Mercury Exposure Among Artisanal and Small-Scale Gold Miners in Four Regions in Uganda

Health Screening Strategies for Artisanal and Small-Scale Miners for Tuberculosis, Human Immunodeficiency Virus and Silicosis: A Case of the USAID-Supported Kunda Nqob'iTB Project in Zimbabwe

Artisanal and small-scale mining is characterized by excessive exposure to physical, chemical, ergonomic, psychosocial and biological hazards. There is a high burden of tuberculosis (TB), human immunodeficiency virus (HIV) infections and silicosis among artisanal and small-scale miners (ASMs). The aim of this project report is to describe lessons learned from strategies implemented to reach ASMs with screening services for TB, HIV and silicosis in Zimbabwe through the Kunda-Nqob'i TB (KNTB) project supported by the United States Agency for International Development (USAID). The intervention package for screening ASMs for TB, HIV and silicosis included service provision through two occupational health clinics at two provincial hospitals and a mobile workplace-based screening (WBS) facility at the mining sites. From 1 October 2020 to 30 September 2023, 10,668 ASMs were screened, with a high number of cases of silicosis (21%) and TB (7.4%). There was a high burden of HIV (30%) in ASMs attending the occupational health clinics. The two occupational health clinics screened 3453 ASMs, while the mobile WBS activities screened 7215 ASMs during the period. A total of 370 healthcare workers (doctors/clinical officers, nurses, environmental health technicians and district tuberculosis and Leprosy control officers) were trained on TB and the fundamental diagnostic principles of silicosis. The KNTB project has been successful in reaching out to many ASMs operating in remote and hard-to-reach mining areas. The KNTB project has brought to light the positive health-seeking behavior of ASMs operating in remote areas. The project has brought to the fore the effectiveness of multi-stakeholder engagement and collaboration in reaching out to ASMs in remote areas with health screening services. There is a high burden of TB, HIV and silicosis in ASMs. Screening for TB, HIV and silicosis using workplace-based screening and occupational health clinics is an effective strategy and should be rolled out to all areas with high artisanal and small-scale mining activity.

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.

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.

Information needs, approaches, and case studies in human health risk communication

This article uses ten case studies to illustrate the information needs, various communication approaches, and the communicator's role in explaining environmental health risks from a variety of hazards, to a variety of audiences, over time frames from days to years, using in person consultation, lectures, zooms, and email formats. Events often had a long history before the communication began and may have had a long tail afterward. Audiences may be public officials, companies, workers, communities, or individuals. Each individual may have their own understanding or mental model regarding the hazard, exposure, and risk. The communicator's role or intention may be to reassure an audience that has unrealistic exaggerated concerns or fears or to protect a client if the fears are realistic. Or it may be altruistic to inform a complacent audience to take the risks it faces more seriously. Although risk assessment research has advanced the techniques for communicating abstruse probabilities to audiences with low numeracy, in my experience, audiences are unimpressed by precise-sounding probability numbers, and are more interested in whether exposure is occurring or may occur and how to stop it. Often audiences have reason to be outraged and may be more concerned about punishing wrong doers than about the hazard itself, particularly when the exposure is past and cannot be undone. Thus, there is a difference between discussing the riskiness of a situation (risk communication) and what you are going to do about the situation (risk management). Risk communication is successful when the audience responds as intended, calming down or taking action. These case studies are drawn from a large number of risk communication experiences that I and my Rutgers colleagues have engaged in over the past four decades. Through the 20th century, New Jersey was the most densely industrialized State in United States. New Jersey experienced growth of the chemical and petrochemical industries and the unfortunately profligate disposal of toxic wastes. Having the most Superfund sites of any state is a dubious distinction, but New Jersey also has the most experience in evaluating and responding to these hazards.

Transporters and Toxicity: Insights from the International Transporter Consortium Workshop 4

Over the last decade, significant progress been made in elucidating the role of membrane transporters in altering drug disposition, with important toxicological consequences due to changes in localized concentrations of compounds. The topic of "Transporters and Toxicity" was recently highlighted as a scientific session at the International Transporter Consortium (ITC) Workshop 4 in 2021. The current white paper is not intended to be an extensive review on the topic of transporters and toxicity but an opportunity to highlight aspects of the role of transporters in various toxicities with clinically relevant implications as covered during the session. This includes a review of the role of solute carrier transporters in anticancer drug-induced organ injury, transporters as key players in organ barrier function, and the role of transporters in metal/metalloid toxicity.

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

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