings suggest that the interplay of host, pathogen, and environment has a determinant effect on the diversity, local distribution, and virulence of Sporothrix schenckii sensu lato, the etiologic agent. Among the environmental factors, we have studied the potential role of repeated exposures to mercury (Hg), a known immunotoxic xenobiotic that is widely used in gold mining regions where sporotrichosis outbreaks are frequently reported. In this study, male Swiss mice received subcutaneous injections of either 300 or 1200 µg/kg of mercury (II) chloride (HgCl₂) for 14 days, three times a week. A control group was injected with the vehicle Phosphate Buffered Saline (PBS). Treatment with HgCl₂ impaired several immunologic parameters that are involved in host response to Sporothrix infection, such as the production of TNFα, IL-1, and nitric oxide by macrophages, and Th1/Th2/Th17 populations and their respective cytokines. The consequences of these effects on the host resistance to S. schenckii infection were subsequently evaluated. Hg-exposed mice exhibited a higher fungal load in the fungal inoculation site associated to systemic dissemination to spleen and liver on 14 days post-infection and a higher production of specific IgG1 and mild reduction of IgG2a. These findings suggest that repeated exposition to Hg enhances susceptibility to S. schenckii infection in mice and can be a factor associated to sporotrichosis outbreaks in endemic and highly Hg-polluted areas.

Neurodevelopmental Effects of Mercury

The toxicology of mercury (Hg) is of concern since this metal is ubiquitously distributed in the environment, and living organisms are routinely exposed to Hg at low to high levels. The toxic effects of Hg are well studied and it is known that they may differ depending on the Hg chemical species. In this chapter, we emphasize the neurotoxic effects of Hg during brain development. The immature brain is more susceptible to Hg exposure, since all the Hg chemical forms, not only the organic ones, can harm it. The possible consequences of Hg exposure during the early stages of development, the additive effects with other co-occurring neurotoxicants, and the known mechanisms of action and targets will be addressed in this chapter.

Global Burden of Disease of Mercury Used in Artisanal Small-Scale Gold Mining

BACKGROUND

Artisanal small-scale gold mining (ASGM) is the world's largest anthropogenic source of mercury emission. Gold miners are highly exposed to metallic mercury and suffer occupational mercury intoxication. The global disease burden as a result of this exposure is largely unknown because the informal character of ASGM restricts the availability of reliable data.

OBJECTIVE

To estimate the prevalence of occupational mercury intoxication and the disability-adjusted life years (DALYs) attributable to chronic metallic mercury vapor intoxication (CMMVI) among ASGM gold miners globally and in selected countries.

METHODS

Estimates of the number of artisanal small-scale gold (ASG) miners were extracted from reviews supplemented by a literature search. Prevalence of moderate CMMVI among miners was determined by compiling a dataset of available studies that assessed frequency of intoxication in gold miners using a standardized diagnostic tool and biomonitoring data on mercury in urine. Severe cases of CMMVI were not included because it was assumed that these persons can no longer be employed as miners. Cases in workers' families and communities were not considered. Years lived with disability as a result of CMMVI among ASG miners were quantified by multiplying the number of prevalent cases of CMMVI by the appropriate disability weight. No deaths are expected to result from CMMVI and therefore years of life lost were not calculated. Disease burden was calculated by multiplying the prevalence rate with the number of miners for each country and the disability weight. Sensitivity analyses were performed using different assumptions on the number of miners and the intoxication prevalence rate.

FINDINGS

Globally, 14-19 million workers are employed as ASG miners. Based on human biomonitoring data, between 25% and 33% of these miners-3.3-6.5 million miners globally-suffer from moderate CMMVI. The resulting global burden of disease is estimated to range from 1.22 (uncertainty interval [UI] 0.87-1.61) to 2.39 (UI 1.69-3.14) million DALYs.

CONCLUSIONS

This study presents the first global and country-based estimates of disease burden caused by mercury intoxication in ASGM. Data availability and quality limit the results, and the total disease burden is likely undercounted. Despite these limitations, the data clearly indicate that mercury intoxication in ASG miners is a major, largely neglected global health problem.

