Health assessment of artisanal gold miners in Indonesia

Change in Values of Illegal Miners and Inhabitants and Reduction in Environmental Pollution after the Cessation of Artisanal and Small-Scale Gold Mining: A Case of Bunikasih, Indonesia

Artisanal and small-scale gold mining (ASGM) harms the environment and human health, because it requires mercury (Hg). Therefore, this study uses a questionnaire survey to identify the effects of the medical checkup findings, group discussion, and educational seminar on the values of illegal miners and residents in Bunikasih, Indonesia, regarding the environmental and health effects of Hg. Transdisciplinary communities of practice (TDCoP) were formed to pursue alternative livelihoods than illegal ASGM. Environmental pollution after ASGM closure was assessed. The questionnaire showed that respondents changed their views on Hg's effects and were willing to stop ASGM practices. In an environmental impact assessment study, tea leaf samples were obtained between the ASGM activity location and village housing in two periods during ASGM closure to identify the concentrations of Hg, lead, and arsenic. Their mean concentration values in Period 1 (2) were 0.54 ± 0.14, 0.66 ± 0.09, and 0.34 ± 0.12 mg kg-1 (0.08 ± 0.04, 0.34 ± 0.14, and 0.07 ± 0.06 mg kg-1), respectively, indicating a decrease in environmental pollution. In conclusion, the government-driven cessation of ASGM in the study area shows a reduction in environmental pollution, and the change in the perception of the participants regarding the ASGM and TDCoP approaches help to make these changes permanent.

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

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

Optimisation of distillation as an isolation method for the determination of low methylmercury concentrations in urine samples

Methylmercury (MeHg) speciation in urine requires a robust, reproducible and sensitive technique that enables reliable measurements in limited sample volumes. Conventional MeHg extraction by acid digestion allows for processing of only small amounts of urine digest, making accurate MeHg determination in low-concentration samples virtually impossible. Distillation has been proven as an efficient isolation method with very low detection limits for measuring MeHg in water samples; therefore, in this study, it was optimised for urine samples. Combined with aqueous phase ethylation, purging with nitrogen, preconcentration on Tenax trap, isothermal gas chromatography and cold vapour atomic fluorescence detection, distillation achieved high and repeatable urine spike recoveries of 94% ± 7%. Larger measured aliquot volume led to a significantly lower limit of detection (LOD) for distillation compared with acid digestion (1.1 versus 5.5 pg g^-1 urine). Thirty-two general population urine samples were analysed using both methods, and the results were compared. Distillation led to better separation of MeHg from inorganic Hg and the matrix. Good correlation was observed between the results obtained by the two methods for samples with MeHg concentrations above 10 pg g^-1 urine (slope = 0.9492, R² = 0.9879). For samples below this MeHg concentration, distillation was superior, enabling the measurement of MeHg in 9 out of 12 urine samples that were below the LOD of acid digestion. Distillation had significantly lower measurement uncertainty, particularly in the low-concentration samples, where the expanded combined standard uncertainty of the acid digestion method reached as high as 43.2% (k = 2), predominantly owing to poor sample repeatability.

Our evolved understanding of the human health risks of mercury

Mercury (Hg) is a chemical of health concern worldwide that is now being acted upon through the Minamata Convention. Operationalizing the Convention and tracking its effectiveness requires empathy of the diversity and variation of mercury exposure and risk in populations worldwide. As part of the health plenary for the 15th International Conference on Mercury as a Global Pollutant (ICMGP), this review paper details how scientific understandings have evolved over time, from tragic poisoning events in the mid-twentieth century to important epidemiological studies in the late-twentieth century in the Seychelles and Faroe Islands, the Arctic and Amazon. Entering the twenty-first century, studies on diverse source-exposure scenarios (e.g., ASGM, amalgams, contaminated sites, cosmetics, electronic waste) from across global regions have expanded understandings and exemplified the need to consider socio-environmental variables and local contexts when conducting health studies. We conclude with perspectives on next steps for mercury health research in the post-Minamata Convention era.

Assessment of surface water quality and mercury levels from Artisanal and small-scale gold mining (ASGM) along Acupan River, Benguet, Philippines

Artisanal and small-scale mining activities are most evident among communities surrounding the Acupan River in Itogon Benguet. The mining activities include manual extraction of gold ores, use of improvised ball/rod mills and sluice boxes, and metallurgical processing such as cyanidation, carbon-in-pulp (CIP) and amalgamation. This study evaluates the influence of small-scale mining and the geology/mineralization of the Acupan Au-Ag-Te deposit to the water quality of the Acupan River and to the possible human exposures to Hg within the small-scale mining community. Different water quality parameters were monitored along selected sites along the Acupan River for a year and the results showed that the low average values of dissolve oxygen (DO) (2.54-4.53 mg L^-1) and the relatively high average values of pH (8.84-10.10), sulfate (300.00-1133.33 mg L^-1), nitrate (11.33-134.67 mg L^-1), arsenic (As) (0.227-0.574 mg L^-1) and mercury (Hg) (0.004-0.054 mg L^-1) have exceeded the acceptable criteria limit of the Department of Environment and Natural Resources for Class C waters. The exceeded values are noted to occur in areas where extensive small-scale mining activities are being done and have affected as well the downstream areas. To test possible human contamination in the use of Hg, hair samples from 56 volunteers were analyzed for total Hg (T-Hg) following standard protocols. The T-Hg concentrations in hair samples are mostly inorganic and are determined in various parameters such as sex, geographic location, occupation, age, fish consumption and localization in hair. Though not significantly different, higher Hg values are noted in males (1.280 ± 0.446 ng mg^-1) than among females (0.651 ± 0.163 ng mg^-1) as well as those with ages 41-50 years (3.130 ± 2.330 ng mg^-1) as compared to other age groups. The higher amounts of inorganic Hg in human hairs could be attributed to the discrete yet prevalent use of amalgamation. The findings of this study emphasize the need for better regulations of the small-scale mining activities and for stricter implementation of the total ban on the use of Hg in ore processing to ensure better water quality of Acupan River as well as the health and safety of the communities surrounding the river.

