Integrated assessment of artisanal and small-scale gold mining in Ghana--part 1: human health review

Assessing inclusiveness for indigenous communities in mineral rights allocation in Ghana

Ghana is blessed with an abundance of mineral resources. These mineral resources are situated in indigenous communities, but the ownership is vested in the government. Indigenous communities where these resources are located are mostly marginalized. Significant legal reforms have been implemented to ensure the inclusivity of these indigenous communities in allocating mineral rights, yet the problem persists. This research investigates the legal framework that governs the allocation of mineral rights in Ghana and the impact thereof on the empowerment of indigenous communities, bringing attention to the difficulties that indigenous communities must overcome to have access to and benefit from mineral resources. To this end, one hundred and eight (108) documents, including legislations and reports on mineral rights allocation in Ghana, were analyzed using thematic analysis. The study found that the current legal framework is deficient in providing sufficient protection for the rights of indigenous communities. Specifically, the absence of a workable scheme for mineral rights allocation from various stakeholders to these indigenous communities is an identifiable lapse in the current legal framework. The findings of this research are relevant to policymakers, legal practitioners, and other stakeholders to improve the rights and well-being of indigenous communities following the analysis of the legal complexities and implications associated with the allocation of mining rights distribution of ensuing royalties inter alia expounded in this paper.

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

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

Persistent organic pollutants and heavy metals in Ghanaian environment: a systematic review of food safety implications

Advances in industrial and technological innovations have led to significant socio-economic benefits, but with overwhelming negative impacts on the environment. These impacts include the infiltration of organic contaminants into soil, water, and air, posing a threat to the environment and public health. Polybrominated diphenyl ethers (PBDEs), heavy metals, and polycyclic aromatic hydrocarbons (PAHs) are increasingly released as waste, endangering the environment. In countries like Ghana, where regulations are weakly enforced, industrial waste is released uncontrollably, posing threats to public health, environmental integrity, and food systems. This study systematically evaluated existing literature on PBDEs, heavy metals, PAHs, and organic contaminant exposure in Ghana and proposes a roadmap for achieving food safety and protecting the environment and human health. The research identified high mobility of specific heavy metals and risks associated with PBDEs and PAHs in sediments, dumpsites, and various food items. Unregulated dumping of electronic waste with PBDEs raised environmental concerns. An integrated approach is needed to address the multifaceted impact of organic pollutants on public health and ecosystems. Urgent implementation of effective environmental management strategies and regulatory measures is crucial. The study proposed short- to mid-term priorities emphasising the need to foster collaboration and implementing global measures. The mid- to long-term strategy includes a national information surveillance system, local monitoring capacity development, and integrating land contamination controls with food safety legislation. These measures would mitigate risks, ensure sustainable practices, and improve overall food safety management in Ghana, serving as a model for regions facing similar challenges with diverse pollutants.

Social determinants of health among people working on informal gold mines in French Guiana: a multicentre cross-sectional survey

INTRODUCTION

Social determinants of health, such as living and working conditions, economical and environmental context and access to care, combine to impact the health of individuals and communities. In French Guiana (FG), the persons working in informal artisanal and small-scale gold mining in the rainforest are a particularly vulnerable population which lives in precarious conditions and far from the health system. Previous studies have demonstrated their high morbidity due to infectious diseases. This study aims to describe the social determinants of health in this specific population.

METHODS

This international multicentre cross-sectional survey included people working on the informal FG gold mines at the crossing points located at both borders with Suriname and Brazil. After collecting written informed consent, a structured questionnaire was administered.

RESULTS

From September to December 2022, 539 gold miners were included. These poorly educated migrants, mainly from Brazil (99.1%) did not have access to drinkable water (95.4%), lived in close contact with wild fauna by hunting, eating bushmeat or being bitten and were exposed to mercury by inhalation (58.8%) or ingestion (80.5%). They report frequent accidents (13.5%) and chronic treatment interruptions (26.6% of the 11.9% reporting chronic treatment). Half of them considered themselves in good health (56.4%).

CONCLUSION

This study shows a singular combination of adverse exposures of gold miners working in FG such as zoonoses, heavy metal poisoning, aggression of wild fauna. For ethical as well as public health reasons, actions towards health equity must be considered at different levels: individual, community, environmental, systemic and global level. As end users of minerals, we must assume our responsibilities for the well-being of the extractors by including health in political decisions to engage together in global health.

TRIAL REGISTRATION NUMBER

NCT05540470.

An analysis of the foremost issues with artisanal and small-scale gold mining from Ghana's perspective

Ghana has abundant mineral reserves in many of its regions, and gold mining remains one of the country's main sources of revenue. Given Ghana's current position in the global gold market, this review provides insight into the ASGM sector to give an understanding of the pertinent issues in the sector and its role in the socio-economic development of the country. This review assesses the effects of ASGM operations in economic, social, health, and environmental contexts to raise awareness of issues related to ASGM. It evaluates the measures taken to lessen the consequences of ASGM and maintain the sector's long-term viability. This review considers the foremost issues, including continued Hg use in ASGM, recent use of cyanide in ASGM, pollution of water bodies, and toxic metal contamination. It takes into account sustainable measures and remedial techniques that Ghana has implemented to alleviate the negative effects and support best mining practices. The primary factors influencing people to participate in ASGM are the need for quick sources of income, the scarcity of jobs in rural areas, the economic hardship, the need to supplement earnings from other activities like trading, and the comparatively meager profits from agricultural activities. Findings indicated that to gain more traction in addressing the challenges in the ASGM sector, the involvement of the community and direct stakeholders is essential to promoting responsible mining and environmentally sustainable practices. This review will increase awareness and pressure on decision-makers, researchers, and ASGM communities about the relevance of environmental conservation and sustainability.

Why is Ghana losing the war against illegal gold mining (Galamsey)? An artificial neural network-based investigations

Ghana, like most resource-rich countries, is saddled and inundated with resource curse challenges. Key among them is the problem of illegal small-scale gold mining activities (ISSGMAs), which is mercilessly robbing the nation of its ecological integrity, despite attempts by successive governments to remedy the situation. In the midst of this challenge, Ghana, year in and year out, performs abysmally on environmental governance score (EGC) variables. Against this framework, this study intends to uniquely establish the drivers behind Ghana's failure to overcome ISSGMAs. To achieve this, a total of 350 respondents were sampled through a structured questionnaire, with a mixed method approach from selected host communities, believed to be the epicenters of ISSGMAs in Ghana. The questionnaires were administered from March to August, 2023. AMOS Graphics and IBM SPSS vs 23 were used to analyze the data. In particular, the novel hybrid artificial neural network (ANN) and linear regression techniques were adopted to establish the relational linkages among the constructs of the study and their respective contribution to ISSGMAs in Ghana. The study displays intriguing results that explain why Ghana has failed to be victorious over ISSGMAs. In particular, the findings of the study demonstrate that the three key drivers of ISSGMAs in Ghana, in a sequential and consecutive order are as follows: bureaucratic licensing regime/weak legal framework, political/traditional leadership failures, and corrupt institutional officials. Moreover, socioeconomic factors and proliferation of foreign miners/mining equipment were also observed to contribute significantly to ISSGMAs. While the study contributes to the ongoing debate on ISSGMAs, it also proffers valuable and practical solutions to the menace as well as theoretical implications.

