title: A review of mercury exposure among artisanal small-scale gold miners in developing countries.
abstract: OBJECTIVE
  Extraction of gold using mercury has been a way out of poverty for millions of people in developing countries. Artisanal small-scale gold mining (ASGM) has expanded during the last decades and is often carried out under primitive conditions. Thus, workers in this industry may be exposed to high levels of mercury and suffer from toxic effects from mercury exposure. The objective of this review was to provide an outline of the studies available on elemental mercury exposure among artisanal small-scale gold miners.
  
  
  METHODS
  Searching the PubMed and Embase databases, 26 studies with a total of 3,005 exposed subjects and 442 controls across 14 different developing countries were found. Urine mercury levels were used as biomarkers of exposure.
  
  
  RESULTS
  In general, the urine mercury levels were elevated and a considerable proportion of workers had urine mercury levels above existing guidelines. Exposed subjects were stratified into residents, miners, millers, smelters, and refiners, who by work task content were expected to be increasingly exposed to mercury. This group order did show a clear trend of increasing mercury levels. Mercury levels differed substantially between studies. Possible explanations include dissimilarities in gold extraction methods, use of protective devices, and selection of participants.
  
  
  CONCLUSIONS
  This review provides evidence that artisanal gold miners and residents of the mining sites are exposed to mercury vapour to an extent where acute and long-term toxic effects of mercury are likely. Interventions aimed at reducing exposure and emission of mercury from ASGM are needed.
authors: Department of Occupational and Environmental Medicine, Bispebjerg Hospital, Bispebjerg Bakke 23, 2400, Copenhagen NV, Denmark, kasperkristensen4@gmail.com.
authors: Anders Kasper Bruun
authors: AK
authors: Kristensen
authors: Jane Frølund
authors: JF
authors: Thomsen
authors: Sigurd
authors: S
authors: Mikkelsen
mesh_terms: D015415:Biomarkers / Q000652:urine; D003906:Developing Countries; D006046:Gold; D006801:Humans; D008628:Mercury / Q000633:toxicity / Q000652:urine*; D008906:Mining; D016273:Occupational Exposure / Q000009:adverse effects / Q000032:analysis*; D009790:Occupations
chemical_list: D015415:Biomarkers; D006046:Gold; D008628:Mercury
references: Int Arch Occup Environ Health. 2001 Apr;74(3):206-12
references: 11355295
references: Bull Environ Contam Toxicol. 2010 Nov;85(5):476-80
references: 21069282
references: Sci Total Environ. 2010 Jan 15;408(4):713-25
references: 19945736
references: J Occup Environ Med. 2001 Feb;43(2):158-65
references: 11227634
references: Sci Total Environ. 2010 Nov 15;408(24):6079-85
references: 20875913
references: Environ Res. 1998 May;77(2):91-7
references: 9600801
references: Environ Geochem Health. 2003 Sep;25(3):325-45
references: 12971253
references: Sci Total Environ. 2001 Feb 21;267(1-3):151-68
references: 11286210
references: Sci Total Environ. 2011 Feb 1;409(5):994-1000
references: 21183207
references: Clin Neuropsychol. 2006 Feb;20(1):108-32
references: 16393923
references: Arch Toxicol. 2004 Apr;78(4):207-11
references: 14598023
references: Arch Environ Occup Health. 2007 Fall;62(3):121-8
references: 18400651
references: Environ Health Perspect. 2002 Feb;110 Suppl 1:11-23
references: 11834460
references: Arch Toxicol. 2002 Apr;76(3):127-36
references: 11967617
references: Bull Environ Contam Toxicol. 2001 Sep;67(3):317-23
references: 11479659
references: Int J Occup Environ Health. 2006 Oct-Dec;12(4):340-5
references: 17168221
references: J Environ Sci Health A Tox Hazard Subst Environ Eng. 2007 Dec;42(14):2071-9
references: 18074277
references: Arch Environ Occup Health. 2005 Jan-Feb;60(1):17-23
references: 16961004
references: Ann Clin Lab Sci. 2004 Summer;34(3):235-50
references: 15487698
references: J Toxicol Clin Toxicol. 1995;33(1):1-10
references: 7837306
references: J Toxicol Clin Toxicol. 1993;31(2):295-306
references: 8492342
references: Environ Health Perspect. 2003 Apr;111(4):623-30
references: 12676626
references: PLoS One. 2011 Apr 19;6(4):e18875
references: 21526143
references: Int Arch Occup Environ Health. 2011 Jun;84(5):539-46
references: 21279378
references: Sci Total Environ. 2010 Jan 15;408(4):796-805
references: 19945738
references: Toxicol Lett. 2012 Aug 13;213(1):75-82
references: 21925580
references: Sci Total Environ. 2000 Oct 2;259(1-3):45-53
references: 11032134
references: Sci Total Environ. 1996 Nov 18;191(1-2):59-68
references: 8885424