Integrated Assessment of Artisanal and Small-Scale Gold Mining in Ghana—Part 1: Human Health Review

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Abstract

This report is one of three synthesis documents produced via an integrated assessment (IA) that aims to increase understanding of artisanal and small-scale gold mining (ASGM) in Ghana. Given the complexities surrounding ASGM, an IA framework was utilized to analyze economic, social, health, and environmental data, and co-develop evidence-based responses with pertinent stakeholders. The current analysis focuses on the health of ASGM miners and community members, and synthesizes extant data from the literature as well as co-authors’ recent findings regarding the causes, status, trends, and consequences of ASGM in Ghana. The results provide evidence from across multiple Ghanaian ASGM sites that document relatively high exposures to mercury and other heavy metals, occupational injuries and noise exposure. The work also reviews limited data on psychosocial health, nutrition, cardiovascular and respiratory health, sexual health, and water and sanitation. Taken together, the findings provide a thorough overview of human health issues in Ghanaian ASGM communities. Though more research is needed to further elucidate the relationships between ASGM and health outcomes, the existing research on plausible health consequences of ASGM should guide policies and actions to better address the unique challenges of ASGM in Ghana and potentially elsewhere.

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Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease.

Bruce McEwen, Peter J. Gianaros (2010)

The brain is the key organ of stress reactivity, coping, and recovery processes. Within the brain, a distributed neural circuitry determines what is threatening and thus stressful to the individual. Instrumental brain systems of this circuitry include the hippocampus, amygdala, and areas of the prefrontal cortex. Together, these systems regulate physiological and behavioral stress processes, which can be adaptive in the short-term and maladaptive in the long-term. Importantly, such stress processes arise from bidirectional patterns of communication between the brain and the autonomic, cardiovascular, and immune systems via neural and endocrine mechanisms underpinning cognition, experience, and behavior. In one respect, these bidirectional stress mechanisms are protective in that they promote short-term adaptation (allostasis). In another respect, however, these stress mechanisms can lead to a long-term dysregulation of allostasis in that they promote maladaptive wear-and-tear on the body and brain under chronically stressful conditions (allostatic load), compromising stress resiliency and health. This review focuses specifically on the links between stress-related processes embedded within the social environment and embodied within the brain, which is viewed as the central mediator and target of allostasis and allostatic load.

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Evidence on the Human Health Effects of Low-Level Methylmercury Exposure

Margaret R. Karagas, Anna Choi, Emily Oken … (2012)

Background: Methylmercury (MeHg) is a known neuro-toxicant. Emerging evidence indicates it may have adverse effects on the neuro-logic and other body systems at common low levels of exposure. Impacts of MeHg exposure could vary by individual susceptibility or be confounded by bene-ficial nutrients in fish containing MeHg. Despite its global relevance, synthesis of the available literature on low-level MeHg exposure has been limited. Objectives: We undertook a synthesis of the current knowledge on the human health effects of low-level MeHg exposure to provide a basis for future research efforts, risk assessment, and exposure remediation policies worldwide. Data sources and extraction: We reviewed the published literature for original human epidemio-logic research articles that reported a direct biomarker of mercury exposure. To focus on high-quality studies and those specifically on low mercury exposure, we excluded case series, as well as studies of populations with unusually high fish consumption (e.g., the Seychelles), marine mammal consumption (e.g., the Faroe Islands, circumpolar, and other indigenous populations), or consumption of highly contaminated fish (e.g., gold-mining regions in the Amazon). Data synthesis: Recent evidence raises the possibility of effects of low-level MeHg exposure on fetal growth among susceptible subgroups and on infant growth in the first 2 years of life. Low-level effects of MeHg on neuro-logic outcomes may differ by age, sex, and timing of exposure. No clear pattern has been observed for cardio-vascular disease (CVD) risk across populations or for specific CVD end points. For the few studies evaluating immunologic effects associated with MeHg, results have been inconsistent. Conclusions: Studies targeted at identifying potential mechanisms of low-level MeHg effects and characterizing individual susceptibility, sexual dimorphism, and non-linearity in dose response would help guide future prevention, policy, and regulatory efforts surrounding MeHg exposure.

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Economic burden of occupational injury and illness in the United States.

