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Landrigan P, Bose-O'Reilly S, Elbel J, Nordberg G, Lucchini R, Bartrem C, Grandjean P, Mergler D, Moyo D, Nemery B, von Braun M, Nowak D. Reducing disease and death from Artisanal and Small-Scale Mining (ASM) - the urgent need for responsible mining in the context of growing global demand for minerals and metals for climate change mitigation. Environ Health 2022; 21:78. [PMID: 36028832 PMCID: PMC9412790 DOI: 10.1186/s12940-022-00877-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 06/27/2022] [Indexed: 06/15/2023]
Abstract
Artisanal and small-scale mining (ASM) takes place under extreme conditions with a lack of occupational health and safety. As the demand for metals is increasing due in part to their extensive use in 'green technologies' for climate change mitigation, the negative environmental and occupational consequences of mining practices are disproportionately felt in low- and middle-income countries. The Collegium Ramazzini statement on ASM presents updated information on its neglected health hazards that include multiple toxic hazards, most notably mercury, lead, cyanide, arsenic, cadmium, and cobalt, as well as physical hazards, most notably airborne dust and noise, and the high risk of infectious diseases. These hazards affect both miners and mining communities as working and living spaces are rarely separated. The impact on children and women is often severe, including hazardous exposures during the child-bearing age and pregnancies, and the risk of child labor. We suggest strategies for the mitigation of these hazards and classify those according to primordial, primary, secondary, and tertiary prevention. Further, we identify knowledge gaps and issue recommendations for international, national, and local governments, metal purchasers, and employers are given. With this statement, the Collegium Ramazzini calls for the extension of efforts to minimize all hazards that confront ASM miners and their families.
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Affiliation(s)
- Philip Landrigan
- Program for Global Public Health and the Common Good, Global Observatory on Planetary Health, Boston College, Boston, USA.
- Centre Scientifique de Monaco, Monaco City, Monaco.
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Johanna Elbel
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
| | - Gunnar Nordberg
- Department of Public Health and Clinical Medicine, Umea University, Umea, Sweden
| | - Roberto Lucchini
- Institute of Occupational Health, University of Brescia, Brescia, Italy
| | - Casey Bartrem
- TerraGraphics International Foundation, Moscow, ID 83843, USA
| | - Philippe Grandjean
- Department of Environmental Health, Harvard T. H. Chan School of Public Health, Cambridge, MA, USA
| | - Donna Mergler
- Centre de recherche interdisciplinaire sur le bien-être, la santé, la société et l'environnement (Center for Interdisciplinary Research in Health, Wellbeing, Society and Environment, Université du Québec à Montréal, Montreal, QC, Canada
| | - Dingani Moyo
- School of Public Health, Faculty of Health Sciences, Occupational Health Division, University of the Witwatersrand, Johannesburg, Republic of South Africa
- Department of Community Medicine, Faculty of Medicine and Health, National University of Science and Technology, Bulawayo, Zimbabwe
- Department of Community Medicine, Faculty of Medicine and Health, Midlands State University, Gweru, Zimbabwe
| | - Benoit Nemery
- Centre for Environment and Health, Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
| | - Margrit von Braun
- TerraGraphics International Foundation, Moscow, ID 83843, USA
- Environmental Science Program, University of Idaho, Moscow, ID 83843, USA
| | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, University Hospital, LMU Munich, Munich, Germany
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Aram SA. Assessing the effect of working conditions on routine medical checkup among artisanal goldminers in Ghana. Heliyon 2021; 7:e07596. [PMID: 34355093 PMCID: PMC8321921 DOI: 10.1016/j.heliyon.2021.e07596] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/06/2021] [Accepted: 07/13/2021] [Indexed: 11/18/2022] Open
Abstract
The socio-economic impacts of unforeseen health challenges among mine workers cannot be overemphasized. Due to the nature of artisanal mining in Ghana, workers are responsible for their own health care. This, however, necessitates the need for insight into the dynamics of self-care among artisanal miners. A cross-sectional survey of 500 artisanal gold miners was conducted to explore the relationship between working conditions of artisanal miners and voluntarily going for routine medical checkup, even in the absence of the right support systems, using a nested binary logistic regression. All the working condition variables were robust in predicting routine medical checkup in all three models. In this case, goldminers who reported good health, safety and environmental conditions were more likely to go for routine medical checkup as compared to their co-workers who reported poor health, safety and environmental conditions. Contrariwise, miners who reported good economic conditions were less likely to go for routine medical checkup as compared to their counterparts who reported poor economic conditions. Also, routine medical checkup was less likely among artisanal miners who did not protect themselves at work and had experienced work related health challenges. For the compositional factors, miners who had senior high school education were more likely to go for routine medical checkup as compared to those with no formal education. Likewise, older miners were more probable to go for routine medical checkup as compared to their younger counterparts. At the contextual level, miners who worked on shift regime and miners who worked in non-production departments were more likely to go for routine medical checkup. The outcome of this study provides insight into the dynamics of self-care amongst artisanal miners and how best to possibly improve it in an attempt to maintain a healthy workforce and its cascading effects. To increase consciousness of self-health care in artisanal mining, there is the need for a national dialogue on how to improve the working conditions of artisanal miners in Ghana.
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Affiliation(s)
- Simon Appah Aram
- Department of Environmental Science, University of Cape Coast, Ghana
- College of Safety and Emergency Management Engineering, Taiyuan University of Technology, Taiyuan 030024, People's Republic of China
- Corresponding author.
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Becker J, Furu P, Singo J, Shoko D, Elbel J, Bose-O'Reilly S, Steckling-Muschack N. Determinants of health and health needs assessment of artisanal and small-scale gold miners in Kadoma, Zimbabwe: A mixed method approach. ENVIRONMENTAL RESEARCH 2021; 197:111081. [PMID: 33775681 DOI: 10.1016/j.envres.2021.111081] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 06/12/2023]
Abstract
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.
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Affiliation(s)
- Jana Becker
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, Munich, Germany
| | - Peter Furu
- University of Copenhagen, Department of Public Health, Copenhagen, Denmark
| | - Josephine Singo
- National University of Science and Technology, Bulawayo, Zimbabwe
| | | | - Johanna Elbel
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, Munich, Germany; Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands
| | - Stephan Bose-O'Reilly
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, Munich, Germany; Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall I. T., Austria.
| | - Nadine Steckling-Muschack
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, Munich, Germany; Department of Public Health, Health Services Research and Health Technology Assessment, UMIT - Private University for Health Sciences, Medical Informatics and Technology, Hall I. T., Austria
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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. Health Qual Life Outcomes 2020; 18:284. [PMID: 32811504 PMCID: PMC7437047 DOI: 10.1186/s12955-020-01530-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2019] [Accepted: 08/06/2020] [Indexed: 11/28/2022] Open
Abstract
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.
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