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.

Emerging mercury and methylmercury contamination from new artisanal and small-scale gold mining along the Nile Valley, Egypt

The past decade witnessed the initiation and boom of the Artisanal and Small-scale Gold Mining (ASGM) activities in the hyper-arid southern Egypt. The ores are mined in the Eastern Desert and then transported to the densely populated farming communities in the Nile Valley, where the river provides the water resources needed for ore processing. In search for economic benefits, the poorly educated farmers with limited technical resources transformed their cultivated lands into ASGM operations, exposing themselves, their families, the residents, and the Nile ecosystems to several environmental and occupational health problems. Using integrated remote sensing, field, geochemical, and isotopic analyses, we report the first inventory of ASGM-related total mercury (THg) and methylmercury (MeHg) levels in tailings, amalgamation-tailing ponds, and surface and groundwater with emphasis on the Edfu city and its surroundings. The field and remote sensing-based mapping of ASGM activities reveals clustering around the Nile waterways and suggests interaction of Hg contamination sources with their surrounding receptors. Common ASGM practices include release of contaminated water from unlined amalgamation-tailing ponds into irrigation and drainage canals, and spreading of tailings over cultivated soils. In a short period (10 years), the released Hg contaminated multiple media, including the surface water, the shallow and deep aquifers, and possibly the soil, crops, and livestock. THg levels in amalgamation-tailing ponds (1200-8470 ng/L) are fourfold higher than US EPA and eightfold the WHO thresholds. The contaminated waters released from amalgamation-tailing ponds raised THg levels in surface water (irrigation canals: 50-100 ng/L; drainage canals: THg: > 200 ng/L) and groundwater (shallow and deep aquifers: 80-500 ng/L). Our findings highlight the need to extend the adopted approach to cover the entire length of the Nile River and its valley and the importance of conducting awareness campaigns to educate residents and health care providers about potential ASGM-related environmental and health hazards.

Artisanal gold mine spoil types within a common geological area and their variations in contaminant loads and human health risks

This study answered the question of whether mine spoils occurring in a common geological location had similarities in their contaminant load and associated health risks. Using inductively coupled plasma mass spectrometry, the total contents of Cd, Pb, As, Hg, Zn, Fe, and Al were determined for 110 digested soil samples obtained from underground rock ore (URS), oxide ore (OXS), and alluvial ore (AVS) mine spoils. Independent sample Kruskal-Wallis test and pairwise comparisons of sources were used to ascertain the variation in elemental load between the mine spoil investigated. The results showed that mine spoil contaminations and their ecological and health risk significantly varied (p < 0.01) from each other and fell in the order OXS > URS > AVS > forest soils because of their geochemistry. Determined enrichment and geo-accumulation indices revealed that OXS and URS sites were severely-extremely polluted with Cd, Hg, and As, while AVS mine spoils were only moderately contaminated by Cd and As contents. Children had the highest tendency for developing noncarcinogenic health defects largely due to toxic contents of As, Cd, and Hg in soil materials near them than adult men and women would after obtaining a hazard index of 73.5 and 67.7 (unitless) at both OXS and URS sites. Mine spoils especially where hard rocks and oxide ores were processed are not fit for agricultural use or human habitation. The restriction of human access and sustainable remediation approaches are required to avert health defects. Even so, area-specific potentially toxic elements must be targeted during soil cleaning due to the significant variations in contaminant load between mined sites.

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

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

The Triple Burden of Tuberculosis, Human Immunodeficiency Virus and Silicosis among Artisanal and Small-Scale Miners in Zimbabwe

Artisanal and small-scale mining is characterized by an excessive exposure to silica-containing dust, overcrowding, poor living conditions and limited access to primary health services. This poses a risk to tuberculosis, HIV infection and silicosis. The main purpose of the study is to evaluate the burden of tuberculosis, HIV and silicosis among artisanal and small-scale miners. We conducted a cross sectional study on 3821 artisanal and small-scale miners. We found a high burden of silicosis (19%), tuberculosis (6.8%) and HIV (18%) in a relatively young population, with the mean age of 35.5 years. Men were 1.8 times more likely to be diagnosed with silicosis compared to women, adjusted prevalence ratio [aPR = 1.75 (95% CI: 1.02-2.74)]. Artisanal and small-scale miners who were living with HIV were 1.25 times more likely to be diagnosed with silicosis compared to those who were negative, [aPR = 1.25 (1.00-1.57)]. The risk of silicosis increased with both duration as a miner and severity of exposure to silica dust. The risk of tuberculosis increased with the duration as a miner. Zimbabwe is currently experiencing a high burden of TB, silicosis and HIV among artisanal and small-scale miners. Multi-sectoral and innovative interventions are required to stem this triple epidemic in Zimbabwe.

Preponderance of vaccine-preventable diseases hotspots in northern Ghana: a spatial and space-time clustering analysis from 2010 to 2014

BACKGROUND

Vaccine-preventable diseases (VPDs) persist globally with a disproportionately high burden in Low and Middle-Income Countries (LMICs). Although this might be partly due to the failure to sustain vaccination coverage above 90% in some WHO regions, a more nuanced understanding of VPD transmission beyond vaccination coverage may unveil other important factors in VPD transmission and control. This study identified VPDs hotspots and explored their relationships with ecology, urbanicity and land-use variations (Artisanal and Small-scale Gold Mining (ASGM) activities) in Ghana.

METHODS

District-level disease count data from 2010 to 2014 from the Ghana Health Service (GHS) and population data from the Ghana Population and Housing Census (PHC) were used to determine clustering patterns of six VPDs (Measles, Meningitis, Mumps, Otitis media, Pneumonia and Tetanus). Spatial and space-time cluster analyses were implemented in SaTScan using the discrete Poisson model. P-values were estimated using a combination of sequential Monte Carlo, standard Monte Carlo, and Gumbel approximations.

RESULTS

The study found a preponderance for VPD hotspots in the northern parts of Ghana and northernmost ecological zones (Sudan Savannah and Guinea Savannah). Incidence of meningitis was higher in the Sudan Savannah ecological zone relative to: Tropical Rain Forest (p = 0.001); Semi Deciduous Forest (p < 0.0001); Transitional Zone (p < 0.0001); Coastal Savannah (p < 0.0001) and Guinea Savannah (p = 0.033). Except for mumps, which recorded a higher incidence in urban districts (p = 0.045), incidence of the other five VPDs did not differ across the urban-rural divide. Whereas spatial analysis suggested that some VPD hotspots (tetanus and otitis media) occur more frequently in mining districts in the southern part of the country, a Mann-Whitney U test revealed a higher incidence of meningitis in non-mining districts (p = 0.019). Pneumonia and meningitis recorded the highest (722.8 per 100,000) and least (0.8 per 100,000) incidence rates respectively during the study period.

CONCLUSION

This study shows a preponderance of VPD hotspots in the northern parts of Ghana and in semi-arid ecoclimates. The relationship between ASGM activities and VPD transmission in Ghana remains blurred and requires further studies with better spatial resolution to clarify.