A Bibliometric Analysis of the Scientific Research on Artisanal and Small-Scale Mining

Mineral resource exploitation is one of the activities that contribute to economic growth and the development of society. Artisanal and small-scale mining (ASM) is one of these activities. Unfortunately, there is no clear consensus to define ASM. However, its importance is relevant in that it represents, in some cases, the only employment alternative for millions of people, although it also significantly impacts the environment. This work aims to investigate the scientific information related to ASM through a bibliometric analysis and, in addition, to define the new lines that are tending to this field. The study comprises three phases of work: (i) data collection, (ii) data processing and software selection, and (iii) data interpretation. The results reflect that the study on ASM developed intensively from 2010 to the present. In general terms, the research addressed focuses on four interrelated lines: (i) social conditioning factors of ASM, (ii) environmental impacts generated by ASM, (iii) mercury contamination and its implication on health and the environment, and (iv) ASM as a livelihood. The work also defines that geotourism in artisanal mining areas is a significant trend of the last decade, explicitly focusing on the conservation and use of the geological and mining heritage and, in addition, the promotion of sustainable development of ASM.

Characterizing Time-Series Roving Artisanal and Small-Scale Gold Mining Activities in Indonesia Using Sentinel-1 Data

The rapid growth of roving mining camps has negatively influenced their surrounding environment. Although artisanal and small-scale gold mining (ASGM) is a major source of gold production, the mining activities and their activeness are not well revealed owing to their informal, illegal, and unregulated characteristics. This study characterizes the transformations of roving camp-type ASGM (R-C-ASGM) activities in Central of Katingan Regency, Central Kalimantan Province, Indonesia, from 2015 to 2021 using remotely sensed data, such as the time-series Sentinel-1 dataset. The results show that the growth of active R-C-ASGM sites was identified at the center of the Galangan mining region with expansions to the northwest part along the Kalanaman River, especially in 2021. Hence, these approaches identify the transformations of roving mining activities and their active or nonactive status even in tropical regions experiencing frequent heavy traffic rainstorms. They provide significant information on the socioenvironmental risks possibly caused at local and regional levels. Our results also inform the design of timely interventions suited to local conditions for strengthening environmental governance.

Investigation of Long-Term Roving Artisanal and Small-Scale Gold Mining Activities Using Time-Series Sentinel-1 and Global Surface Water Datasets

Artisanal and small-scale gold mining (ASGM) is a significant source of gold production globally despite the sector being informal and illegal. The rapid increase in the number of roving mining camps has negatively impacted the surrounding environment; however, the formation and transformation of roving mining camps have not been well studied. This study investigated the long-term trends and significant hotspots of roving camp-type ASGM (R-C-ASGM) in Katingain Regency, Central Kalimantan Province, Indonesia, from 1988 to 2020 using remotely sensed data, including Sentinel-1 time-series, global surface water (GSW), and world landcover datasets. Results show that several active R-C-ASGM sites existed in the Galangan and Kalanaman areas in 2017/2018. According to the GSW dataset, the Galangan area was estimated to be formed earlier, whereas the Kalanaman areas were recently formed and were associated with the Kalanaman river expansion. Notably, the center of Galangan was still a significant R-C-ASGM hotspot. The findings of this study broaden our understanding of R-C-ASGM transformation and identify significant R-C-ASGM hotspots over a long period. This study contributes to the development of timely and appropriate interventions for strengthening environmental governance.

Transdisciplinary Communities of Practice to Resolve Health Problems in Southeast Asian Artisanal and Small-Scale Gold Mining Communities

Artisanal and small-scale gold mining (ASGM) has been a major part of people's livelihood in the rural areas of many developing countries, including those in Southeast Asia (SEA). Nevertheless, because of the use of mercury, ASGM activities have significant local and global adverse impacts on the environment and ASGM community health. Although there have been many monodisciplinary projects by academic researchers and governments to solve the environmental and health problems in SEA ASGM communities, they have not been sufficient to solve the complex socioeconomic problems. This review first outlines the nature of the SEA ASGM activities and the consequent environmental, community health, and socioeconomic problems and then introduces an approach using transdisciplinary communities of practice that involves both academic and nonacademic participants to relieve these wicked ASGM problems and to improve the environmental governance and community health in ASGM communities in SEA.

Analysis of the Mercury Distribution in Blood as a Potential Tool for Exposure Assessment - Results from Two Artisanal and Small-Scale Gold Mining Areas in Zimbabwe

People in artisanal and small-scale gold mining (ASGM) areas are frequently exposed to high levels of mercury (Hg). Hg analyses in urine and whole blood are the gold standard of biomonitoring, although this may not provide sufficient information about the source of exposure, e.g., due to the use of Hg for gold extraction or due to nutrition. To evaluate, whether the pharmacokinetic properties of individual Hg species may be useful for exposure assessment, we determined the Hg levels in different blood components from 199 participants. Therefore, whole blood was centrifuged on-site to yield erythrocytes and plasma. Globin was isolated from the erythrocytes by precipitation with ethyl acetate. Albumin was isolated from plasma by gradual precipitation with saturated ammonium sulfate solution. Hg levels in all samples were determined by using a direct Hg analyzer. Median Hg levels for whole blood, erythrocytes, and plasma were 2.7, 3.7, and 1.3 μg/l, respectively. In globin and albumin, median Hg levels were 10.3 and 7.9 μg/kg, respectively. The distribution of Hg was strongly correlated with whole blood Hg levels (p < 0.01) and the time between the last use of Hg and the date of the participation (p < 0.01). The results suggest that the distribution of Hg in blood is substantially affected by the extent and the frequency of the exposure to elemental Hg. Therefore, the analysis of Hg in erythrocytes and plasma may be a valuable tool for Hg exposure assessment in ASGM areas.

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

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

Environmental Survey of the Distribution and Metal Contents of Pteris vittata in Arsenic-Lead-Mercury-Contaminated Gold Mining Areas along the Bone River in Gorontalo Province, Indonesia

In this paper, we report ecological and environmental investigations on Pteris vittata in the As-Pb-Hg-polluted Bone River area, Gorontalo Province, Indonesia. The density distribution of P. vittata decreases from around the artisanal and small-scale gold mining (ASGM) site to the lower reaches of the Bone River, and it is rarely found near Gorontalo City. The maximum concentrations of As, Hg, and Pb recorded in the soil samples were 401, 36, and 159 mg kg^-1, respectively, with their maximum concentrations in P. vittata recorded as 17,700, 5.2, and 39 mg kg^-1, respectively. Around the ASGM sites, the concentrations of As, Pb, and Hg in P. vittata were highest in the study area. These data suggest that P. vittata, a hyperaccumulator of As, may be useful as a bioindicator for assessing environmental pollution by Pb and Hg.

