Health survey among people living near an abandoned mine. A case study: Jales mine, Portugal

Human Biomonitoring of Selected Hazardous Compounds in Portugal: Part I-Lessons Learned on Polycyclic Aromatic Hydrocarbons, Metals, Metalloids, and Pesticides

Human biomonitoring (HBM) data provide information on total exposure regardless of the route and sources of exposure. HBM studies have been applied to quantify human exposure to contaminants and environmental/occupational pollutants by determining the parent compounds, their metabolites or even their reaction products in biological matrices. HBM studies performed among the Portuguese population are disperse and limited. To overcome this knowledge gap, this review gathers, for the first time, the published Portuguese HBM information concerning polycyclic aromatic hydrocarbons (PAHs), metals, metalloids, and pesticides concentrations detected in the urine, serum, milk, hair, and nails of different groups of the Portuguese population. This integrative insight of available HBM data allows the analysis of the main determinants and patterns of exposure of the Portuguese population to these selected hazardous compounds, as well as assessment of the potential health risks. Identification of the main difficulties and challenges of HBM through analysis of the enrolled studies was also an aim. Ultimately, this study aimed to support national and European policies promoting human health and summarizes the most important outcomes and lessons learned through the HBM studies carried out in Portugal.

Respiratory Health in a Community Living in Close Proximity to Gold Mine Waste Dumps, Johannesburg, South Africa

The effects on respiratory health in populations living close to silica-rich gold mine dumps are unknown. This pilot study related respiratory health and exposure to mine dump dust using two measures of exposure: exposure group, based on distance lived from the mine dump-high (n = 93) (home <500 m from a mine dump), moderate (n = 133) (500-1.5 km), and low (n = 84) (>15 km, control group); and cumulative exposure index (CEI) derived from exposure group and number of years of residence in each exposure group. Participants were interviewed about respiratory symptoms and had chest X-rays and spirometry. We adjusted for key respiratory confounders. No subject had radiological features of silicosis. The high relative to low exposure group had significantly elevated adjusted odds ratios (aORs) for upper respiratory symptoms (aOR: 2.76, 95% CI: 1.28-5.97), chest wheezing (aOR: 3.78; 95% CI: 1.60-8.96), and spirometry-diagnosed chronic obstructive pulmonary disease (COPD) (aOR: 8.17; 95%CI: 1.01-65.85). These findings were similar for the high relative to medium exposure group, but no significant associations were found for the medium versus low exposure group. Chronic bronchitis and tuberculosis risks did not differ significantly among groups. CEI and exposure group produced similar results. In conclusion, residents residing <500 m from mine dumps had elevated adverse respiratory health effects.

Chronic respiratory disease among the elderly in South Africa: any association with proximity to mine dumps?

BACKGROUND

There is increasing evidence that environmental factors such as air pollution from mine dumps, increase the risk of chronic respiratory symptoms and diseases. The aim of this study was to investigate the association between proximity to mine dumps and prevalence of chronic respiratory disease in people aged 55 years and older.

METHODS

Elderly persons in communities 1-2 km (exposed) and 5 km (unexposed), from five pre-selected mine dumps in Gauteng and North West Province, in South Africa were included in a cross-sectional study. Structured interviews were conducted with 2397 elderly people, using a previously validated ATS-DLD-78 questionnaire from the British Medical Research Council.

RESULTS

Exposed elderly persons had a significantly higher prevalence of chronic respiratory symptoms and diseases than those who were unexposed., Results from the multiple logistic regression analysis indicated that living close to mine dumps was significantly associated with asthma (OR = 1.57; 95% CI: 1.20 - 2.05), chronic bronchitis (OR = 1.74; 95 CI: 1.25 - 2.39), chronic cough (OR = 2.02; 95% CI: 1.58 - 2.57), emphysema (OR = 1.75; 95% CI: 1.11 - 2.77), pneumonia (OR = 1.38; 95% CI: 1.07 - 1.77) and wheeze (OR = 2.01; 95% CI: 1.73 - 2.54). Residing in exposed communities, current smoking, ex-smoking, use of paraffin as main residential cooking/heating fuel and low level of education emerged as independent significant risk factors for chronic respiratory symptoms and diseases.

CONCLUSION

This study suggests that there is a high level of chronic respiratory symptoms and diseases among elderly people in communities located near to mine dumps in South Africa.

Mine dumps, wheeze, asthma, and rhinoconjunctivitis among adolescents in South Africa: any association?