Challenges and opportunities for managing aquatic mercury pollution in altered landscapes

The environmental cycling of mercury (Hg) can be affected by natural and anthropogenic perturbations. Of particular concern is how these disruptions increase mobilization of Hg from sites and alter the formation of monomethylmercury (MeHg), a bioaccumulative form of Hg for humans and wildlife. The scientific community has made significant advances in recent years in understanding the processes contributing to the risk of MeHg in the environment. The objective of this paper is to synthesize the scientific understanding of how Hg cycling in the aquatic environment is influenced by landscape perturbations at the local scale, perturbations that include watershed loadings, deforestation, reservoir and wetland creation, rice production, urbanization, mining and industrial point source pollution, and remediation. We focus on the major challenges associated with each type of alteration, as well as management opportunities that could lessen both MeHg levels in biota and exposure to humans. For example, our understanding of approximate response times to changes in Hg inputs from various sources or landscape alterations could lead to policies that prioritize the avoidance of certain activities in the most vulnerable systems and sequestration of Hg in deep soil and sediment pools. The remediation of Hg pollution from historical mining and other industries is shifting towards in situ technologies that could be less disruptive and less costly than conventional approaches. Contemporary artisanal gold mining has well-documented impacts with respect to Hg; however, significant social and political challenges remain in implementing effective policies to minimize Hg use. Much remains to be learned as we strive towards the meaningful application of our understanding for stakeholders, including communities living near Hg-polluted sites, environmental policy makers, and scientists and engineers tasked with developing watershed management solutions. Site-specific assessments of MeHg exposure risk will require new methods to predict the impacts of anthropogenic perturbations and an understanding of the complexity of Hg cycling at the local scale.

Efficacy of N,N'bis-(2-mercaptoethyl) isophthalamide on mercury intoxication: a randomized controlled trial

BACKGROUND

Chronic mercury intoxication is a severe health issue and occurs especially in gold mining communities. Common chelators used for improving mercury elimination are not everywhere available and challenged by poor cell wall penetration. This study is part of a feasibility trial and the aim was to gather first information about the efficacy of the newly developed chelator N,N'bis-(2-mercaptoethyl) isophthalamide (NBMI) on chronic mercury intoxication.

METHODS

In this three-armed, placebo-controlled randomized trial, 36 miners with mercury urine levels exceeding 15 μg/l were administered 100 mg NBMI, 300 mg NBMI or placebo for 14 days. Levels of mercury in urine [μg/l and μg/g creatinine] and plasma l were analyzed. Therapeutic effect was assessed using the medical intoxication score (MIS) and its single health outcomes (e.g. excessive salivation, sleeping problems), fatigue scores, a neuromotoric test battery (CATSYS) and a neurological outcome (Finger to nose test).

RESULTS

Physical fatigue was significantly decreased in the 300 mg NBMI group compared to the control. Mercury concentration in urine following 300 mg NBMI treatment was significantly lowered compared to control, however, this effect was less distinct with adjustment for creatinine.

CONCLUSION

NBMI showed an effect on physical fatigue and there were indications to positive effects on other symptoms as well. More comprehensive studies are mandatory to verify the effects of NBMI as a novel tool for treating mercury intoxications.

TRIAL REGISTRATION

ClinicalTrials.gov Identifier: NCT02486289 . Date of registration: June 24, 2015.

Oxidative stress and repetitive element methylation changes in artisanal gold miners occupationally exposed to mercury

Mercury (Hg) exposure is a public health concern due to its persistence in the environment and its high toxicity. Such toxicity has been associated with the generation of oxidative stress in occupationally exposed subjects, such as artisanal gold miners. In this study, we characterize occupational exposure to Hg by measuring blood, urine and hair levels, and investigate oxidative stress and DNA methylation associated with gold mining. To do this, samples from 53 miners and 36 controls were assessed. We show higher levels of oxidative stress marker 8-OHdG in the miners. Differences in LINE1 and Alu(Yb8) DNA methylation between gold miners and control group are present in peripheral blood leukocytes. LINE1 methylation is positively correlated with 8-OHdG levels, while XRCC1 and LINE1 methylation are positively correlated with Hg levels. These results suggest an effect of Hg on oxidative stress and DNA methylation in gold miners that may have an impact on miners' health.