Global Health Impact of Atmospheric Mercury Emissions from Artisanal and Small-Scale Gold Mining

Artisanal and small-scale gold mining (ASGM) is the leading source of mercury (Hg), a global neurotoxin. Past research has focused on the health impacts on miners and nearby residents; here, we estimate the risk for global general populations by employing a comprehensive atmosphere-land-ocean-ecosystem and exposure-risk-valuation model framework. Our results suggest that ASGM sources contribute 12%, 10%, and 0.63% to the atmospheric Hg deposition, plankton methylmercury concentrations, and soil total Hg concentrations at present day, respectively, and cause 5.8×10⁵ points of intelligence quotient decrements and 1,430 deaths for global general populations per year. The monetized global health impact of ASGM ($154 billion) is 1.5 times its local impact and accounts for half of the total revenue of ASGM ($319 billion). A major spatial decoupling between the health impact and economic gains is also revealed, suggesting that intervention measures such as awareness-raising, capacity-building, and technology transfer funded by the Global North are cost-effective.

•

Contributions of ASGM to MeHg concentrations in different organisms are calculated

•

The global health impact of atmospheric Hg from ASGM is first revealed

•

The health impacts and economic gains of ASGM are compared

•

Intervention measures for ASGM are proved to be cost-effective

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.

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.

Climate Change, Conflict, and Resource Extraction: Analyses of Nigerian Artisanal Mining Communities and Ominous Global Trends

Background:

The 2010 lead poisoning outbreak that claimed the lives of more than 400 children in artisanal gold mining villages in Zamfara, Nigeria is the tragic result of high gold prices, a geologic anomaly, and processing of ores in residential areas. Today, these villages face a growing crisis related to conflict and climate change. While the situation in Zamfara is unparalleled in many ways, the interactions between climate change, conflict, and mining consistently overlap a global scale. The scope of this analysis extends beyond the Nigerian crisis.

Objectives:

Understanding the complexities of challenges faced in Zamfara provides insight into how these issues impact vulnerable communities globally, and which strategies should be considered to solve this wicked problem.

Methods:

Analysis of the relationships between climate change, conflict, and mining in Zamfara and globally via literature review and examination of current events in the Sahel region.

Findings:

Supporting healthy artisanal mining communities, as was prioritized in Zamfara, must be a focus of environmental, health, and mineral management policies. This includes the consideration of multiple environmental health challenges, the protection of vulnerable groups, government-supported formalization programs, and meaningful involvement of local leadership in developing, implementing, and sustaining intervention strategies to enshrine ASM as a poverty reduction, climate change adaptation strategy.

Conclusions:

Rapidly rising metal prices and demand will continue to fuel environmental health crises associated with mining. Given Africa’s growing role in the global mineral economy and the massive number of subsistence communities who will continue to be impacted by climate change, strategies that support responsible artisanal mining are both a necessity for preventing future health crises and an opportunity for promoting regional stability and peace.

Environmental and health risks posed to children by artisanal gold mining: A systematic review

There are an estimated 5 million children working in artisanal and small-scale gold mines worldwide; however, the hazards are poorly characterized and often underreported. We systematically reviewed the literature on reports of hazards among children as a consequence of such activities through PubMed database using pre-defined search terms. We identified 113 articles published between 1984 and 2021 from 31 countries. Toxicological hazards were reported in 91 articles, including mercury, lead, and arsenic. Infectious hazards, noted in 18 articles, included malaria, cholera, and hepatitis. Six articles reported occupational hazards, including malnutrition, heat stroke, and reactive airway disease. Three articles reported traumatic hazards, including cave-ins, burns, animal attacks, falls, and weapon-inflected wounds. Those findings likely indicate a profound underreporting of the prevalence and consequences of such hazards among children. More work is needed both to characterize the burdens of those hazards and to address the underlying drivers of child labor in those settings.

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.

Efficacy of Hair Total Mercury Content as a Biomarker of Methylmercury Exposure to Communities in the Area of Artisanal and Small-Scale Gold Mining in Madre de Dios, Peru

Total mercury content (THg) in hair is an accepted biomarker for chronic dietary methylmercury (MeHg) exposure. In artisanal and small-scale gold mining (ASGM) communities, the validity of this biomarker is questioned because of the potential for contamination from inorganic mercury. As mining communities may have both inorganic and organic mercury exposures, the efficacy of the hair-THg biomarker needs to be evaluated, particularly as nations begin population exposure assessments under their commitments to the Minamata Convention. We sought to validate the efficacy of hair THg for public health monitoring of MeHg exposures for populations living in ASGM communities. We quantified both THg and MeHg contents in hair from a representative subset of participants (N = 287) in a large, population-level mercury exposure assessment in the ASGM region in Madre de Dios (MDD), Peru. We compared population MeHg-THg correlations and %MeHg values with demographic variables including community location, sex, occupation, and nativity. We observed that hair MeHg-THg correlations were high (r > 0.7) for all communities, regardless of location or nativity. Specifically, for individuals within ASGM communities, 81% (121 of 150 total) had hair THg predominantly in the form of MeHg (i.e., >66% of THg) and reflective of dietary exposure to mercury. Furthermore, for individuals with hair THg exceeding the U.S. EPA threshold (1.0 μg/g), 88 out of 106 (83%) had MeHg as the predominant form. As a result, had urine THg solely been used for mercury exposure monitoring, approximately 59% of the ASGM population would have been misclassified as having low mercury exposure. Our results support the use of hair THg for monitoring of MeHg exposure of populations in ASGM settings where alternative biomarkers of MeHg exposure are not feasible.

Impact of Small-Scale Mining Activities on Physicochemical Properties of Soils in Dunkwa East Municipality of Ghana

The quality of soils in rehabilitated small-scale mined sites needs thorough investigation since a lot of changes do occur. The study assessed the impacts of small-scale mining activities on concentration and distribution of soil physicochemical properties and heavy metals. The soil samples were collected from 120 (50 m × 50 m) plots. The concentrations of soil physicochemical properties (Ca, Mg, Na, N, P, K, and OC and EC) varied significantly (p < 0.05) between unmined and mined soils. However, there were no statistically, significant differences (p < 0.05) observed in the concentrations of Cd, Hg, Pb, As, and Cu between the unmined and mined soils. Despite the generally poor (33.8%) soil quality in the study area, mining activities further reduced it by 24.2%. Soils from mined sites with unfilled/partially filled pits had higher levels of K, Mg, and Na. As mined sites fallow period increased, concentrations of OC and Cd increased, while Ca, Mg, pH, Cu, Pb, and As and value of EC decreased. The number of years that mined land remained fallow, and whether the pits were filled or unfilled during this period should be factored into the mined land rehabilitation processes.

Mental health in mine workers: a literature review

The mining environment is hazardous for worker's health. It can affect the mental health, triggering symptoms and diseases, such as anxiety, job stress, depression, sleep disorders, mental fatigue and other. The aim of this study was to describe and analyze the scientific literature about the mental health in mine workers and to summarize the findings. The method used was scoping review. The principal outcomes were the following: evidence in the last 12 years in the topic was focused in four themes 1) Psychological problems & personal factors (38.2%); 2) Psychosocial problems & health related factor (23.6%); 3) Well-being (21.1%) and 4) Physical problems & organization factors (17.1%). Several affections, symptoms, characteristics or disorders were inquired about mine worker's mental health, such as job strain, unsafety experiences, poor quality of sleep, non-subjective well-being, job unsatisfaction, social-relations conflict, risk of accidents and injuries, musculoskeletal disorders (MSDs), substance abuse, dangerous working conditions and demanding job organization, and so on. For those factors, Mining could expose to serious mental health problems to a part of their workers. It's necessary to deepen the elaboration of international policies and carry out more scientific research and suggestions to make programs on the topic.