Risk Analysis Approaches to Evaluating Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries

Risk analysis offers a useful framework for evaluating and managing environmental health risks across different settings. In this Perspective, we question whether the principles and practice of risk analysis could be beneficial in the context of land-based pollution in low- and middle-income countries (LMICs) to better support risk-based decision making. Specifically, potential health and economic impacts from land-based pollution in LMICs has become an increasing issue of concern due to widespread environmental contamination from active and legacy operations, particularly informal activities that are becoming increasingly dispersed throughout communities, such as used lead acid battery recycling, artisanal and small-scale gold mining, and small-scale tanneries. However, the overall magnitude and scale of the public health problem arising from these sources remains highly uncertain and poorly characterized and cannot be compared to land-based pollution in high-income countries due to unique factors. This lack of knowledge has negatively affected the political priority and level of funding for risk mitigation actions targeting land-based pollution in these countries. Our primary objective is to raise further awareness of this emerging issue among risk analysts and decisionmakers and to advocate for more robust and focused research. Here, we highlight the types of industries and activities contributing to land-based pollution in LMICs and describe key findings and knowledge and data gaps that have hindered a fuller understanding of this issue. We also discuss how several risk assessment and risk management approaches might be useful in this resource-constrained context. We conclude that a combination of risk analysis approaches may be worthwhile, but more work is needed to determine which methods or tools will be most informative, technically feasible, and cost-effective for identifying, prioritizing, and mitigating land-based pollution in LMICs. Affected researchers, funding agencies, and local or national governments will need to work together to develop improved study designs and risk mitigation strategies.

Detection of Artisanal and Small-Scale Gold Mining Activities and Their Transformation Using Earth Observation, Nighttime Light, and Precipitation Data

The rapid growth of artificially constructed mining camps has negatively impacted the camps' surrounding environment and the informal communities that have developed inside the camps. However, artisanal and small-scale gold mining (ASGM) is generally informal, illegal, and unregulated; thus, transformations of the mining activities and potential social-environmental problems resulting from these changes are not revealed. This study assesses the transformation of mining activities in camp-type ASGM sectors in Gorontalo, Indonesia, during 2014-2020 using remotely sensed data, such as Landsat series, nighttime light, and precipitation data obtained through Google Earth Engine. Results show that the combined growth of the built-up areas increased 4.8-fold, and their annual mean nighttime light increased 3.8-fold during 2014-2019. Furthermore, diverse increases in the sizes of area and nighttime light intensity were identified from the mining camps. Among the studied camps, since 2017, Motomboto camp 3 showed a particularly rapid change in activity regardless of the season of the year. Hence, these approaches are capable of identifying rapid transformations in the mining activities and provide significant insight into the socio-environmental problems originating from the closed and vulnerable camp-based ASGM sector. Our results also contribute to developing rapid and appropriate interventions and strengthening environmental governance.

Registration status, mercury exposure biomarkers, and neuropsychological assessment of artisanal and small-scale gold miners (ASGM) from the Western Region of Ghana

The artisanal and small-scale gold mining (ASGM) sector is estimated to be the largest anthropogenic source of mercury pollution worldwide, and not surprisingly human exposures in this sector are amongst the highest of all population groups. While formalization of the sector has been proposed as a solution to help improve health and safety within ASGM sites, there are few empirical studies in support of this notion. The objective of this study was to assess if individuals working in ASGM sites that are registered have reduced mercury exposures and better neuropsychological scores than workers from unregistered sites. To achieve this objective, we studied biological samples (urine, hair) and survey data from a study of 404 ASGM workers (of which, 295 worked in registered ASGM sites) conducted in Tarkwa (Ghana) in 2014. Between miners working in registered and unregistered sites, there were few differences in socio-demographic characteristics. Median urinary mercury concentration (specific gravity-corrected) among those from unregistered mines was nearly 3-fold higher than those from the registered mines (18.5 versus 6.6 μg/L), and in the overall population the median concentration was 10.0 μg/L, and ranged from 0.3 to 2499 μg/L. Mercury biomarkers varied across ASGM work categories (e.g., those who burned or amalgamated had the highest) and users of personal protective equipment. Nearly 30% of the study population indicated having some challenges concerning, for example, reduced appetite, hair loss, or excess salivation. Ataxia and rigidity of gait were absent in most of the participants, and for those with slight, moderate, or marked responses, there were no differences between miners from registered and unregistered sites, across work groups, as well as in reference to mercury biomarker measures. For the pencil tapping, Frostig, matchbox, and Wechsler tests, no striking differences were found though a correlation was found between urinary mercury levels and matchbox scores among those who amalgamate and burn, and scores were similar to past studies using the same tests in ASGM sites. We believe this is the first study to compare mercury exposures and neuropsychological test results between miners from registered and unregistered ASGM sites. In doing so, the research findings provide the necessary evidence for stakeholders and parties of the Minamata Convention considering various response options to help fulfill their obligations.

Time-Series Assessment of Camp-Type Artisanal and Small-Scale Gold Mining Sectors with Large Influxes of Miners Using LANDSAT Imagery

Mining sites development have had a significant impact on local socioeconomic conditions, the environment, and sustainability. However, the transformation of camp-type artisanal and small-scale gold mining (ASGM) sites with large influxes of miners from different regions has not been properly evaluated, owing to the closed nature of the ASGM sector. Here, we use remote sensing imagery and field investigations to assess ASGM sites with large influxes of miners living in mining camps in Bone Bolango Regency, Gorontalo Province, Indonesia, in 1995-2020. Built-up areas were identified as indicators of transformation of camp-type ASGM sites, using the Normalized Difference Vegetation Index, from the time series of images obtained using Google Earth Engine, then correlated with the prevalent gold market price. An 18.6-fold increase in built-up areas in mining camps was observed in 2020 compared with 1995, which correlated with increases in local gold prices. Field investigations showed that miner influx also increased after increases in gold prices. These findings extend our understanding of the rate and scale of development in the closed ASGM sector and the driving factors behind these changes. Our results provide significant insight into the potential rates and levels of socio-environmental pollution at local and community levels.

Determinants of health and health needs assessment of artisanal and small-scale gold miners in Kadoma, Zimbabwe: A mixed method approach

BACKGROUND

The role of artisanal and small-scale gold mining (ASGM) as a source of income is rapidly gaining importance in the economically difficult times in Zimbabwe. Small-scale miners are now responsible for over 50% of the Zimbabwean gold production. However, the sector is still characterised by high labour-intensity, low productivity and capital, limited mechanisation and outdated technologies. Since increasing efforts in recent years to improve miners' health while reducing the exposure to mercury have not been effective, a more sustainable approach is needed to identify interventions targeting the health of artisanal and small-scale miners and the mining communities.

OBJECTIVE

The main objective of this study was the accurate and extensive empirical identification of the determinants of health in ASGM and of the miners' health needs. In tandem with these needs, topics which generate more effective, sustainable, and feasible future health interventions targeting occupational health should be identified.

