Artisanal and small-scale gold miners are confronted with numerous hazards often resulting in varying degrees of injuries and fatalities. In Ghana, like many developing countries, there is paucity of ...information on the causes and nature of the accidents that result in the injuries. The study was a retrospective, cross sectional type that examined the records of injuries of artisanal and small-scale gold miners presented to the emergency department of a district hospital in the Eastern Region of Ghana from 2006 to 2013. The causes, types, and outcomes of reported injuries were analyzed for 72 cases. Occurrences of mining accidents reported in selected Ghanaian media during the year 2007-2012 were also analyzed to corroborate the causes of the accidents. Fractures and contusions constituted the most frequently occurring injuries, with collapse of the mine pits and falls being the most frequent cause of accidents reported both by the hospital and media records. This study shows that though varied degrees of injuries occur among the miners, the potential for serious injuries is substantial. Measures to reduce the incidence of injuries and fatalities should include education and training on the use of safe working tools and means of creating a safe working environment.
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.
Human exposure to polychlorinated biphenyls (PCBs) and brominated flame retardants (BFRs) such as polybrominated diphenyl ethers (PBDEs) and hexabromocyclododecanes (HBCDs) was evaluated in Ghana ...using breast milk samples collected in 2004 and 2009. Mean levels and ranges of PBDEs (4.5; 0.86–18ng/g lw) and PCBs (62; 15–160ng/g lw) observed in the present study were unexpectedly high, in spite of the fact that Ghana is a non-industrialized country when compared with many of the Asian and European countries. Significant increases were found in the concentrations of PCBs and PBDEs over the years, while no significant increase was observed for HBCDs. Estimated hazard quotient (HQ) showed that all the mothers had HQ values exceeding the threshold of 1 for PCBs, indicating potential health risk for their children. PCBs in dirty oils and obsolete equipment should be of concern as potential sources in Ghana, and e-waste recycling with little or no experience in safe handling could be a threat to this sub-region noted for unregulated disposal of e-waste. The results may point towards an increase in trends in human milk in Ghana, especially in the larger cities but further analysis would be required to confirm this upward trend in levels. This is the first study to report BFRs in human breast milk from Africa, and undoubtedly from Ghana.
► Human exposure to PCBs, PBDEs and HBCDs was done in Ghana using breast milk samples. ► Significant increases were found in the levels of PCBs and PBDEs over the years. ► All the mothers had hazard quotient values exceeding the threshold of 1 for PCBs. ► This is the first study to report BFRs in human breast milk from Africa.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK
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.
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.
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).
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.
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DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
Background: One of the concerns raised regarding the introduction of any new HIV-prevention measure, such as PrEP, is the potential for risk disinhibition or sexual risk compensation. The oral ...tenofovir HIV prevention trial has been the subject of international discussion in this regard. Methods: This article maps the changes in sexual risk behavior among women participating in the oral tenofovir HIV prevention trial in Ghana. Content-driven, thematic analysis was carried out on qualitative data obtained from in-depth interviews with study participants. Growth curve analysis was the primary method used to document trends over time in self-reported sexual behavior collected monthly. Results: Overall, the study found that sexual risk behavior did not increase during the trial. Number of sexual partners and rate of unprotected sex acts decreased across the 12-month period of study enrollment. Certain subgroups of women, however, exhibited different growth curves. Data indicate that the HIV prevention counseling associated with the trial was effective. Conclusions: Counseling during the trial was effective. Different types of counseling and messaging may be needed for different subgroups within a population. These findings also have implications for required sample sizes for future HIV prevention trials where seroconversion is the main outcome.
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BFBNIB, NMLJ, NUK, PNG, UL, UM, UPUK
Exposure to arsenic is one of the major global health problems, affecting > 300 million people worldwide, but arsenic's effects on human reproduction are uncertain.
We conducted a systematic review ...and meta-analysis to examine the association between arsenic and adverse pregnancy outcomes/infant mortality.
We searched PubMed and Ovid MEDLINE (from 1946 through July 2013) and EMBASE (from 1988 through July 2013) databases and the reference lists of reviews and relevant articles. Studies satisfying our a priori eligibility criteria were evaluated independently by two authors.
Our systematic search yielded 888 articles; of these, 23 were included in the systematic review. Sixteen provided sufficient data for our quantitative analysis. Arsenic in groundwater (≥ 50 μg/L) was associated with increased risk of spontaneous abortion (6 studies: OR = 1.98; 95% CI: 1.27, 3.10), stillbirth (9 studies: OR = 1.77; 95% CI: 1.32, 2.36), moderate risk of neonatal mortality (5 studies: OR = 1.51; 95% CI: 1.28, 1.78), and infant mortality (7 studies: OR = 1.35; 95% CI: 1.12, 1.62). Exposure to environmental arsenic was associated with a significant reduction in birth weight (4 studies: β = -53.2 g; 95% CI: -94.9, -11.4). There was paucity of evidence for low-to-moderate arsenic dose.