Mercury (Hg) use and pollution assessment of ASGM in Ghana: challenges and strategies towards Hg reduction

Reduction or possible elimination of Hg from artisanal and small-scale gold mining (ASGM) is one of the main goals of the Minamata Convention on Mercury, which has been signed by many countries involved in ASGM, including Ghana. This article provides a recent overview of ASGM gold production and Hg use in Ghana. In addition, in order to highlight the impacts of Hg use in Ghana, a review was conducted on research studies investigating Hg pollution in waterbodies, soils, fish, and humans caused by ASGM over the past two decades. The continued use of Hg in Ghana's growing ASGM sector has resulted in reportedly high Hg levels found in water, sediments, crops, and miners, which exceed international guidelines. A subsequent ASGM ban and increased monitoring of illegal mining activities in Ghana have not ultimately been successful at significantly reducing Hg use and its associated impacts caused by rampant use in the country. Moreover, Hg alternatives in the ASGM sector are limited in Ghana, with little funding, support, education, and training in place to promote their implementation. As gold produced by ASGM continues to increase annually, clear policy reforms targeting Hg use are vitally needed, as well as efficient strategies to remediate Hg-contaminated areas.

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.

Occupational health and safety in mining: Predictive probabilities of Personal Protective Equipment (PPE) use among artisanal goldminers in Ghana

Artisanal goldminers in Ghana are exposed to various levels and forms of health, safety and environmental threats. Without the required legislation and regulations, artisanal miners are responsible for their own health and safety at work. Consequently, understanding the probabilities of self-protection at work by artisanal goldminers is crucial. A cross-sectional survey of 500 artisanal goldminers was conducted to examine the probabilities of personal protective equipment use among artisanal goldminers in Ghana. The data was subjected to both descriptive and inferential statistics. Initial findings showed that personal protective equipment use among artisanal miners was 77.4%. Overall, higher probabilities of personal protective equipment use was observed among artisanal goldminers who work in good health and safety conditions as compared to artisanal miners who work in poor health and safety conditions. Also, personal protective equipment use was more probable among the highly educated artisanal goldminers, miners who regularly go for medical screening and the most experienced miners. Additionally, personal protective equipment use was more probable among artisanal miners who work in non-production departments and miners who work in the medium scale subsector. Inversely, personal protective equipment use was less probable among female artisanal miners and miners who earn more monthly income ($174 and above). To increase self-care and safety consciousness in artisanal mining, there is the need for a national occupational health and safety legislation in Ghana. Also, interventions and health promotion campaigns for better occupational conditions in artisanal mining should target and revise the health and safety related workplace programs and conditions.

Health risk assessment of trace metals in selected food crops at Abuakwa South Municipal, Ghana

Trace metals contamination has recently been a major issue due to its damaging effects on public health and environmental receptors. This study focussed on the health risk assessment of trace metals (As, Pb, Cr, and Ni) associated with the direct intake of some selected food crops (namely cocoyam and plantain) at Abuakwa South Municipal, Ghana. The food crops and soil samples were selected randomly from three reclaimed mined sites and one non-mining site in the study area. Results from the trace metal concentration analyses in the soil samples showed that As, Cr, and Ni were above the control. The daily intake of metals (DIM), target hazard quotient (THQ), and carcinogenic risk (CR) assessments of health risks accompanied by the continuous ingestion of the selected food crops polluted through these trace metals were evaluated. 0.23 mg/kg and 0.05 mg/kg, 0.11 mg/kg and 0.02 mg/kg, 0.78 mg/kg and 0.65 mg/kg, and 0.23 mg/kg and 0.09 mg/kg were recorded for As, Cr, Ni, and Pb in that order in the cocoyam and plantain, respectively. The As and Pb concentrations in the food crops were above the WHO recommended limits. This implies that individuals within the vicinity are exposed to high levels of As and Pb through food intake which could result in varying health implications. The DIM and THQ for the studied trace metals were below their permissible limits suggesting that there is a tolerable non-carcinogenic adverse health risk level for adults and children within the studied area. In addition, the lifetime probability of contracting cancer by ingesting Ni, Pb, and Cr in plantain grown in the study area is high. It is recommended that regular monitoring of these trace metals in food crops be carried out in preventing their excessive accumulation.

Burden of malaria in children under five and caregivers' health-seeking behaviour for malaria-related symptoms in artisanal mining communities in Ghana

Background

Artisanal mining creates enabling breeding ground for the vector of malaria parasites. There is paucity of data on the effects of artisanal mining on malaria. This study assessed burden of malaria and caregivers’ health-seeking behaviour for children under five in artisanal mining communities in East Akim District in Ghana.

Methods

A cross-sectional study involving caregivers and their children under five was conducted in three artisanal mining communities in the East Akim District in Ghana. Caregivers were interviewed using a structured questionnaire. Finger prick blood samples were collected and analysed for haemoglobin concentration using a rapid diagnostic test, and thick and thin blood smears were analysed to confirm the presence of malaria parasites.

Results

Of the 372 children under 5 years included in the study, 197 (53.1%) were male, with a mean age (± SD) of 23.0 ± 12.7 months. The proportion of children with malaria (Plasmodium falciparum and P. malariae) was 98.1% and 1.9%, respectively, whilst the proportion with anaemia (Hb < 11.0 g/dl) was 39.5% (n = 147). Almost all caregivers were female (98.9%), and 28.6% (n = 106) did not have access to any malaria control information. Caregivers associated malaria infection with mosquito bites (68.3%, n = 254) and poor sanitation (21.2%, n = 79). Malaria in children under five was significantly associated with anaemia (OR 11.07, 95% CI 6.59–18.68, n = 111/160, 69.4%; P < 0.0001), residing close to stagnant water (≤ 25 m) from an artisanal mining site (AOR 2.91, 95% CI 1.47–5.76, P = 0.002) and caregiver age younger than 30 years (OR 0.44, 95% CI 0.208–0.917, n = 162, 43.55%, P = 0.001).

Conclusions

There is a high burden of malaria and anaemia among children under five in artisanal mining communities of the East Akim District, and far higher than in non-artisanal mining sites. Interventions are needed to effectively regulate mining activities in these communities, and strengthen malaria control and health education campaigns to curtail the high malaria burden and improve health-seeking behaviour.

Graphical abstract

Supplementary Information

The online version contains supplementary material available at 10.1186/s13071-021-04919-8.

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.