Semiquantitative determination of total mercury in Pygocentrus nattereri Kner, 1858 and sediment at the plateau of Upper Paraguai River, Brazil

In this study an environmental assessment of contamination by total mercury (THg) was carried out at the Plateau of the Upper Paraguai River. Total mercury was evaluated in sediment and muscle of the red piranha Pygocentrus nattereri Kner, 1858, a piscivorous species at the top of the food chain consumed for subsistence and commercially. THg concentrations were below national guidelines established by WHO for sediments (100 ng g^-1) and fish (100-600 ng g^-1) for most of the sampled sites. Two sites located downstream of artisanal diamond and gold mines had THg concentrations in fish equal or greater than 600 ng g^-1.

Inorganic mercury prevents the differentiation of SH-SY5Y cells: Amyloid precursor protein, microtubule associated proteins and ROS as potential targets

Exposure to mercury (Hg) occurs through different pathways and forms including methylmecury (MeHg) from seafood and rice, ethylmercury (EtHg), and elemental Hg (Hg⁰) from dental amalgams and artisanal gold mining. Once in the brain all these forms are transformed to inorganic Hg (I-Hg), where it bioaccumulates and remains for long periods. Hg is a well-known neurotoxicant, with its most damaging effects reported during brain development, when cellular key events, such as cell differentiation take place. A considerable number of studies report an impairment of neuronal differentiation due to MeHg exposure, however the effects of I-Hg, an important form of Hg found in brain, have received less attention. In this study, we decided to examine the effects of I-Hg exposure (5, 10 and 20μM) on the differentiation of SH-SY5Y cells induced by retinoic acid (RA, 10μM). We observed extension of neuritic processes and increased expression of neuronal markers (MAP2, tubulin-βIII, and Tau) after RA stimulation, all these effects were decreased by the co-exposure to I-Hg. Interestingly, I-Hg increased the levels of reactive oxygen species (ROS) and nitric oxide (NO) accompanied with increased levels of inducible nitric oxide synthase (iNOS) and, dimethylarginine dimethylaminohydrolase 1 (DDHA1). Remarkably I-Hg decreased levels of nitric oxide synthase neuronal (nNOS). Moreover I-Hg reduced the levels of tyrosine hydroxylase (TH) and amyloid precursor protein (APP) a protein recently involved in neuronal differentiation. These data suggest that the exposure to I-Hg impairs cell differentiation, and point to new potential targets of Hg toxicity such as APP and NO signaling.

Biomarkers of mercury toxicity: Past, present, and future trends

Mercury (Hg) toxicity continues to represent a global health concern. Given that human populations are mostly exposed to low chronic levels of mercurial compounds (methylmercury through fish, mercury vapor from dental amalgams, and ethylmercury from vaccines), the need for more sensitive and refined tools to assess the effects and/or susceptibility to adverse metal-mediated health risks remains. Traditional biomarkers, such as hair or blood Hg levels, are practical and provide a reliable measure of exposure, but given intra-population variability, it is difficult to establish accurate cause-effect relationships. It is therefore important to identify and validate biomarkers that are predictive of early adverse effects prior to adverse health outcomes becoming irreversible. This review describes the predominant biomarkers used by toxicologists and epidemiologists to evaluate exposure, effect and susceptibility to Hg compounds, weighing on their advantages and disadvantages. Most importantly, and in light of recent findings on the molecular mechanisms underlying Hg-mediated toxicity, potential novel biomarkers that might be predictive of toxic effect are presented, and the applicability of these parameters in risk assessment is examined.