METHODS

Based on the identification of determinants of health, a health needs assessment (HNA) was used to conduct miners' needs by applying a mixed methods approach and triangulation. This included qualitative and quantitative interviews with individuals, group interviews, focus group discussions, observations and informal conversations.

RESULTS

There were 85 structured and 84 semi-structured interviews, a focus group discussion, and observations conducted. Six main themes were identified around which miners' health needs can be aggregated as follows: living conditions, nutrition and hygiene; safe work environment and mining processes; financial support; health care services; formalisation and education.

DISCUSSION

The following aspects were considered most important for sustainable interventions: possible health impacts, feasibility, value for miners and their willingness to adapt. Accordingly, interventions aiming at increasing education, knowledge and awareness of miners were identified as most promising in improving occupational health.

Dried blood spots to characterize mercury speciation and exposure in a Colombian artisanal and small-scale gold mining community

The artisanal and small-scale gold mining (ASGM) sector uses the most mercury (Hg) worldwide. Despite health concerns associated with high Hg exposures in these communities, ASGM sites are often situated in resource limited and remote regions which challenge traditional human biomonitoring approaches. To help overcome such challenges, here we report on the development of a high-quality method to characterize chemical speciation of Hg in dried blood spots (DBS), and then apply this method to assess Hg exposures in people sampled from an ASGM community (Pueblito Mejia) and a nearby town (Barranco de Loba) in Colombia. We collected DBS and urine samples from 35 individuals in 2018, and used these to assess occupational (DBS inorganic Hg (InHg) and urine total Hg (THg) measures) and environmental (DBS methylmercury (MeHg) measures) exposure of participants to different forms of Hg. The accuracy and precision of the DBS-based measures generally met assay performance guideline. In study participants, the mean concentrations of DBS MeHg, InHg, and THg, and urine THg were 1.9, 4.1, 6.0, and 3.1 μg/L, respectively. For 37% of the participants, DBS THg values exceeded the 5 μg/L 'alert level' proposed by the German HBM Commission. About 60% of the blood Hg was in the InHg form thus exemplifying a need to speciate Hg in blood sampled from ASGM sites to better understand the contributions of environmental and occupational exposure sources. This study demonstrates the feasibility of using DBS for Hg speciation exposure assessments in remote and resource-limited areas such as ASGM communities.

Status of chromium accumulation in agricultural soils across China (1989-2016)

The first national-scale assessment of chromium (Cr) contamination in China's agricultural soils was performed based on 1625 sites analysed with 1799 previously published papers. Spatial and temporal variations were assessed, and the ecological risk was estimated. The range of Cr concentrations in farmland soil is 1.48-820.24 mg/kg. At approximately 4.31% and 0.12% of the sampling sites, Cr concentrations exceeded the screening value (150 mg/kg) and the control value (800 mg/kg), respectively (GB15618-2018). Cr concentrations decreased in the following order: Southwest > Northwest > East > South > Northeast > Central > North China. Moreover, the Cr accumulation rate in agricultural soils may have decreased during 2011-2016, possibly due to government-led changes in China's industrial structure and policies limiting the discharge of polluted industrial wastes. Linear correlations were observed between the application amounts of fertilizers and Cr concentrations in the soil, indicating that the application of nitrogen, phosphorus and potassium fertilizers is an important contributor of Cr in agricultural soils. Additionally, geoaccumulation index (I_geo) values for Cr showed that more than 83.4% of the sampling sites were uncontaminated, with high I_geo values distributed in some areas, especially those with mining and electroplating industries. Overall, this study details the Cr contamination status of agricultural soils in China and provides insights for policymakers enacting measures to prevent pollution.

The relationship of mercury exposure with neurological problems in artisanal gold in Makassar city

Objectives This research aims to analyse the relationship between urine mercury levels and neurological problems. Methods This research is an observational study with a cross-sectional approach. There are 44 goldsmiths in the gold jewellery small scale industry involved in this study. Urine mercury levels were measured using an atomic absorption spectrophotometer. Neurological problems were assessed by a medician. Data collected includes age, time of exposure, work duration, smoking behaviour and nutrition status of the goldsmiths which were obtained by interview. Results The results showed that the concentration of mercury in the goldsmith's urine was around 0.93-64.59 μg/L. The analysis showed that there were 63% of goldsmiths experiencing neurological problems, such as tremors (9.1%) and knee pass reflex (6.8%). The bivariate analysis showed that there is no significant relationship between the concentration of mercury (p=0.133), age (p=0.155), time of exposure (p=0.702), time of working (p=0.354), smoking behaviour (p=0.169) and nutrition status (p=0.541) with neurological problems. Conclusions The goldsmiths who had high levels of mercury in urine samples were diagnosed with at least one of the neurological symptoms. It is recommended that the goldsmith use personal protective equipment during work such as mask, glasses and gloves.

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.

Public health risk of toxic metal(loid) pollution to the population living near an abandoned small-scale polymetallic mine

Small-scale mining activities in many developing countries have caused severe environmental issues to the surrounding areas, which ultimately threatened the health of local populations. Based on detailed characterization of the local drinking water and surface soil, as well as foodstuffs, this study comprehensively assessed the public health risk of toxic metal(loid)s to the population living in three villages surrounding an abandoned small-scale polymetallic mine in southern China. The agricultural soils contained elevated levels of Cu, Zn, As, Cd, and Pb, which originated from the mining district, and as expected, the locally cultivated rice and vegetables were contaminated by As, Cd, and Pb to varying extents. Arsenic occurred in both inorganic and organic forms in the rice and vegetables, with inorganic As (i-As) accounting for 82.2% (45.4-100%) and 94.7% (65.2-100%) of the total As contents in rice and vegetables, respectively. Results of health risk assessment indicate that the residents in the impacted villages had serious non-carcinogenic and carcinogenic risk. Dietary exposure to i-As and Cd through rice and vegetable consumption was the primary cause of non-carcinogenic risk, while i-As intake was the dominant contributor of carcinogenic risk. These findings suggest that significant environmental pollution by toxic metal(loid)s could result from small-scale metal mines, even after being abandoned, and the accumulation of the toxic metal(loid)s in food crops could pose significant health risk to the local residents. Immediate actions should be taken to discourage them from consuming the locally produced food crops, while long-term control measures for containment of toxic metal(loid) pollution are being developed, and high priority should be given to the remediation of Cd and As in the contaminated soils.

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.