A Systematic Framework for Collecting Site-Specific Sampling and Survey Data to Support Analyses of Health Impacts from Land-Based Pollution in Low- and Middle-Income Countries

The rise of small-scale and localized economic activities in low- and middle-income countries (LMICs) has led to increased exposures to contaminants associated with these processes and the potential for resulting adverse health effects in exposed communities. Risk assessment is the process of building models to predict the probability of adverse outcomes based on concentration-response functions and exposure scenarios for individual contaminants, while epidemiology uses statistical methods to explore associations between potential exposures and observed health outcomes. Neither approach by itself is practical or sufficient for evaluating the magnitude of exposures and health impacts associated with land-based pollution in LMICs. Here we propose a more pragmatic framework for designing representative studies, including uniform sampling guidelines and household surveys, that draws from both methodologies to better support community health impact analyses associated with land-based pollution sources in LMICs. Our primary goal is to explicitly link environmental contamination from land-based pollution associated with specific localized economic activities to community exposures and health outcomes at the household level. The proposed framework was applied to the following three types of industries that are now widespread in many LMICs: artisanal scale gold mining (ASGM), used lead-acid battery recycling (ULAB), and small tanning facilities. For each activity, we develop a generalized conceptual site model (CSM) that describes qualitative linkages from chemical releases or discharges, environmental fate and transport mechanisms, exposure pathways and routes, populations at risk, and health outcomes. This upfront information, which is often overlooked, is essential for delineating the contaminant zone of influence in a community and identifying relevant households for study. We also recommend cost-effective methods for use in LMICs related to environmental sampling, biological monitoring, survey questionnaires, and health outcome measurements at contaminated and unexposed reference sites. Future study designs based on this framework will facilitate consistent, comparable, and standardized community exposure, risk, and health impact assessments for land-based pollution in LMICs. The results of these studies can also support economic burden analyses and risk management decision-making around site cleanup, risk mitigation, and public health education.

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.

Health Studies in the Context of Artisanal and Small-Scale Mining: A Scoping Review

Artisanal and small-scale mining (ASM) is an important livelihood activity in many low- and middle-income countries. It is widely acknowledged that there are a myriad of health risk and opportunities associated with ASM. However, little is known with regard to which aspects of health have been studied in ASM settings. We conducted a scoping review of peer-reviewed publications, using readily available electronic databases (i.e., PubMed, Scopus, and Web of Science) from inception to 14 July 2020. Relevant information was synthesized with an emphasis on human and environmental exposures and health effects in a context of ASM. Our search yielded 2764 records. After systematic screening, 176 health studies from 38 countries were retained for final analysis. Most of the studies (n = 155) focused on health in ASM extracting gold. While many of the studies included the collection of environmental and human samples (n = 154), only few (n = 30) investigated infectious diseases. Little attention was given to vulnerable groups, such as women of reproductive age and children. Our scoping review provides a detailed characterisation of health studies in ASM contexts. Future research in ASM settings should address health more comprehensively, including the potential spread of infectious diseases, and effects on mental health and well-being.

A Review of the Scope of Artisanal and Small-Scale Mining Worldwide, Poverty, and the Associated Health Impacts

Some of the poorest people in the world's poorest countries eke out a living in artisanal and small-scale mining (ASM). Equipped with primitive tools like picks, shovels, buckets, and gold pans, they work mining valuable resources, like gold, diamonds, tin, lithium, rare earth elements, tantalum, and cobalt, and any other usable commodity, for example, sand, coal, or mica. The mining and refining processes are labor intensive and associated with a variety of health problems due to accidents, overheating, overexertion, dust inhalation, exposure to toxic chemicals and gases, violence, and illicit and prescription drug and alcohol addiction. Evident disadvantages with ASM are counterbalanced by the immense economic benefits. For many, the true scope and scale of ASM activities are unappreciated, along with the unknown health and societal impacts. Here, we set out to elucidate the scope of ASM beyond the recovery of familiar commodities, such as gold and diamonds. We adopt a holistic perspective toward health impacts of ASM, which includes unique occupational, environmental, and human/social drivers. A particular focus is poverty as a health risk with artisanal miners. They are commonly poverty-stricken people in poor countries, ensnared by a variety of poverty traps, which take a toll on the health and well-being of individuals and communities. ASM sometimes provides an opportunity to diversify income in the face of a decline in subsistence agriculture. However, ASM often trades one kind of generational poverty for another, coming along with serious health risks and turmoil associated with work in an informal "cash-rich" business.

Mercury Exposure in Artisanal and Small-Scale Gold Mining Communities in Sukabumi, Indonesia

BACKGROUND

Artisanal and small-scale gold mining (ASGM) is one of the largest sources of mercury (Hg) pollution in Indonesia. In West Java Province, ASGM is found in Bogor, Cianjur, and Sukabumi Regencies.

OBJECTIVES

The present study aimed to evaluate Hg contamination effects and socioeconomic factors in communities living around ASGM operations in Sukabumi Regency.

METHODS

A quantitative method was used to describe socioeconomic ASGM communities. The concentrations of total mercury (T-Hg) in hair were measured in 71 respondents. This study also assessed perception of the use of Hg in the gold ore processing and their impact on the environment.

RESULTS

The population of gold miners in the studied three villages was 1300 households (25.77% from a total of 5044 households). Artisanal and small-scale gold mining involves both men and women employed as miners and gold amalgam processors, respectively. The average monthly income generated as much as Indonesian Rupiah (IDR) 272 000-2 000 000 (about 19-140 USD). Total Hg analysis was conducted for hair samples of 71 respondents (38 men, 33 women). The results showed an average T-Hg in men of 3.27±2.89 ppm, and women of 5.91±4.69 ppm. The level of T-Hg in the respondents was associated with distance to the ball mills and not related to distance to the mine site.

PARTICIPANT CONSENT

Obtained.

ETHICS APPROVAL

This study was approved by Ministry of Environment and Forestry of the Republic of Indonesia.

COMPETING INTERESTS

The authors declare no competing financial interests.

Biomonitoring of Mercury, Cadmium and Selenium in Fish and the Population of Puerto Nariño, at the Southern Corner of the Colombian Amazon

Heavy metals threaten communities near biodiversity hotspots, as their protein sources come from the environment. This study assessed Hg, Cd, and Se concentrations in fish, as well as the magnitude of exposure and hematological conditions of adult citizens from Puerto Nariño (Colombian Amazon). Among fish samples, greater Hg concentrations were found in higher trophic level species, including Rhaphiodon vulpinus (880 ± 130 ng/g) and Pseudoplatystoma tigrinum (920 ± 87 ng/g). These species presented the highest hazard quotients and lowest Se:Hg molar ratios among those studied, showing their consumption represents a health risk to consumers. Moreover, some samples of Mylossoma duriventre and Prochilodus magdalenae had Cd levels greater than the regulated limit (100 ng/g). The average total Hg (T-Hg) concentrations in human hair and blood were 5.31 µg/g and 13.7 µg/L, respectively. All hair samples exceeded the 1.0 μg/g threshold set by the USEPA, whereas 93% of the volunteers had T-Hg blood levels greater than 5 μg/L, suggesting elevated exposure. The mean Cd level was 3.1 µg/L, with 21% of samples surpassing 5 µg/L, value at which mitigating actions should be taken. Eighty-four percent of participants presented Se deficiencies (<100 μg/L). There was a significant association between fish consumption and T-Hg in hair (ρ = 0.323; p = 0.032) and blood (ρ = 0.381; p = 0.011). In this last matrix, Se correlated with Cd content, whereas lymphocytes were inversely linked to Hg concentrations. The results of this study show that there is  extensive exposure to Hg in fish, the consumption of which may promote detrimental impacts on hematology parameters within the community.

Comparing the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners and the urban population in Zimbabwe using the EuroQol (EQ-5D-3L+C) questionnaire: a cross-sectional study

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. Besides limited epidemiological data, no data about the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners exist. The aim of the project was to access HRQoL of ASGM workers to improve the data base and compare the data to the urban Zimbabwean population.