The study investigated the association between community proximity to mine dumps, and current wheeze, rhinoconjunctivitis, and asthma among adolescents. This study was conducted during May-November 2012 around five mine dumps in South Africa. Communities in close proximity to mine dumps had an increased likelihood of current wheeze OR 1.38 (95 % CI: 1.10-1.71), rhinoconjunctivitis OR 1.54 (95 % CI: 1.29-1.82), and a protective association with asthma OR 0.29 (95 % CI: 0.23-0.35). Factors associated with health outcomes included other indoor and outdoor pollution sources. Wheeze and rhinoconjunctivitis appear to be a public health problem in these communities. The findings of this study serve as a base for further detailed epidemiological studies for communities in close proximity to the mine dumps e.g. a planned birth cohort study.

[Study of self-reported health of people living near point sources of environmental pollution: a review. Second part: analysis of results and perspectives]

BACKGROUND

Epidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. This second part presents the results of the studies.

METHODS

Based on a literature review (51 papers), this article presents an analysis of the contribution of self-reported health to epidemiological studies investigating local sources of environmental pollution. It discusses the associations between self-reported health and exposure variables, and other risk factors that can influence health reporting.

RESULTS

Studies using self-reported health showed that local sources can be associated with a wide range of health outcomes, including an impact on mental health and well-being. The perception of pollution, especially sensory information such as odors, affects self-reported health. Attitudes referring to beliefs, worries and personal behaviors concerning the source of pollution have a striking influence on reported health. Attitudes can be used to estimate the reporting bias in a biomedical approach, and also constitute the main explanatory factors in biopsychosocial studies taking into account not only the biological, physical, and chemical factors but also the psychological and social factors at stake in a situation of environmental exposure.

CONCLUSION

Studying self-reported health enables a multifactorial approach to health in a context of environmental exposure. This approach is most relevant when conducted within a multidisciplinary framework involving human and social sciences to better understand psychosocial factors. The relevance of this type of approach used as an epidemiological surveillance tool to monitor local situations should be assessed with regard to needs for public health management of these situations.

[Study of self-reported health of people living near point sources of environmental pollution: a review. First part: health indicators]

BACKGROUND

Epidemiological studies have investigated the health impacts of local sources of environmental pollution using as an outcome variable self-reported health, reflecting the overall perception interviewed people have of their own health. This work aims at analyzing the advantages and the results of this approach. A first step focused on describing the indicators.

METHODS

The literature on indicators of self-reported health was reviewed, leading to a discussion on data collection, selection of health effects, data processing, and construction of indicators.

RESULTS

The literature review concerned 51 articles. The use of self-reported health indicators allowed the studies to take into account the health concerns and complaints of populations exposed to environmental pollution. Various indicators of self-reported health were used in the studies. They measured physical, psychological and general dimensions of health. Standardized questionnaires were used less often than ad hoc questionnaires (78% of studies) developed to fit the needs of a given study. Three standardized questionnaires were used more frequently: the MOS Short-Form Health Survey (SF-36) to measure general health perceptions, the General Health Questionnaire (GHQ), and the Symptoms Checklist (SCL-90) to measure psychological distress.

CONCLUSION

The choice of self-reported health indicators is a compromise between specificity of the studied health issues within a given environment and standardization of the questionnaires used to measure them. Such standardization is necessary to ensure the validity and the reliability of the information collected across time and situations. The psychometric properties of the measuring questionnaires are rarely estimated or verified when they are used.

Blood biomonitoring of metals in subjects living near abandoned mining and active industrial areas

A human blood biomonitoring campaign to detect the environmental exposure to metals (Cd, Cu, Cr, Mn, Pb and Zn) in 265 subjects was performed in the South-Western part of Sardinia (an Italian island) that is a particular area with a great history of coal and metal mining (Pb/Zn mainly) activities and large industrial structures (as metallurgy). Subjects living near the industrial plant area had geometric means (GM) of blood Cd (0.79 μg/l), Cu (971 μg/l), Mn (12.2 μg/l), and Pb (55.7 μg/l) significantly higher than controls (Cd, 0.47 μg/l; Cu, 900 μg/l; Mn 9.98 μg/l; Pb, 26.5 μg/l) and than people living nearby the past mining sites. Subjects living next to one dismissed mine were statistically higher in blood Cu (GM, 1,022 μg/l) and Pb (GM, 41.4 μg/l) concentrations than controls. No differences were observed in people living in the different mining sites, and this might be related to the decennial disclosure of mines and the adoption of environmental remediation programmes. Some interindividual variables influenced blood biomonitoring data, as smoke and age for Cd, gender for Cu, age, sex and alcohol for Pb, and age for Zn. Moreover, blood metal levels of the whole population were similar to reference values representative of the Sardinian population and acceptably safe according to currently available health guidelines.