Fiona Leigh (2011)

The allocation of scarce health care resources requires a knowledge of disease costs. Whereas many studies of a variety of diseases are available, few focus on job-related injuries and illnesses. This article provides estimates of the national costs of occupational injury and illness among civilians in the United States for 2007. This study provides estimates of both the incidence of fatal and nonfatal injuries and nonfatal illnesses and the prevalence of fatal diseases as well as both medical and indirect (productivity) costs. To generate the estimates, I combined primary and secondary data sources with parameters from the literature and model assumptions. My primary sources were injury, disease, employment, and inflation data from the U.S. Bureau of Labor Statistics (BLS) and the Centers for Disease Control and Prevention (CDC) as well as costs data from the National Council on Compensation Insurance and the Healthcare Cost and Utilization Project. My secondary sources were the National Academy of Social Insurance, literature estimates of Attributable Fractions (AF) of diseases with occupational components, and national estimates for all health care costs. Critical model assumptions were applied to the underreporting of injuries, wage-replacement rates, and AFs. Total costs were calculated by multiplying the number of cases by the average cost per case. A sensitivity analysis tested for the effects of the most consequential assumptions. Numerous improvements over earlier studies included reliance on BLS data for government workers and ten specific cancer sites rather than only one broad cancer category. The number of fatal and nonfatal injuries in 2007 was estimated to be more than 5,600 and almost 8,559,000, respectively, at a cost of $6 billion and $186 billion. The number of fatal and nonfatal illnesses was estimated at more than 53,000 and nearly 427,000, respectively, with cost estimates of $46 billion and $12 billion. For injuries and diseases combined, medical cost estimates were $67 billion (27% of the total), and indirect costs were almost $183 billion (73%). Injuries comprised 77 percent of the total, and diseases accounted for 23 percent. The total estimated costs were approximately $250 billion, compared with the inflation-adjusted cost of $217 billion for 1992. The medical and indirect costs of occupational injuries and illnesses are sizable, at least as large as the cost of cancer. Workers' compensation covers less than 25 percent of these costs, so all members of society share the burden. The contributions of job-related injuries and illnesses to the overall cost of medical care and ill health are greater than generally assumed. © 2011 Milbank Memorial Fund.

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Author and article information

Contributors

Nil Basu: Role: Academic Editor

Susan Keane: Role: Academic Editor

Paleah Black Moher: Role: Academic Editor

Journal

Journal ID (nlm-ta): Int J Environ Res Public Health

Journal ID (iso-abbrev): Int J Environ Res Public Health

Journal ID (publisher-id): ijerph

Title: International Journal of Environmental Research and Public Health

Publisher: MDPI

ISSN (Print): 1661-7827

ISSN (Electronic): 1660-4601

Publication date (Electronic): 13 May 2015

Publication date (Print): May 2015

Volume: 12

Issue: 5

Pages: 5143-5176

Affiliations

[1 ]Faculty of Agricultural and Environmental Sciences, McGill University, CINE Building Macdonald Campus of McGill University, 21,111 Lakeshore Rd., Ste. Anne de Bellevue, QC H9X 3V9, Canada

[2 ]Ghana Health Service, Accra, Ghana; E-Mails: essieclarke@ 123456yahoo.com (E.C.); odeieric@ 123456gmail.com (E.O.)

[3 ]Department of Environmental Health Sciences, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; E-Mails: aggreen@ 123456umich.edu (A.G.); rachlong@ 123456umich.edu (R.N.L.); rneitzel@ 123456umich.edu (R.L.N.); lovadje@ 123456umich.edu (L.O.); mrajae@ 123456umich.edu (M.R.)

[4 ]Korle Bu Teaching Hospital, Accra, Ghana; E-Mail: calys75@ 123456hotmail.com

[5 ]Faculty of Science, Department of Biology, University of Ottawa, ON K1N 6N5, Canada; E-Mail: laurie.chan@ 123456uottawa.ca

[6 ]Department of Biological, Environmental, and Occupational Health Sciences, School of Public Health, University of Ghana, Legon Boundary, Accra, Ghana; E-Mails: mdzodzo@ 123456hotmail.com (M.D.); jfobil@ 123456gmail.com (J.F.)

[7 ]Council for Scientific and Industrial Research-Water Research Institute, Accra, Ghana; E-Mail: obirisamuel@ 123456gmail.com

[8 ]Noguchi Institute for Medical Research, College of Health Sciences, University of Ghana, Legon Boundary, Accra, Ghana; E-Mail: yaw121@ 123456yahoo.co.uk

[9 ]Department of Epidemiology, Department of Ecology and Evolutionary Biology, University of Michigan School of Public Health, Ann Arbor, MI 48109, USA; E-Mail: wilsonml@ 123456umich.edu

Author notes

[* ]Author to whom correspondence should be addressed; E-Mail: niladri.basu@ 123456mcgill.ca ; Tel.: +1-514-398-8642.

Article

Publisher ID: ijerph-12-05143

DOI: 10.3390/ijerph120505143

PMC ID: 4454960

PubMed ID: 25985314

SO-VID: 24216a95-bd02-44c5-acf9-43ecd6502224

License:

This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution license ( http://creativecommons.org/licenses/by/4.0/).

Integrated Assessment of Artisanal and Small-Scale Gold Mining in Ghana—Part 1: Human Health Review

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Most cited references 128

Central role of the brain in stress and adaptation: links to socioeconomic status, health, and disease.

Evidence on the Human Health Effects of Low-Level Methylmercury Exposure

Economic burden of occupational injury and illness in the United States.

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