Chemical Speciation of Selenium and Mercury as Determinant of Their Neurotoxicity

The antagonism of mercury toxicity by selenium has been well documented. Mercury is a toxic metal, widespread in the environment. The main target organs (kidneys, lungs, or brain) of mercury vary depending on its chemical forms (inorganic or organic). Selenium is a semimetal essential to mammalian life as part of the amino acid selenocysteine, which is required to the synthesis of the selenoproteins. This chapter has the aim of disclosing the role of selenide or hydrogen selenide (Se^-2 or HSe^-) as central metabolite of selenium and as an important antidote of the electrophilic mercury forms (particularly, Hg²⁺ and MeHg). Emphasis will be centered on the neurotoxicity of electrophile forms of mercury and selenium. The controversial participation of electrophile mercury and selenium forms in the development of some neurodegenerative disease will be briefly presented. The potential pharmacological use of organoseleno compounds (Ebselen and diphenyl diselenide) in the treatment of mercury poisoning will be considered. The central role of thiol (-SH) and selenol (-SeH) groups as the generic targets of electrophile mercury forms and the need of new in silico tools to guide the future biological researches will be commented.

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.

Gold Mining in Ecuador: A Cross-Sectional Assessment of Mercury in Urine and Medical Symptoms in Miners from Portovelo/Zaruma

Mercury is a toxic metal and is used in small scale gold mining. In Portovelo, Ecuador, mercury has been an environmental and health problem for decades. The target of this study was to assess the mercury concentration in the urine of miners from Portovelo/Zaruma to establish a prevalence of high values. Eight hundred and sixty-five (865) urine samples were collected and analysed for their mercury content, using cold vapor atom absorption spectroscopy. The prevalence of high mercury values (>25 μg/L) was estimated. Forty-four (44) miners with mercury levels >15 μg/L filled in a questionnaire for characteristics and possible confounders, and were examined for intoxication symptoms to establish the ten points medical score sum. The median urine value was 1.8 μg/L; 78.3% of miners were below 7 μg/L and were not at risk of an intoxication, whereas 5.9% of miners exceeded the limit of 25 μg/L and were probable to experience intoxication symptoms. The medical score sum had a range of 2 to 8 points with a median of 6. The low prevalence of high mercury concentrations shows that the politics and techniques to eliminate the use of mercury are being successfully implemented. Further studies are needed to identify factors enabling this process.

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.

Mechanisms involved in the transport of mercuric ions in target tissues

Mercury exists in the environment in various forms, all of which pose a risk to human health. Despite guidelines regulating the industrial release of mercury into the environment, humans continue to be exposed regularly to various forms of this metal via inhalation or ingestion. Following exposure, mercuric ions are taken up by and accumulate in numerous organs, including brain, intestine, kidney, liver, and placenta. In order to understand the toxicological effects of exposure to mercury, a thorough understanding of the mechanisms that facilitate entry of mercuric ions into target cells must first be obtained. A number of mechanisms for the transport of mercuric ions into target cells and organs have been proposed in recent years. However, the ability of these mechanisms to transport mercuric ions and the regulatory features of these carriers have not been characterized completely. The purpose of this review is to summarize the current findings related to the mechanisms that may be involved in the transport of inorganic and organic forms of mercury in target tissues and organs. This review will describe mechanisms known to be involved in the transport of mercury and will also propose additional mechanisms that may potentially be involved in the transport of mercuric ions into target cells.

Mercury and neuromotor function among children in a rural town in Chile

BACKGROUND

Mercury (Hg) exposure from artisanal gold mining has adverse effects on the neuromotor function in adults. However, few studies have examined this relationship in children.

OBJECTIVES

To investigate the impact of Hg exposure on children's neuromotor function.

METHODS

Cross-sectional data on Hg risk factors and demographics were collected from n = 288 children (response = 68.9%). Based on complete cases (CCs) (n = 130) and multiple imputations (n = 288), associations between fingernail Hg and four different neuromotor function components were calculated using multiple logistic regression adjusted for confounders.

RESULTS

Of the children, 11.1, 14.9, 63.9, and 10.4% had pathologic pure motor skills, adaptive fine motor skills, adaptive gross motor skills, and static balance, respectively. No significant association between fingernail Hg and any neuromotor component was found. However, Hg burning in the household was significantly associated with children's pathologic pure motor skills (OR 3.07 95% CI 1.03-9.18).