Methods

Data from 83 artisanal and small-scale gold miners in Kadoma, Zimbabwe was analysed. The HRQoL was assessed using the EuroQol dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) accompanied by the cognition add-on questionnaire (EQ-5D-3L+C) and associated visual analogue scale (VAS). We described the EQ-5D dimensions and VAS values and computed health utility (HU) values using the Zimbabwean tariff. The proportions of miners reporting no problem in each EQ-5D dimension were compared with corresponding proportions reporting any problem (moderate or severe), and mean HU and VAS values were analysed across subgroups of the sample. To test differences between subgroups, Fisher’s exact test was used and between urban and mining population, Student’s t-test was used.

Results

The reported health states of miners were homogenous, with a large amount (42%) reporting ‘full health’. Mean (SD) VAS and HU values were 81.0 (17.5) and 0.896 (0.13), respectively. Subgroup analysis showed that miners with a lower education reported significantly more problems in the dimension of daily activities and miners with mercury contact had more problems in the dimensions of pain/discomfort and cognition. Comparison between mining and urban population showed that in the oldest age group, self-rated VAS values of miners were significantly higher than of their urban counterparts.

Conclusions

There were no significant differences in the HRQoL of mining and urban populations. However, the reason might be adverse health effects faced by the urban population that do not apply to rural mining areas. A higher education level of miners can improve the HRQoL, which is especially impaired by problems in the cognition dimension.

Mining is bad for health: a voyage of discovery

Mining continues to be a dangerous activity, whether large-scale industrial mining or small-scale artisanal mining. Not only are there accidents, but exposure to dust and toxins, along with stress from the working environment or managerial pressures, give rise to a range of diseases that affect miners. I look at mining and health from various personal perspectives: that of the ordinary man (much of life depends on mined elements in the house, car and phone); as a member of the Society for Environmental Geochemistry and Health (environmental contamination and degradation leads to ill health in nearby communities); as a public health doctor (mining health is affected by many factors, usually acting in a mix, ranging from individual inheritance-genetic makeup, sex, age; personal choices-diet, lifestyle; living conditions-employment, war; social support-family, local community; environmental conditions-education, work; to national and international constraints-trade, economy, natural world); as a volunteer (mining health costs are not restricted to miners or industry but borne by everyone who partakes of mining benefits-all of us); and as a lay preacher (the current global economy concentrates on profit at the expense of the health of miners). Partnership working by academics with communities, government and industry should develop evidence-based solutions. Employment, health, economic stability and environmental protection need not be mutually exclusive. We all need to act.

Chemical analysis of Hg0-containing Hindu religious objects

Parad items used in Hindu practices and Ayurvedic medicines contain elemental mercury (Hg⁰) and have traditionally been used in prayer and to treat a variety of diseases including diabetes, heart conditions, and sexual dysfunction. These items are often referred to as amalgams of silver, and take the form of shivlings, statues of gods, necklaces, and other jewelry. Fourteen parad items were purchased from online vendors in India and the United States and analyzed. All items produced copious amounts of Hg⁰ vapor, with Hg⁰ concentrations exceeding 1,000,000 ng/m³ as measured using a Mercury Instruments Mercury Tracker 3000 IP atomic absorption spectrometer. Measured concentrations were highly variable, so a simple qualitative experiment employing a UV-C light source and a thin-layer chromatography plate impregnated with a fluorescent dye that glows green when irradiated at 254 nm allowed for the indirect visualization of the Hg⁰ being evolved. In addition, all items were screened using a hand-held X-ray fluorescence analyzer to estimate the concentration of Hg, Sn, Pb, As, and Cd on the surface of the item. Select samples were then digested in aqua regia and analyzed for Hg content using a direct mercury analyzer. All samples were found to exceed 20% by mass Hg. The digestates were analyzed using inductively-coupled plasma–optical emission spectrometry and were determined to be between 10–55% by mass Pb and contain up to 0.3% by mass As. While Article 4 of the Minamata Convention on Mercury specifically requires parties to stop importing, exporting, and manufacturing Hg-added products, products used in traditional and religious practices are excluded.

Predisposing factors influencing occupational injury among frontline building construction workers in Ghana

OBJECTIVE

This study aims to examine the predisposing factors influencing occupational injuries among frontline construction workers in Ghana. A cross-sectional survey was carried out with 634 frontline construction workers in Kumasi metropolis of Ghana using a structured questionnaire. The study was conducted from December 2016 to June 2017 using a household-based approach. The respondents were selected through a two-stage sampling approach. A multivariate logistics regression model was employed to examine the association between risk factors and injury. Data was analyzed employing descriptive and inferential statistics with STATA version 14.

RESULTS

The study found an injury prevalence of 57.91% among the workers. Open Wounds (37.29%) and fractures (6.78%) were the common and least injuries recorded respectively. The proximal factors (age, sex of worker, income) and distal factors (e.g. work structure, trade specialization, working hours, job/task location, and monthly off days) were risk factors for occupational injuries among frontline construction workers. The study recommends that policymakers and occupational health experts should incorporate the proximal and distal factors in the design of injury prevention as well as management strategies.

Occupational Health Programs for Artisanal and Small-Scale Gold Mining: A Systematic Review for the WHO Global Plan of Action for Workers' Health

Background:

Workers in the informal economy often incur exposure to well-documented occupational health hazards. Insufficient attention has been afforded to rigorously evaluating intervention programs to reduce the risks, especially in artisanal and small-scale gold mining (ASGM).

Objectives:

This systematic review, conducted as part of the World Health Organization’s Global Plan of Action for Workers’ Health, sought to assess the state of knowledge on occupational health programs and interventions for the informal artisanal and small-scale gold mining (ASGM) sector, an occupation which directly employs at least 50 million people.

Methods:

We used a comprehensive search strategy for four well-known databases relevant to health outcomes: PubMed, Engineering Village, OVID Medline, and Web of Science, and employed the PRISMA framework for our analysis.

Findings:

Ten studies met the inclusion criteria of a primary study focused on assessing the impact of interventions addressing occupational health concerns in ASGM. There were no studies evaluating or even identifying comprehensive occupational health and safety programs for this sector although target interventions addressing specific hazards exist. Major areas of intervention—education and introduction of mercury-reducing/eliminating technology were identified, and the challenges and limitations of each intervention taken into assessment. Even for these, however, there was a lack of standardization for measuring outcome or impact let alone long-term health outcomes for miners and mining communities.

Conclusion:

There is an urgent need for research on comprehensive occupational health programs addressing the array of hazards faced by artisanal and small-scale miners.