Infants and mothers levels of mercury in breast milk, urine and hair, data from an artisanal and small-scale gold mining area in Kadoma / Zimbabwe

In Kadoma (Zimbabwe) gold is extracted from ore based on a simple technology using mercury. Women are exposed whilst living in an exposed area, or even more working directly with mercury. Breast fed infants are exposed via mercury contaminated milk and the general environmental mercury exposure. The aim of the study was to measure infants and mothers levels of mercury in urine and hair, as well as in breast milk. In 2006, an environmental epidemiological field study with 120 mother - child pairs was conducted. A non exposed control group (n = 42) was compared with a medium exposed group (n = 51) and a high exposed group (occupational exposure, n = 27). Urine and hair samples from mother and infants plus breast milk samples were analyzed for total mercury. 120 breast milk samples were analyzed, median (maximum) concentrations [μg Hg/l] were (i) control group < 0.50 (1.55), (ii) medium exposed group 1.10 (10.48), (iii) high exposed group 1.20 (24.80) (p < 0,001). Urine and hair results were distributed similarly for infants and mothers, with higher levels according to the exposure subgroup. All specimen results correlated very well with another, indicating there is a pathway between breast milk and infant's level of mercury. The daily uptake of mercury via breast milk was calculated. The reference dose of 0.3°[μg Hg/kg BW/d] was used to compare the burden of the infants. No infant from the control group, but 17.6% of the medium and 18.5% of the high exposed group were above the reference dose. Mercury in breast milk is generally higher in artisanal and small scale gold mining areas. Breast fed infants were burdened with toxic mercury via breast milk and via the general environment, both are important public health issues.

Polymorphisms in potential mercury transporter ABCC2 and neurotoxic symptoms in populations exposed to mercury vapor from goldmining

BACKGROUND

Artisanal small-scale gold miners have high levels of mercury in human specimens often above recommended threshold values. There are differences reported in the manifestation of neurological symptoms of individuals with a comparable level of exposure to mercury, suggesting a genetic component influencing the susceptibility to mercury neurotoxicity.

OBJECTIVE

To investigate associations between polymorphisms (rs1885301, rs717620, rs2273697) in the potential Hg-transporter ABCC2 gene and neurological effects.

METHODS

968 participants from the Philippines, Indonesia, Tanzania and Zimbabwe were included in this study (age 12-59 years). For the statistical analysis the countries were categorized into Africa (Philippines, Indonesia) and Asia (Tanzania, Zimbabwe). Study participants were from three exposure groups: without mercury exposure from goldmining (n = 129); living in mercury-contaminated areas (n = 281) and mercury working exposure (n = 558). To identify chronic inorganic mercury intoxication we applied a modified neurological score sum including eight binary coded parameters (from anamnestic, clinical and neurophysiological examinations). Associations between genotype and neurological score sum, as well as between genotype and separate neurological tests (ataxia of gait, dysdiadochokinesia, ataxia heel to shin, pencil tapping test and matchbox test) were evaluated.

RESULTS

We found that ABCC2 genotype were associated with performance on certain neurological tests: for rs1885301, A-allele carriers in the African populations showed significantly worse performance than GG carriers on the pencil tapping test; whereas for rs2273697, A-allele carriers in the African and Asian populations showed a significantly better performance than GG carriers on this test. When including an interaction term between genotype and exposure subgroup, interaction effects were also seen for the pencil tapping test and matchbox tests for rs2273697 in Asia.

CONCLUSIONS

The results suggest that certain ABCC2 polymorphisms may influence the neurotoxic effects in mercury-burdened individuals. ABCC2 alleles associated with worse neurological performance in the present study. These alleles have previously been correlated with higher levels of urinary mercury concentrations in the same cohort. Taken together, these associations between ABCC2 genotype, mercury levels, and neurological effects support the hypothesis that some ABCC2 genotypes may have a higher neurotoxic potential, although further functional studies are needed to prove causation.

Concentration of mercury species in hair, blood and urine of individuals occupationally exposed to gaseous elemental mercury in Asturias (Spain) and its comparison with individuals from a control group formed by close relatives

Between November 19th, 2012 and December 3rd, 2012, 50 workers were intoxicated with gaseous Hg in San Juan de Nieva (Asturias, Spain) during the maintenance of a heat exchanger of a zinc manufacturer. We have quantified the concentration of methylmercury (MeHg), ethylmercury (EtHg) and Hg(II) in blood, hair and urine samples of those individuals taken three years after the accident. Blood, hair and urine of their closest relatives were also analyzed to assess whether the mercury burden present in the intoxicated individuals was due to the occupational exposure or to environmental or lifestyle-related factors. The determination of the mercury species in the samples was carried out applying multiple spiking Isotope Dilution GC-ICP-MS. This procedure corrects for possible interconversion reactions between the Hg species during the sample preparation procedure. Linear correlations were observed for both groups when plotting MeHg in blood vs MeHg in hair, and MeHg in hair vs Hg (II) in urine. The concentrations of Hg species in the intoxicated individuals were not significantly different from those obtained in the control group except for MeHg in blood. Significantly higher levels of MeHg in blood were obtained in some of the intoxicated individuals who had not consumed fish or seafood since the accident. A different correlation between MeHg in hair and MeHg in blood was obtained for these individuals compared to the control group who showed a hair-to-blood ratio consistent with the reported value for people exposed to Hg via fish consumption. Our results suggest that ingested MeHg followed the same pathway of deposition in hair in exposed and non-exposed individuals. However, the exposed individuals with high MeHg levels in blood showed a significantly different extent of MeHg deposition in hair compared to the control group.

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.

Mercury pollution in modern times and its socio-medical consequences

Mercury plays a critical role in serious health problems due to environmental or occupational exposures. Aquatic ecosystems are an essential component of the global biogeochemical cycle of mercury, as inorganic mercury can be converted to toxic methyl mercury in these environments and reemissions of elemental mercury rival anthropogenic mercury releases on a global scale. The history of the Minamata disease, a typical example of industrial pollution, has shown how corporate secrecy and ignorance on part of the health authorities may influence the devastating spread of environmental contamination and the progress of disease. While the Minamata Convention, in place since 2017, is aiming to lower mercury exposure and to prevent adverse effects, there are still knowledge gaps in the areas of global environmental mercury exposure. Areas of uncertainty in the global biogeochemical cycle of mercury include oxidation processes in the atmosphere, land-atmosphere and ocean-atmosphere cycling, and methylation processes in the ocean. Pollution related to climate change (especially in boreal and arctic regions), bioaccumulation and biomagnification of methyl mercury in the food chain, especially in fish and marine mammals, needs to be addressed in more detail. Information is lacking on numerous hidden contaminant exposures i.e. from globally applied traditional medicine, mercury containing skin creams and soaps, dental amalgam, ethyl mercury containing vaccines and latex paint additives, as well as on mercury releases from power plants, e-waste/fluorescent lamps, wildfire emissions, and global artisanal small-scale gold mining activities. Mercury occurs in various forms with different levels of toxicity. While much is already known and documented on the health effects of mercury, present knowledge and translation into preventive actions is still incomplete. Risks for long term health effects trough prolonged low dose exposure and trough cumulative exposures of various mercury forms should be further addressed. Preventive actions should include adequate human biomonitoring programs. Research data should be translated swiftly into management tools for local policy makers and health professionals, also paying attention at the major differences in mercury contamination across the globe.