Assessment of exposure to heavy metals and health risks among residents near abandoned metal mines in Goseong, Korea

Metal contamination from mining activity is of great concern because of potential health risks to the local inhabitants. In the present study, we investigated the levels of Cd, Cu, As, Pb, and Zn in environmental samples and foodstuffs grown in the vicinity of the mines in Goseong, Korea, and evaluated potential health risks among local residents. Soils near the mines exceeded the soil quality standard values of Cu, As, and Zn contamination. The concentrations of Cd, Cu, Pb, and Zn in crop samples collected from the study area were significantly higher than those of the reference area. Some rice samples collected from the study area exceeded the maximum permissible level of 0.2 mg Cd/kg. The intake of rice was identified as a major contributor (≥75%) to the estimated daily intake among the residents. The average estimated daily intakes of metals were, however, below the provisional tolerable daily intake.

Biomarkers of lead exposure among a population under environmental stress

This study aimed to evaluate the relationship between blood lead and serum creatinine and blood lead and serum urea nitrogen levels as biomarkers of lead exposure from subjects living in a historic polymetallic mining area in China. Elevated levels were found for blood lead, serum creatinine, and serum urea nitrogen in the mining area with mean values at 245.65 μg/l, 74.16 μmol/l, and 12.79 mmol/l, which were significantly higher than those in the control area, respectively. Moreover, the coefficients between paired results for blood lead and serum creatinine and blood lead and serum urea nitrogen were positively statistically significant (serum creatinine vs. blood lead, r = 0.35, p < 0.05; serum urea nitrogen vs. blood lead, r = 0.48, p < 0.05). With respect to the effects of sex and age on the blood lead, serum creatinine, and serum urea nitrogen levels, data analysis revealed there was a tendency for higher blood lead, serum creatinine, and serum urea nitrogen levels in females than in males, and the levels of blood lead, serum creatinine, and serum urea nitrogen increased among older residents. We conclude that females and the older population in the mining area are more susceptible to lead exposure. Blood lead, serum creatinine, and serum urea nitrogen can be useful biomarkers of lead exposure among populations under environmental stress.

Blood lead levels of residents living around 350 abandoned metal mines in Korea

In 2007, as part of the control and prevention of environmental contamination threatening public health, the Korean Ministry of Environment planned to implement a national biomonitoring survey of three metals: lead, cadmium, and mercury in the blood of residents living near 350 abandoned metal mines known to be contaminated and as possible threats to the health of inhabitants. Thus, we investigated demographic and lifestyle variables and blood lead levels in residents living around the mines and compared them against those of control subjects. We measured the blood lead concentrations in 14,849 subjects (14,132 from nearby the 350 abandoned metal mines and 717 subjects from eight control areas). A questionnaire was provided to all subjects to determine gender, age, mining experience, period of time living in the vicinity of mines, smoking status, and personal perception of abandoned mines as a health risk. The geometric means (95% confidence intervals) of the blood lead levels of residents living around the abandoned metal mines and control areas were 3.017 (2.996-3.037 μg/dL) [female, 2.797 μg/dL (2.771-2.822 μg/dL); male, 3.330 μg/dL (3.298-3.363 μg/dL)] and 2.757 (2.677-2.837 μg/dL) [female, 2.604 μg/dL (2.506-2.700 μg/dL); male, 2.993 μg/dL (2.859-3.126 μg/dL)], respectively. Among residents of the mining areas, nonsmokers and residents who had no mining experience showed significantly lower mean blood lead levels than did smokers, past smokers, and those with mining experience. The mean blood lead concentrations of residents who expressed some concern about the abandoned mines were significantly higher than those of residents without concerns. The mean blood lead concentration of residents living around the abandoned mines was significantly higher than that of residents living in control areas as well as that of the general adult Korean population. We also confirmed that smoking is an important variable to consider, as it increases blood lead concentration.

Investigation on health effects of an abandoned metal mine

To investigate potential health risks associated with exposure to metals from an abandoned metal mine, the authors studied people living near an abandoned mine (n=102) and control groups (n=149). Levels of cadmium, copper, arsenic, lead, and zinc were measured in the air, soil, drinking water, and agricultural products. To assess individual exposure, biomarkers of each metal in blood and urine were measured. beta2-microglobulin, alpha1-microglobulin, and N-acetyl-beta-glucosaminidase and bone mineral density were measured. Surface soil in the study area showed 2-10 times higher levels of metals compared to that of the control area. Metal concentrations in the groundwater and air did not show any notable differences between groups. Mean concentrations of cadmium and copper in rice and barley from the study area were significantly higher than those of the control area (p<0.05). Geometric means of blood and urine cadmium in the study area were 2.9 microg/L and 1.5 microg/g Cr, respectively, significantly higher than those in the control area (p<0.05). There were no differences in the levels of urinary markers of early kidney dysfunction and bone mineral density. The authors conclude that the residents near the abandoned mine were exposed to higher levels of metals through various routes.