An Integrated Assessment Approach to Address Artisanal and Small-Scale Gold Mining in Ghana

Exploring sustainable healthcare: Innovations in health economics, social policy, and management

The healthcare sector faces several challenges, such as rising costs, rising demand, and the need for sustainability. A new area of healthcare has emerged due to these problems, focusing on long-term improvements in management, social policy, and health economics. This research explores the cutting edge of healthcare, concentrating on long-term advancements in management, social policy, and health economics. To better understand the problems affecting the healthcare sector and to pinpoint the areas where sustainable solutions are most required, a survey of 2000 healthcare professionals and policymakers was performed. The data were analyzed using structural equation modeling (SEM), and a thorough sustainable healthcare model was created. According to the survey's findings, the healthcare sector now faces three significant challenges: growing prices, increased demand, and the need for sustainability. According to the respondents, the three main areas where sustainable innovations are most required are management, social policy, and health economics. These conclusions were supported by the (SEM) analysis, which also showed that sustainable practices in these fields significantly impact the sustainability of the healthcare system. These findings lead this research to conclude that to guarantee the accessibility and affordability of healthcare for everyone, a move towards sustainable practices in health economics, social policy, and management is needed. Cooperation between healthcare providers, policymakers, and other stakeholders is required to create creative solutions that support sustainability in the healthcare sector. This study offers a thorough framework for sustainable healthcare that may act as a guide for further research and the formulation of new regulations.

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

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

An examination of mercury levels in the coastal environment and fish of Cote d'Ivoire

Artisanal and small-scale gold mining (ASGM), energy production and other industrial inputs are a major source of anthropogenic mercury (Hg) to the aquatic environment globally, and these inputs have led to environmental contamination and human exposure. While studies have documented the effects of Hg inputs to rivers and marine waters of the West African region, estuarine waters of Cote d'Ivoire have been understudied, besides the waters surrounding Abidjan. To fill this gap, and to examine the potential for human exposure to methylmercury (MeHg), we measured the concentrations of total Hg, MeHg, and ancillary parameters in water (dissolved and particulate phases), sediment and fish to determine the extent of environmental impact and the potential for MeHg exposure for people consuming these fish. Levels of Hg and MeHg in sediment were elevated in the vicinity of the urban environment (up to 0.3 ng/g dry weight (dw) MeHg and 623 ng/g dw total Hg) and lowest in the more remote estuarine environments. Measurements of Hg in tuna and other larger pelagic coastal species indicated that levels were elevated but comparable to other North Atlantic regions. However, levels of Hg in fish, even smaller estuarine species, were such that the rural and urban populations are potentially being exposed to unsafe levels of MeHg, primarily as a result of the relatively high fish consumption in Cote d'Ivoire compared to other countries. Overall, both local point sources and the transport of Hg used in interior ASGM activities are the sources for Hg contamination to these coastal waters.

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

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

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

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

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

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

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

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

Barriers to occupational heat stress risk adaptation of mining workers in Ghana

Increasing temperature and climate warming impacts are aggravating the vulnerability of workers to occupational heat stress. Adaptation and social protection strategies have become crucial to enhance workers' health, safety, productive capacity and social lives. However, the effective implementation of work-related heat stress adaptation mechanisms appears to be receiving little attention. This study assessed the barriers to occupational heat stress adaptation and social protection strategies of mining workers in Ghana. Based on a mixed methods approach, focus group discussions and questionnaires were used to elicit data from 320 mining workers. Workers' adaptation strategies (water intake, wearing loose and light-coloured clothing, participating in training programmes, taking regular breaks, use of mechanical equipment, use of cooling systems and housing designs) varied significantly across the type of mining activity (p < .001). Workers' social protection measures were adequate. The disparities in workers' social protection measures significantly differed across the type of mining activity (p < .001). Barriers of workers to the implementation of relevant adaptation strategies (inadequate knowledge of coping and adaptive behaviour, lack of regular training on adaptation measures, lack of specific heat-related policy regulations, lack of management commitment and the lack of access to innovative technology and equipment) also differed across the type of mining activity (p < .001). Adaptation policy options and recommendations centred on overcoming the barriers that constrain the adaptive capacity of workers and employers have the potential to reduce workers' vulnerability to occupational heat stress.

An assessment of the impact of artisanal and commercial gold mining on mercury and methylmercury levels in the environment and fish in Cote d'Ivoire

Artisanal and small-scale gold mining (ASGM) activities are an important source of mercury (Hg) to the atmosphere globally, and in most countries in West Africa, where gold production has increased dramatically in the last decade from both commercial and ASGM activities. This study focused on examining the concentrations of Hg and methylmercury (MeHg) in water, sediments and fish in four regions associated with gold mining activities in Cote d'Ivoire to assess the potential exposure of the local communities to MeHg from fish consumption. Concentrations of dissolved total Hg and MeHg in water and sediment were elevated at some locations sample and were indicative of local contamination. Several locations had sediment total Hg above 100 ng g^-1 and sediment %MeHg ranged from 0.03 to 4.4%. Fish concentrations exceeded 0.3 μg/ g wet wt., especially for carnivores and fish caught in the western region of the country. Bioaccumulation factors, relative to dissolved MeHg, were higher for carnivores than omnivores and varied with region, suggesting other factors besides MeHg concentration alone were impacting uptake and trophic transfer. Given that people in Cote d'Ivoire consume fish at a higher level than other countries, the levels in fish were sufficient to exceed the US EPA's guidance criteria even at average consumption levels, and particularly for people consuming fish at a higher rate. Overall, this study provides compelling evidence that ASGM activities in Cote d'Ivoire are leading to elevated exposure and likely impacting the health of the local populations in regions where such activity is occurring.

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.

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.

Identification of Response Options to Artisanal and Small-Scale Gold Mining (ASGM) in Ghana via the Delphi Process

The Delphi technique is a means of facilitating discussion among experts in order to develop consensus, and can be used for policy formulation. This article describes a modified Delphi approach in which 27 multi-disciplinary academics and 22 stakeholders from Ghana and North America were polled about ways to address negative effects of small-scale gold mining (ASGM) in Ghana. In early 2014, the academics, working in disciplinary groups, synthesized 17 response options based on data aggregated during an Integrated Assessment of ASGM in Ghana. The researchers participated in two rounds of Delphi polling in March and April 2014, during which 17 options were condensed into 12. Response options were rated via a 4-point Likert scale in terms of benefit (economic, environmental, and benefit to people) and feasibility (economic, social/cultural, political, and implementation). The six highest-scoring options populated a third Delphi poll, which 22 stakeholders from diverse sectors completed in April 2015. The academics and stakeholders also prioritized the response options using ranking exercises. The technique successfully gauged expert opinion on ASGM, and helped identify potential responses, policies and solutions for the sector. This is timely given that improvement to the ASGM sector is an important component within the UN Minamata Convention.