Arsenic is associated with adverse pregnancy outcomes and infant mortality. The interpretation of the causal association is hampered by methodological challenges and limited number of studies on dose response. Exposure to arsenic continues to be a major global health issue, and we therefore advocate for high-quality prospective studies that include individual-level data to quantify the impact of arsenic on adverse pregnancy outcomes/infant mortality.
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CEKLJ, DOBA, IZUM, KILJ, NUK, OILJ, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK, VSZLJ
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.
•Unclear if formalization of ASGM can improve health and safety•Mercury measures and neurological tests on registered and unregistered ASGM workers•Urine mercury ~3-fold higher in miners from unregistered versus registered sites•~30% of miners indicated health challenges•Findings relevant for Minamata Convention stakeholders considering options for ASGM
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
In this study, polybrominated and mixed halogenated dibenzo-p-dioxins and furans (PBDD/Fs and PXDD/Fs), and dioxin-like polychlorinated biphenyls (dlPCBs) were quantified in 24 human milk samples of ...first-time lactating mothers from Greater Accra region in Ghana. The aims of the study were to determine the concentrations and toxic equivalent concentrations of PBDD/F, PXDD/F and dlPCBs in human milk, and to estimate an infant's daily intake. The samples were analysed for 12 dioxin-like PCBs, 7 congeners of 2,3,7,8-polybrominated dibenzo-p-dioxins and furans (PBDD/Fs), and 7 congeners of 2,3,7,8-mixed halogenated dioxins and furans (PXDD/Fs, where X = Br/Cl). The mean concentrations in human milk ranged from 0.15 to 212.9 pg/g lipid for dlPCB congeners (mean TEQ: 1.67 pg WHO2005-TEQ/g lipid). Lesser concentrations for 2,3,7,8-PXDD/Fs (and PBDD/Fs congeners) ranged between <0.01–1.67 pg/g lipid, with a total mean tentative TEQ of 0.56 pg WHO2005-TEQ/g lipid. For an infant of average weight 7 kg, consuming an estimated volume of 600 mL human milk, the estimated average daily intake of dlPCBs in 21 human milk samples was 4.95 pg TEQ/kg bw/day; contributions from dlPCBs, PXDD/Fs and PBDD/Fs resulted in an average estimated daily intake of 6.56 pg TEQ/kg bw/day. The results obtained in this study, although lower than infant dietary intake estimates in human milk from industrialized countries, exceeded the recommended safety standards of 1 pg TEQ/kg bw/day and 1–4 pg TEQ/kg bw/day from the Agency for Toxic Substances and Disease Registry (ATSDR) and the World Health Organization (WHO), respectively.
•First study on Ghanaian infant dietary intake of PBDD/Fs, PXDD/Fs from human milk.•Average daily intake of DLCs exceeded WHO recommended safety standards.•Concentrations dlPCBs ≫ PBDD/Fs > PXDD/Fs.•Human milk TEQ concentrations: lower than estimates from industrialized countries.
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
Human exposure data on dioxins and dioxin-like compounds (DLCs) in Ghana are limited. Based on health risks associated with dioxins and DLCs, the impact of maternal body burdens on foetal exposure is ...significant. This is the first study that assesses polychlorinated, polybrominated and mixed halogenated dibenzo-p-dioxins and dibenzofurans (PCDD/Fs, PBDD/Fs and PXDD/Fs), and dioxin-like polychlorinated biphenyls (dlPCBs) in sera of primiparous Ghanaians. Our sample selection includes 34 participants from two municipalities (Accra and Tema), and explores contributions from environmental and dietary exposures using questionnaire data. Sample preparation involved C18 solid phase extraction, purification with acidified silica and lipid removal cartridges, and detection with gas chromatography-atmospheric pressure chemical ionization-tandem mass spectrometry. The calculated average toxic equivalent concentration was 5.3 pg TEQ/g lw, with contributions from dlPCBs (1.25 pg TEQ/g lw), PCDD/Fs (3.10 pg TEQ/g lw), PBDD/Fs (0.49 pg TEQ/g lw) and PXDD/Fs (0.50 pg TEQ/g lw). The calculated total TEQ concentration was lower than background TEQ concentrations reported in sera of pregnant women globally. Positive correlations were obtained for total dioxins and DLC concentrations with age and Body Mass Index (BMI). Dietary intake of seafood and dairy products had a strong influence on PCDD/F and dlPCB concentrations. Statistically significant differences were observed for dioxins and DLCs in participants from Accra (in close proximity to Agbogbloshie e-waste site) and Tema. Given the significant TEQ contribution of PBDD/Fs and PXDD/Fs (~20%), it is essential to explore these classes of dioxins and DLCs in future biomonitoring studies as they may pose health risks, and add extra diagnostic information in source exposure investigations.
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•First study on PCDD/Fs, PBDD/Fs, PXDD/Fs and dlPCBs in primiparous Ghanaian sera•Significant % TEQ contributions from PXDD/F and PBDD/F (~20%) to total TEQ•Closer proximity to Agbogbloshie e-waste site: higher dioxins & DLC concentrations•Major sources of exposure: Dietary intake & combustion
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GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UILJ, UL, UM, UPCLJ, UPUK, ZAGLJ, ZRSKP
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