Heavy metal pollution caused by small-scale metal ore mining activities: A case study from a polymetallic mine in South China

Although metal ore mining activities are well known as an important source of heavy metals, soil pollution caused by small-scale mining activities has long been overlooked. This study investigated the pollution of surface soils in an area surrounding a recently abandoned small-scale polymetallic mining district in Guangdong province of south China. A total of 13 tailing samples, 145 surface soil samples, and 29 water samples were collected, and the concentrations of major heavy metals, including Cr, Mn, Co, Ni, Cu, Zn, As, Cd, Pb, and Se, were determined. The results show that the tailings contained high levels of heavy metals, with Cu, Zn, As, Cd, and Pb occurring in the ranges of 739-4.15 × 10³, 1.81 × 10³-5.00 × 10³, 118-1.26 × 10³, 8.14-57.7, and 1.23 × 10³-6.99 × 10³ mg/kg, respectively. Heavy metals also occurred at high concentrations in the mine drainages (15.4-17.9 mg/L for Cu, 21.1-29.3 mg/L for Zn, 0.553-0.770 mg/L for Cd, and 1.17-2.57 mg/L for Pb), particularly those with pH below 3. The mean contents of Cu, Zn, As, Cd, and Pb in the surface soils of local farmlands were up to 7 times higher than the corresponding background values, and results of multivariate statistical analysis clearly indicate that Cu, Zn, Cd, and Pb were largely contributed by the mining activities. The surface soils from farmlands surrounding the mining district were moderately to seriously polluted, while the potential ecological risk of heavy metal pollution was extremely high. It was estimated that the input fluxes from the mining district to the surrounding farmlands were approximately 17.1, 59.2, 0.311, and 93.8 kg/ha/yr for Cu, Zn, Cd, and Pb, respectively, which probably occurred through transport of fine tailings by wind and runoff, and mine drainage as well. These findings indicate the significant need for proper containment of the mine tailings at small-scale metal ore mines.

A review of human biomonitoring in selected Southeast Asian countries

Rapid development and industrialization in Southeast (SE) Asia has led to environmental pollution, potentially exposing the general population to environmental contaminants. Human biomonitoring (HBM), measurement of chemical and/or their metabolites in human tissues and fluids, is an important tool for assessing cumulative exposure to complex mixtures of chemicals and for monitoring chemical exposures in the general population. While there are national HBM programs in several developed countries, there are no such national programs in most of the SE Asian countries. However, in recent years there has been progress in the field of HBM in many of the SE Asian countries. In this review, we present recent HBM studies in five selected SE Asian countries: Bangladesh, Indonesia, Malaysia, Myanmar and Thailand. While there is extensive HBM research in several SE Asian countries, such as Thailand, in other countries HBM studies are limited and focus on traditional environmental pollutants (such as lead, arsenic and mercury). Further development of this field in SE Asia would be benefited by establishment of laboratory capacity, improving quality control and assurance, collaboration with international experts and consortiums, and sharing of protocols and training both for pre-analytical and analytical phases. This review highlights the impressive progress in HBM research in selected SE Asian countries and provides recommendations for development of this field.

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.

A new method for quasi-reagent-free biomonitoring of mercury in human urine

A novel analytical method for sampling and extraction of mercury (Hg) from human urine is presented in this work. The method is based on selective accumulation and separation of Hg from fresh urine sample onto active nanogold-coated silica material by highly efficient solid-phase extraction. After thermal desorption of Hg from the extractant, detection is performed by atomic fluorescence spectrometry (AFS). The feasibility and validity of the optimized, quasi-reagent-free approach was confirmed by recovery experiments in spiked real urine (recovery rate 96.13 ± 5.34%) and by comparison of found Hg concentrations in real urine samples - originating from occupationally exposed persons - with values obtained from reference methods cold vapor - atomic absorption spectrometry (CVAAS) and cold vapor - atomic fluorescence spectrometry (CV-AFS). A very good agreement of the found values reveals the validity of the proposed approach. The limit of detection (LOD) was found to be as low as 0.004 μg Hg L^-1 and a high reproducibility with a relative standard deviations ≤4.2% (n = 6) is given. Moreover, storage of the samples for up to one week at an ambient temperature of 30 °C reveals no analyte losses or contamination. In conclusion, the proposed method enables easy-to-handle on-site extraction of total Hg from human urine ensuring at the same time reagent-free sample stabilization, providing quick and safe sampling, which can be performed by untrained persons.

Current Mercury Exposure from Artisanal and Small-Scale Gold Mining in Bombana, Southeast Sulawesi, Indonesia-Future Significant Health Risks

The rapid expansion of the artisanal and small-scale gold mining (ASGM) industry in developing countries has marginalized the local communities in poverty, and resulted in occupational exposure to mercury via the gold extraction process. We investigated the mercury exposure of the mining workers lived inside and outside the mining area. Based on the occupations of the contributors, the hair samples were divided into three subgroups: directly exposed, indirectly exposed, and a control. A total of 81 hair samples were analyzed by particle-induced X-ray emission spectrometry. The median mercury concentration was highest in the hair from the directly exposed group (12.82 μg/g hair) (control group median: 4.8 μg/g hair, p < 0.05), and the concentrations in hair from 45 respondents exceeded the Human Biomonitoring I (HBM I) threshold limit. Mercury concentrations were also elevated in the hair from the indirectly exposed group (median 7.64 μg/g hair, p < 0.05), and concentrations in hair from 24 respondents exceeded the HBM I threshold limits. Exposure to mercury during ASGM presents health risks and is harmful for the miners; mercury is also at hazardous levels for people who live in the mining area but who are not engaged in mercury-based gold extraction.