Insights into the Potential Role of Mercury in Alzheimer's Disease

Mercury (Hg), which is a non-essential element, is considered a highly toxic pollutant for biological systems even when present at trace levels. Elevated Hg exposure with the growing release of atmospheric pollutant Hg and rising accumulations of mono-methylmercury (highly neurotoxic) in seafood products have increased its toxic potential for humans. This review aims to highlight the potential relationship between Hg exposure and Alzheimer's disease (AD), based on the existing literature in the field. Recent reports have hypothesized that Hg exposure could increase the potential risk of developing AD. Also, AD is known as a complex neurological disorder with increased amounts of both extracellular neuritic plaques and intracellular neurofibrillary tangles, which may also be related to lifestyle and genetic variables. Research reports on AD and relationships between Hg and AD indicate that neurotransmitters such as serotonin, acetylcholine, dopamine, norepinephrine, and glutamate are dysregulated in patients with AD. Many researchers have suggested that AD patients should be evaluated for Hg exposure and toxicity. Some authors suggest further exploration of the Hg concentrations in AD patients. Dysfunctional signaling pathways in AD and Hg exposure appear to be interlinked with some driving factors such as arachidonic acid, homocysteine, dehydroepiandrosterone (DHEA) sulfate, hydrogen peroxide, glucosamine glycans, glutathione, acetyl-L carnitine, melatonin, and HDL. This evidence suggests the need for a better understanding of the relationship between AD and Hg exposure, and potential mechanisms underlying the effects of Hg exposure on regional brain functions. Also, further studies evaluating brain functions are needed to explore the long-term effects of subclinical and untreated Hg toxicity on the brain function of AD patients.

A Case Study of Heavy Metal Pollution in Water of Bone River by Artisanal Small-Scale Gold Mine Activities in Eastern Part of Gorontalo, Indonesia

Bone River, which is located in the eastern part of Gorontalo, Indonesia, has an issue of contamination by heavy metals due to artisanal small-scale gold mine (ASGM) activities. This river is used as a source of water by inhabitants living along the river, due to the lack of another clean water supply. The purpose of this study is to investigate the concentration of As from the mining site alongside Bone River, and to reveal the As pollution source. Water and sediment samples were collected from ASGM and along Bone River to the delta. The concentrations of As, Hg, and Pb in water samples were identified by inductively coupled plasma mass spectroscopy (ICP–MS), while concentrations in sediment samples were determined by particle-induced X-ray emission (PIXE). Results showed that the concentrations of As, Hg, and Pb in water ranged from 66 to 82,500 µg/L, 17 to 2080 µg/L, and 11 to 1670 µg/L, respectively. These levels exceeded, by 1000 to 10,000 times, the safe limits of drinking water defined by the World Health Organization, which indicated that Bone River water is not safe for drinking or cooking purposes.

A State-of-the-Science Review of Mercury Biomarkers in Human Populations Worldwide between 2000 and 2018

BACKGROUND

The Minamata Convention on Mercury provided a mandate for action against global mercury pollution. However, our knowledge of mercury exposures is limited because there are many regions and subpopulations with little or no data.

OBJECTIVE

We aimed to increase worldwide understanding of human exposures to mercury by collecting, collating, and analyzing mercury concentrations in biomarker samples reported in the published scientific literature.

METHOD

A systematic search of the peer-reviewed scientific literature was performed using three databases. A priori search strategy, eligibility criteria, and data extraction steps were used to identify relevant studies.

RESULTS

We collected 424,858 mercury biomarker measurements from 335,991 individuals represented in 312 articles from 75 countries. General background populations with insignificant exposures have blood, hair, and urine mercury levels that generally fall under [Formula: see text], [Formula: see text], and [Formula: see text], respectively. We identified four populations of concern: a) Arctic populations who consume fish and marine mammals; b) tropical riverine communities (especially Amazonian) who consume fish and in some cases may be exposed to mining; c) coastal and/or small-island communities who substantially depend on seafood; and d) individuals who either work or reside among artisanal and small-scale gold mining sites.

CONCLUSIONS

This review suggests that all populations worldwide are exposed to some amount of mercury and that there is great variability in exposures within and across countries and regions. There remain many geographic regions and subpopulations with limited data, thus hindering evidence-based decision making. This type of information is critical in helping understand exposures, particularly in light of certain stipulations in the Minamata Convention on Mercury. https://doi.org/10.1289/EHP3904.

Mercury Levels in Women and Children from Interior Villages in Suriname, South America

Natural sources of mercury, historical gold mining, and contemporary artisanal and small-scale gold mining (ASGM) activities have led to mercury contamination in Suriname. Our primary objective was to evaluate mercury levels in hair of women and children from interior villages in Suriname where mercury levels in fish are elevated. We also estimated blood levels of mercury using an established mathematical conversion to facilitate comparison with other biomonitoring programs in the United States. Estimated levels of mercury in the blood of participants from Suriname were significantly higher than those in women from a heavy marine fish-consuming population in southeast Louisiana and estimates of the US national average. This includes women from Surinamese villages well upstream of ASGM activities. Since residents in these areas rely heavily on local fish, this is likely the source of their exposure to mercury. The levels in hair are similar to those seen in women from longitudinal studies finding neurological impairments in children exposed pre- and postnatally. Additional biomonitoring and neurodevelopmental assessments are warranted in these areas, as well as other areas of the Suriname. Mercury levels in hair (Suriname) and blood (southeast LA USA) were determined using cold vapor atomic absorption spectroscopy (CVAAS).

Estimating the Prevalence of Toxic Waste Sites in Low- and Middle-Income Countries

BACKGROUND

Exposure to heavy metals at contaminated industrial and mining sites, known also as hot spots, is a significant source of toxic exposure and adverse health outcomes in countries around the world. The Toxic Sites Identification Program (TSIP) developed by Pure Earth, a New York-based nongovernmental organization, is the only systematic effort to catalogue contaminated sites globally. To date, TSIP has identified and catalogued 3282 sites in low- and middle-income countries. The TSIP methodology is not designed to survey all contaminated sites in a country. Rather sites are prioritized based on their perceived impact on human health, and only a limited number of the most highly hazardous sites are surveyed. The total number of contaminated sites globally and the fraction of contaminated sites captured by TSIP is not known.

OBJECTIVE

To determine the TSIP site capture rate, the fraction of contaminated sites in a country catalogued by TSIP.

METHODS

Ghana was selected for this analysis because it is a rapidly industrializing lower middle income country with a heterogeneous industrial base, a highly urban population (51%), and good public records systems. To develop an estimate of the fraction of sites in Ghana captured by TSIP, assessors targeted randomly selected geographic quadrats for comprehensive assessment using area and population statistics from the Ghana Statistical Service. Investigators physically walked all accessible streets in each quadrat to visually identify all sites. Visual identification was supplemented by field-based confirmation with portable x-ray fluorescence instruments to test soils for metals. To extrapolate from survey findings to develop a range of estimates for the entire country, the investigators used 2 methodologies: a "bottom-up" approach that first estimated the number of waste sites in each region and then summed these regional subtotals to develop a total national estimate; and a "top-down" method that estimated the total number of sites in Ghana and then allocated these sites to each region. Both methods used cluster random sampling principles.

FINDINGS

The investigators identified 72 sites in the sampled quadrats. Extrapolating from these findings to the entire country, the first methodology estimated that there are 1561 sites contaminated by heavy metals in Ghana (confidence interval [CI]: 1134-1987), whereas the second estimated 1944 sites (CI: 812-3075). The estimated total number of contaminated sites in Ghana is thus 7-9 times the number of sites captured through TSIP. On a population basis, it was estimated that there are between 31 and 115 contaminated sites per million inhabitants in Ghana.

CONCLUSIONS

The findings of this study indicate that the TSIP methodology provides a sound statistical basis for policy formulation. The statistical approaches used in this study can be replicated in other countries to improve estimates of the prevalence of contaminated sites. This information provides important input to calculations of the global burden of disease attributable to hazardous exposures at contaminated sites.

