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Original Research

Global Burden of Disease of Mercury Used in Artisanal Small-Scale Gold Mining

Authors:

Nadine Steckling ,

Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany; University Hospital Munich, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit Paediatric Environmental Epidemiology, Munich, Germany; Department of Public Health and Health Technology Assessment, University for Health Sciences, Medical Computer Science and Technology, Hall in Tirol, Austria
About Nadine
PhD
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Myriam Tobollik,

Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany; German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
About Myriam
MSc
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Dietrich Plass,

German Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Berlin, Germany
About Dietrich
PhD
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Claudia Hornberg,

Bielefeld University, School of Public Health, Department Environment & Health, Bielefeld, Germany
About Claudia
PhD
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Bret Ericson,

Pure Earth, formerly Blacksmith Institute, New York, NY
About Bret
MSc
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Richard Fuller,

Pure Earth, formerly Blacksmith Institute, New York, NY
About Richard
BE
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Stephan Bose-O'Reilly

University Hospital Munich, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Unit Paediatric Environmental Epidemiology, Munich, Germany; Department of Public Health and Health Technology Assessment, University for Health Sciences, Medical Computer Science and Technology, Hall in Tirol, Austria
About Stephan
MD
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Abstract

Background

Artisanal small-scale gold mining (ASGM) is the world's largest anthropogenic source of mercury emission. Gold miners are highly exposed to metallic mercury and suffer occupational mercury intoxication. The global disease burden as a result of this exposure is largely unknown because the informal character of ASGM restricts the availability of reliable data.

Objective

To estimate the prevalence of occupational mercury intoxication and the disability-adjusted life years (DALYs) attributable to chronic metallic mercury vapor intoxication (CMMVI) among ASGM gold miners globally and in selected countries.

Methods

Estimates of the number of artisanal small-scale gold (ASG) miners were extracted from reviews supplemented by a literature search. Prevalence of moderate CMMVI among miners was determined by compiling a dataset of available studies that assessed frequency of intoxication in gold miners using a standardized diagnostic tool and biomonitoring data on mercury in urine. Severe cases of CMMVI were not included because it was assumed that these persons can no longer be employed as miners. Cases in workers' families and communities were not considered. Years lived with disability as a result of CMMVI among ASG miners were quantified by multiplying the number of prevalent cases of CMMVI by the appropriate disability weight. No deaths are expected to result from CMMVI and therefore years of life lost were not calculated. Disease burden was calculated by multiplying the prevalence rate with the number of miners for each country and the disability weight. Sensitivity analyses were performed using different assumptions on the number of miners and the intoxication prevalence rate.

Findings

Globally, 14-19 million workers are employed as ASG miners. Based on human biomonitoring data, between 25% and 33% of these miners—3.3-6.5 million miners globally—suffer from moderate CMMVI. The resulting global burden of disease is estimated to range from 1.22 (uncertainty interval [UI] 0.87-1.61) to 2.39 (UI 1.69-3.14) million DALYs.

Conclusions

This study presents the first global and country-based estimates of disease burden caused by mercury intoxication in ASGM. Data availability and quality limit the results, and the total disease burden is likely undercounted. Despite these limitations, the data clearly indicate that mercury intoxication in ASG miners is a major, largely neglected global health problem.

How to Cite: Steckling, N., Tobollik, M., Plass, D., Hornberg, C., Ericson, B., Fuller, R. and Bose-O'Reilly, S., 2017. Global Burden of Disease of Mercury Used in Artisanal Small-Scale Gold Mining. Annals of Global Health, 83(2), pp.234–247. DOI: http://doi.org/10.1016/j.aogh.2016.12.005
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Published on 12 Jun 2017.
Peer Reviewed

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