Mercury Distribution Along the Food Chain of a Wetland Ecosystem at Sanjiang Plain, Northeast China

Concentrations of total mercury (T-Hg) and methylmercury (MeHg) in a wetland food chain were determined at Majuan Island of the Sanjiang Plain in China. Four tissues (muscle, liver, kidney and brain) of three waterbird species (great cormorant, grey heron and great egret), muscle tissues of fish (grass carp, crucian carp and longnose gudgeon), insects (predacious diving beetle), aquatic plants (ditch reed) and soil were analyzed. The mean concentrations of T-Hg were 0.392 ± 0.237 mg/kg for tissues of all juveniles, 1.999 ± 2.053 mg/kg for great cormorant adults, and 0.029 ± 0.019 mg/kg for fish muscle, respectively. While the relative contents of T-Hg of insects, plants and sediments were 0.012 ± 0.002, 0.006 ± 0.001 and 0.020 ± 0.002 mg/kg, respectively. Bioaccumulation of Hg along the wetland food chain may be able to show the current situation of Hg contamination in remote regions of East Asia.

Mercury Human Exposure in Populations Living Around Lake Tana (Ethiopia)

A survey carried out in Lake Tana in 2015 found that Hg levels in some fish species exceeded internationally accepted safe levels for fish consumption. The current study assesses human exposure to Hg through fish consumption around the Lake Tana. Of particular interest was that a dietary intake of fishes is currently a health risk for Bihar Dar residents and anglers. Hair samples were collected from three different groups: anglers, college students and teachers, and daily laborers. A questionary includes gender, age, weight, activity. Frequency of fish consumption and origin of the eaten fish were completed by each participant. Mercury concentrations in hair were significantly higher (P value <0.05) for anglers (mean ± standard deviation 0.120 ± 0.199 μg/g) than college students (mean ± standard deviation 0.018 ± 0.039 μg/g) or daily workers (mean ± standard deviation 16 ± 9.5 ng/g). Anglers consumed fish more often than daily workers and college group. Moreover, there was also a strong correlation (P value <0.05) between the logarithms of total mercury and age associated with mercury concentration in scalp hair. Mercury concentrations in the hair of men were on average twice the value of the women. Also, users of skin lightening soap on a daily basis had 2.5 times greater mercury in scalp hair than non-users. Despite the different sources of mercury exposure mentioned above, the mercury concentrations of the scalp hair of participants of this study were below levels deemed to pose a threat to health.

Current progress on understanding the impact of mercury on human health

Mercury pollution and its impacts on human health is of global concern. The authors of this paper were members of the Plenary Panel on Human Health in the 12th International Conference on Mercury as a Global Pollutant held in Korea in June 2015. The Panel was asked by the conference organizers to address two questions: what is the current understanding of the impacts of mercury exposure on human health and what information is needed to evaluate the effectiveness of the Minamata Convention in lowering exposure and preventing adverse effects. The authors conducted a critical review of the literature published since January 2012 and discussed the current state-of-knowledge in the following areas: environmental exposure and/or risk assessment; kinetics and biomonitoring; effects on children development; effects on adult general populations; effects on artisanal and small-scale gold miners (ASGM); effects on dental workers; risk of ethylmercury in thimerosal-containing vaccines; interactions with nutrients; genetic determinants and; risk communication and management. Knowledge gaps in each area were identified and recommendations for future research were made. The Panel concluded that more knowledge synthesis efforts are needed to translate the research results into management tools for health professionals and policy makers.

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.

Economic implications of mercury exposure in the context of the global mercury treaty: Hair mercury levels and estimated lost economic productivity in selected developing countries

Several developing countries have limited or no information about exposures near anthropogenic mercury sources and no studies have quantified costs of mercury pollution or economic benefits to mercury pollution prevention in these countries. In this study, we present data on mercury concentrations in human hair from subpopulations in developing countries most likely to benefit from the implementation of the Minamata Convention on Mercury. These data are then used to estimate economic costs of mercury exposure in these communities. Hair samples were collected from sites located in 15 countries. We used a linear dose-response relationship that previously identified a 0.18 IQ point decrement per part per million (ppm) increase in hair mercury, and modeled a base case scenario assuming a reference level of 1 ppm, and a second scenario assuming no reference level. We then estimated the corresponding increases in intellectual disability and lost Disability-Adjusted Life Years (DALY). A total of 236 participants provided hair samples for analysis, with an estimated population at risk of mercury exposure near the 15 sites of 11,302,582. Average mercury levels were in the range of 0.48 ppm-4.60 ppm, and 61% of all participants had hair mercury concentrations greater than 1 ppm, the level that approximately corresponds to the USA EPA reference dose. An additional 1310 cases of intellectual disability attributable to mercury exposure were identified annually (4110 assuming no reference level), resulting in 16,501 lost DALYs (51,809 assuming no reference level). A total of $77.4 million in lost economic productivity was estimated assuming a 1 ppm reference level and $130 million if no reference level was used. We conclude that significant mercury exposures occur in developing and transition country communities near sources named in the Minamata Convention, and our estimates suggest that a large economic burden could be avoided by timely implementation of measures to prevent mercury exposures.

Analysis of Artisanal Small-scale Gold Mining Sector in West Sumbawa Regency, Indonesia

BACKGROUND

The high value of gold reserves in West Sumbawa Regency (WSR) and West Nusa Tenggara Province, Indonesia has resulted in an increase in small-scale gold mining activity in this area. Artisanal and small-scale gold mining (ASGM) is an attractive alternative livelihood for rural workers because it has good potential to improve the wealth of a community. Miners need very little training to mine gold and the transition from traditional farming or fishing is easy to make. However, the key environmental consequence of ASGM in West Sumbawa is the extensive use of mercury and its impact on human health.

OBJECTIVES

The ASGM activity in WSR is quite recent when compared to other ASGM activity in Indonesia. The current study was conducted to better understand the lifestyle, extent of mercury exposure, and the health of people living in WSR, West Nusa Tenggara Province, Indonesia.

METHODS

The present study was designed as a purposive field sampling study conducted in WSR, West Nusa Tenggara Province, Indonesia. The subjects were miners and families from three different sites within the WSR: individuals directly exposed to mercury, indirectly exposed individuals and non-exposed individuals. Hair mercury analysis was done with all subjects. Health questionnaires, physical examinations and socio-economic surveys were conducted with exposed subjects.

RESULTS

The ASGM sector in the WSR consists of a high number of migrant workers who have a great economic impact on the local area, high mercury use, a great deal of illegal mercury trading, and a high mercury concentration (>13 mg/kg) in their hair. The results suggest that ASGM activities affect the health of exposed and indirectly exposed individuals.

CONCLUSIONS

The current scale of ASGM activity in the WSR is predicted to rise. ASGM activities in the WSR is an important challenge that needs to be addressed.

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.