CONCLUSION

Elemental Hg exposure in the household might have adverse long-term effects on children's pure motor skills.

Introduction of Mercury-free Gold Extraction Methods to Medium-Scale Miners and Education of Health Care Providers to Reduce the use of Mercury in Sorata, Bolivia

BACKGROUND

Artisanal and small-scale miners in Bolivia release on the order of 120 tons of mercury annually. The mercury finds its way to the Amazon with catastrophic consequences for the biosphere. A project aimed at reducing the release of mercury was carried out in 2013 and 2014.

OBJECTIVES

The project had two objectives: to test whether the mercury-free gold extraction method could be an alternative to whole ore amalgamation in medium-scale mining in Bolivia and to teach mercury toxicology to health care providers in the gold mining area. The mercury-free gold extraction method has been successfully introduced in other countries, but mainly in very small-scale mining communities.

MATERIALS AND METHODS

The targets in Bolivia were medium-scale miners processing over a hundred tons of ore per day. The chosen gold ores proved amenable to gold extraction using mercury-free extraction. Demonstrations of the mercury-free methods were carried out by processing similar quantities of gold ores using the amalgamation and the mercury-free method.Miners, mining communities and local health providers were informed on the toxicity of mercury. Health providers were shown how to conduct epidemiological surveillance. Posters explaining the path of mercury from the processing stations to local households were prepared.

CONCLUSIONS

The gold ores tested during the project proved amenable to mercury-free gold extraction using borax smelting. The miners also realized that gold recovery increased when performing mercury-free gold extraction. The miners decided to stop using mercury and a follow-up project cleaned their mining equipment for mercury and modified the processing lines. The health care providers were also successfully trained.

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.

Mercury Pollution from Small-Scale Gold Mining Can Be Stopped by Implementing the Gravity-Borax Method--A Two-Year Follow-Up Study from Two Mining Communities in the Philippines

Mercury is used globally to extract gold in artisanal and small-scale gold mining. The mercury-free gravity-borax method for gold extraction was introduced in two mining communities using mercury in the provinces Kalinga and Camarines Norte. This article describes project activities and quantitative changes in mercury consumption and analyzes the implementation with diffusion of innovations theory. Activities included miner-to-miner training; seminars for health-care workers, school teachers, and children; and involvement of community leaders. Baseline (2011) and follow-up (2013) data were gathered on mining practices and knowledge about mercury toxicology. Most miners in Kalinga converted to the gravity-borax method, whereas only a few did so in Camarines Norte. Differences in the nature of the social systems impacted the success of the implementation, and involvement of the tribal organization facilitated the shift in Kalinga. In conclusion, the gravity-borax method is a doable alternative to mercury use in artisanal and small-scale gold mining, but support from the civil society is needed.

A Comparative Land Use-Based Analysis of Noise Pollution Levels in Selected Urban Centers of Nigeria

Growth in the commercialization, mobility and urbanization of human settlements across the globe has greatly exposed world urban population to potentially harmful noise levels. The situation is more disturbing in developing countries like Nigeria, where there are no sacrosanct noise laws and regulations. This study characterized noise pollution levels in Ibadan and Ile-Ife, two urban areas of Southwestern Nigeria that have experienced significant increases in population and land use activities. Eight hundred noise measurements, taken at 20 different positions in the morning, afternoon, and evening of carefully selected weekdays, in each urban area, were used for this study. Findings put the average noise levels in the urban centers at between 53 dB(A) and 89 dB (A), a far cry from the World Health Organization (WHO) permissible limits in all the land use types, with highest noise pollution levels recorded for transportation, commercial, residential and educational land use types. The result of the one-way ANOVA test carried out on the dependent variable noise and fixed factor land use types reveals a statistically significant mean noise levels across the study area (F(3,34) = 15.13, p = 0.000). The study underscores noise pollution monitoring and the urgent need to control urban noise pollution with appropriate and effective policies.