Review of Environmental and Health Impacts of Mining in Ghana

Mining has played an important role in the development of Ghana. Like all industries, mining has both benefits and risks for the people living in communities where minerals are found. How these environmental and health impacts are managed by the government, nearby communities and mining companies can either worsen or improve the lives of community inhabitants. The current analysis focuses on the environmental and health impacts of mining in Ghana and blends extant data from the literature as well as the co-authors' recent findings on the causes, status, trends, and consequences of mining in Ghana. The work reviews data on environmental and health impacts of mining such as pollution of water bodies, degradation of forest resources, depletion of soil nutrients, destruction of wildlife habitat, and reduction in quality and threats to human health.

Modulators of mercury risk to wildlife and humans in the context of rapid global change

Environmental mercury (Hg) contamination is an urgent global health threat. The complexity of Hg in the environment can hinder accurate determination of ecological and human health risks, particularly within the context of the rapid global changes that are altering many ecological processes, socioeconomic patterns, and other factors like infectious disease incidence, which can affect Hg exposures and health outcomes. However, the success of global Hg-reduction efforts depends on accurate assessments of their effectiveness in reducing health risks. In this paper, we examine the role that key extrinsic and intrinsic drivers play on several aspects of Hg risk to humans and organisms in the environment. We do so within three key domains of ecological and human health risk. First, we examine how extrinsic global change drivers influence pathways of Hg bioaccumulation and biomagnification through food webs. Next, we describe how extrinsic socioeconomic drivers at a global scale, and intrinsic individual-level drivers, influence human Hg exposure. Finally, we address how the adverse health effects of Hg in humans and wildlife are modulated by a range of extrinsic and intrinsic drivers within the context of rapid global change. Incorporating components of these three domains into research and monitoring will facilitate a more holistic understanding of how ecological and societal drivers interact to influence Hg health risks.

Spatial, Temporal, and Dietary Variables Associated with Elevated Mercury Exposure in Peruvian Riverine Communities Upstream and Downstream of Artisanal and Small-Scale Gold Mining

Artisanal and small-scale gold mining (ASGM) is a primary contributor to global mercury and its rapid expansion raises concern for human exposure. Non-occupational exposure risks are presumed to be strongly tied to environmental contamination; however, the relationship between environmental and human mercury exposure, how exposure has changed over time, and risk factors beyond fish consumption are not well understood in ASGM settings. In Peruvian riverine communities (n = 12), where ASGM has increased 4–6 fold over the past decade, we provide a large-scale assessment of the connection between environmental and human mercury exposure by comparing total mercury contents in human hair (2-cm segment, n = 231) to locally caught fish tissue, analyzing temporal exposure in women of child bearing age (WCBA, 15–49 years, n = 46) over one year, and evaluating general mercury exposure risks including fish and non-fish dietary items through household surveys and linear mixed models. Calculations of an individual’s oral reference dose using the total mercury content in locally-sourced fish underestimated the observed mercury exposure for individuals in many communities. This discrepancy was particularly evident in communities upstream of ASGM, where mercury levels in river fish, water, and sediment measurements from a previous study were low, yet hair mercury was chronically elevated. Hair from 86% of individuals and 77% of children exceeded a USEPA (U.S. Environmental Protection Agency) provisional level (1.2 µg/g) that could result in child developmental impairment. Chronically elevated mercury exposure was observed in the temporal analysis in WCBA. If the most recent exposure exceeded the USEPA level, there was a 97% probability that the individual exceeded that level 8–10 months of the previous year. Frequent household consumption of some fruits (tomato, banana) and grains (quinoa) was significantly associated with 29–75% reductions in hair mercury. Collectively, these data demonstrate that communities located hundreds of kilometers from ASGM are vulnerable to chronically elevated mercury exposure. Furthermore, unexpected associations with fish mercury contents and non-fish dietary intake highlight the need for more in-depth analyses of exposure regimes to identify the most vulnerable populations and to establish potential interventions.

A comparison of licensed and un-licensed artisanal and small-scale gold miners (ASGM) in terms of socio-demographics, work profiles, and injury rates

Background

Artisanal and small-scale gold mining (ASGM) represents one of the most hazardous work environments. While formalization of this sector has been suggested (e.g., Minamata Convention) as a means to improve working conditions, we are unaware of empirical evidence that supports this notion.

This study aimed to compare sociodemographic profiles, work profiles, and injury rates among miners working in licensed versus un-licensed ASGM sites.

Methods

In the Tarkwa mining region of Ghana, 404 small-scale miners were recruited in 2014 and interviewed regarding their occupational injury experiences over the preceding 10 years. Workers were drawn from 9 mining sites, of which 5 were licensed and 4 were not licensed.

Results

Sociodemographic characteristics of miners from the two groups were relatively similar. Those currently working in an un-licensed mine have spent more time in the ASGM sector than those currently working in a licensed mine (94 vs. 70 months). Miners working in an un-licensed site tended to experience more injury episodes (e.g., 26% vs. 8% had 3 or more injury events) and not use personal protective equipment during the time of an injury (92% indicated to not using vs. 73%) when compared to miners working in a licensed site. A total of 121 injury episodes were recorded for 2245 person years of ASGM work. The injury rate for those working in un-licensed mines was 5.9 per 100 person years (59 injuries in 995 person years) versus 5.0 (62 injuries in 1250 person-years) in the licensed mines. When focusing on the male miners, there was a significant difference in injury rates between those working in a licensed mine (4.2 per 100 person years) versus an un-licensed mine (6.1 per 100 person years).

Conclusions

These findings advance our understanding of injuries amongst ASGM workers, and help identify important differences in socio-demographics, work profiles, and injury rates between miners working in a licensed versus and un-licensed site. The findings suggest that certain working conditions in a licensed site may be safer.

Pulmonary function and respiratory health of rural farmers and artisanal and small scale gold miners in Ghana

The recent increase in artisanal and small scale gold mining (ASGM) worldwide has elicited a number of public health concerns for miners and mining communities, including respiratory health. The two primary inhalational exposures of concern are crystalline silica expected to be present in gold ore and smoke from biomass fuels used in cooking. Here, measurements of pulmonary function and of respiratory symptoms were performed in an ASGM community, Kejetia, and a comparison agricultural community, Gorogo, in the Upper East Region of Ghana in May-July 2011. Of 172 participants, 159 performed spirometry, yielding 119 and 95 valid measurements for FEV₁ and FVC, respectively. Percent predicted FEV₁, FVC and FEV₁/FVC, which were lower than predicted for a healthy population, were not significantly different between Kejetia and Gorogo or by mining status in Kejetia. Abnormal lung function was elevated for predicted FEV₁ (15.0%) and FEV₁/FVC (22.0%) beyond an expected five percent in healthy populations. This first examination of pulmonary function in an ASGM community in Ghana (and possibly worldwide) did not show an obvious relationship between mining involvement and lung function abnormality, but did show associations between the use of biomass fuels, adverse respiratory symptoms, and reduced pulmonary function in both populations. A number of factors including age differences between the populations and the required lag time after silica exposure for the onset of respiratory disease may have affected results. Additional research is needed with larger sample sizes and with more detailed questionnaires to further assess the impact of multiple stressors on respiratory health in ASGM communities.