A preliminary study on health effects in villagers exposed to mercury in a small-scale artisanal gold mining area in Indonesia

Cisitu is a small-scale gold mining village in Indonesia. Mercury (Hg) is used to extract gold from ore, heavily polluting air, soil, fish and rice paddy fields with Hg. Rice in Cisitu is burdened with mercury. The main staple food of the inhabitants of Cisitu is this polluted rice. Villagers were concerned that the severe diseases they observed in the community might be related to their mining activities, including high mercury exposure. Case report of the medical examinations and the mercury levels in urine and hair of 18 people with neurological symptoms. Typical signs and symptoms of chronic mercury intoxication were found (excessive salivation, sleep disturbances, tremor, ataxia, dysdiadochokinesia, pathological coordination tests, gray to bluish discoloration of the oral cavity and proteinuria). Mercury levels in urine were increased in eight patients (>7µg Hg/L urine). All 18 people had increased hair levels (>1µg Hg/g hair). 15 patients exhibited several, and sometimes numerous, symptoms in addition to having moderately to highly elevated levels of mercury in their specimens. These patients were classified as intoxicated. The situation in Cisitu is special, with rice paddy fields being irrigated with mercury-contaminated water and villagers consuming only local food, especially mercury-contaminated rice. Severe neurological symptoms and increased levels of mercury in urine and hair support are possibly caused by exposure to inorganic mercury in air, and the consumption of mercury-contaminated fish and rice. The mercury exposure needs to be reduced and treatment provided. Further research is needed to test the hypothesis that mercury-contaminated rice from small-scale gold mining areas might cause mercury intoxication.

No effect of mercury exposure on kidney function during ongoing artisanal gold mining activities in Colombia

This cross-sectional study examined whether people who are exposed to mercury (Hg) vapours in ongoing artisanal gold mining activities have alteration in kidney function monitoring parameters. The study enrolled 164 miners and 127 participant controls. The Hg concentrations for miners and control participants were measured in blood (B-Hg; median 7.0 vs. 2.5 µg/L), urine (U-Hg; median 3.9 vs. 1.5 µg/g creatinine) and hair (H-Hg; median 0.8 vs. 0.4 µg/g hair). The biomarkers of renal function were creatinine, albumin and excretion of β-2 microglobulin. Glomerular filtration rate (eGFR) was calculated using the chronic kidney disease epidemiology collaboration equation. Significant statistical differences were found in Hg concentrations and eGFR levels between the two study groups ( p < 0.01) but not with the other biomarkers of renal function. A multiple regression model was applied to explore the relationship of eGFR levels and Hg concentrations. However, no association was found between the prevalence of reduced eGFR (<71.96 mL/min/1.73 m²) and the B-Hg or U-Hg levels after adjustment for covariates. Nevertheless, it was observed that having B-Hg levels above 10 µg Hg/L decreased the eGFR by 1.7 mL/min/1.73 m² (confidence interval 95% -5.1 to 1.7) compared to having levels below 2.0 µg Hg/L. Our results found no support for kidney damage associated with Hg vapour exposure in ongoing artisanal gold mining, whose population has a level of Hg exposure from low to moderate (B-Hg from 3.4 to 11.0 µg/L and U-Hg from 1.3 to 9.6 µg/g creatinine).

Disease profile and health-related quality of life (HRQoL) using the EuroQol (EQ-5D + C) questionnaire for chronic metallic mercury vapor intoxication

Background

Toxic mercury is still being used today for example by workers mining gold, resulting in diverse health symptoms in users and individuals in proximity. A considerable burden of disease (BoD) can be assumed, while previous analyses were limited by data scarcity. Besides limited epidemiological data, neither data about the health-related quality of life (HRQoL) nor about the disease severity (disability weight, DW) is available. The aim of the project was to develop disease profiles of chronic metallic mercury vapor intoxication (CMMVI) by including the HRQoL to improve the data basis for BoD analyses of gold miners exposed to mercury.

Methods

Disease profiles comprising the disease label [a], differentiation into disease stages [b], description of the cause of exposure [c], a list of common symptoms [d], and an assessment of the HRQoL [e] were developed using expert elicitation and literature search. The HRQoL was assessed by experts using the five EuroQol dimensions accompanied by the cognition add-on questionnaire (EQ-5D + C).

Results

The ten sources used for the analyses (interview transcript, presentation, and eight literature reviews) identified more than 250 terms describing 85 distinguishable health effects of CMMVI. The analysis revealed 29 common symptoms that were frequently mentioned. Moderate and severe CMMVI cases differ regarding their symptoms and/or symptom severity and HRQoL, resulting in the EQ-5D + C-3L codes 121222 and 233333, respectively.

Conclusions

The profiles should be used to facilitate the ascertainment of CMMVI cases, to compare the HRQoL with other diseases, to derive DWs for improving BoD estimates, and to foster discussions about how to reduce the associated burden.

Electronic supplementary material

The online version of this article (doi:10.1186/s12955-015-0388-0) contains supplementary material, which is available to authorized users.

Sources of Mercury Exposure to Children in Low- and Middle-Income Countries

BACKGROUND

Many children in low- and middle-income countries face enhanced risks of exposure to contaminants via the environment, parental occupation, and other routes. While mercury (Hg) is a global pollutant whose transport properties allow it to have an impact even in pristine areas, the presence of significant Hg sources in the developing world can cause localized effects that are more severe than those observed in other areas.

OBJECTIVES

This paper provides a narrative review of sources of Hg exposure to people in the developing world with a particular focus on children, and presents an overview of key aspects to this important issue.

METHODS

We searched Web of Knowledge and Google Scholar using keywords including combinations of "mercury" and one or more of the following: "children," "exposure," "breast milk," "artisanal mining," "prenatal," "religion," "medicine," "dental amalgam," "chlor-alkali," "VCM," "vaccine," "e-waste," "industry," "beauty," "cosmetics," "strategies," "child labor," "costs," and "developing countries" to find peer-reviewed articles pertaining to Hg exposure in the developing world.

RESULTS

Sources of Hg exposure include mining, consumption, industrial operations, religious practices, traditional medicines, beauty products, vaccines, dental amalgams, and waste scavenging and recycling.

CONCLUSION

Children in the developing world are often subject to higher levels of Hg exposure than those living in developed countries due to the higher prevalence of Hg-intensive industrial processes and consumer products, lack of environmental regulation, and limits in mobility and food choices, among other factors. This issue can be addressed through additional research to fill in data gaps on exposure sources, establish sound and enforceable policies, and increase education and participation in affected communities. Challenges to addressing this problem include limited resources for needed equipment, training, and manpower to implement solutions.