title: Disease profile and health-related quality of life (HRQoL) using the EuroQol (EQ-5D + C) questionnaire for chronic metallic mercury vapor intoxication.
abstract: BACKGROUND
  Toxic mercury is still being used today for example by workers mining gold, resulting in diverse health symptoms in users and individuals in proximity. A considerable burden of disease (BoD) can be assumed, while previous analyses were limited by data scarcity. Besides limited epidemiological data, neither data about the health-related quality of life (HRQoL) nor about the disease severity (disability weight, DW) is available. The aim of the project was to develop disease profiles of chronic metallic mercury vapor intoxication (CMMVI) by including the HRQoL to improve the data basis for BoD analyses of gold miners exposed to mercury.
  
  
  METHODS
  Disease profiles comprising the disease label [a], differentiation into disease stages [b], description of the cause of exposure [c], a list of common symptoms [d], and an assessment of the HRQoL [e] were developed using expert elicitation and literature search. The HRQoL was assessed by experts using the five EuroQol dimensions accompanied by the cognition add-on questionnaire (EQ-5D + C).
  
  
  RESULTS
  The ten sources used for the analyses (interview transcript, presentation, and eight literature reviews) identified more than 250 terms describing 85 distinguishable health effects of CMMVI. The analysis revealed 29 common symptoms that were frequently mentioned. Moderate and severe CMMVI cases differ regarding their symptoms and/or symptom severity and HRQoL, resulting in the EQ-5D + C-3L codes 121222 and 233333, respectively.
  
  
  CONCLUSIONS
  The profiles should be used to facilitate the ascertainment of CMMVI cases, to compare the HRQoL with other diseases, to derive DWs for improving BoD estimates, and to foster discussions about how to reduce the associated burden.
authors.affiliation: WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Workgroup Paediatric Environmental Epidemiology, University Hospital Munich, Ziemssenstr. 1, D-80336, Munich, Germany. nadine.steckling@uni-bielefeld.de.|School of Public Health, Department of Environment & Health, Bielefeld University, Universitätsstraße, 25, D-33615, Bielefeld, Germany. nadine.steckling@uni-bielefeld.de.
authors.forename: Nadine
authors.initials: N
authors.lastname: Steckling
authors.affiliation: Federal Environment Agency, Section Exposure Assessment and Environmental Health Indicators, Corrensplatz 1, D-14195, Berlin, Germany. Dietrich.Plass@uba.de.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Plass
authors.affiliation: WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, Workgroup Paediatric Environmental Epidemiology, University Hospital Munich, Ziemssenstr. 1, D-80336, Munich, Germany. Stephan.BoeseOReilly@med.uni-muenchen.de.|Institute of Public Health, Medical Decision Making and Health Technology Assessment, Department of Public Health and Health Technology Assessment, Eduard Wallnoefer Center I, UMIT (The Health & Life Sciences University), A-6060, Hall i.T., Austria. Stephan.BoeseOReilly@med.uni-muenchen.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bose-O'Reilly
authors.affiliation: Department of Occupational Medicine, Idrija Mercury Mine, Idrija, Slovenia. abkobal@amis.net.
authors.forename: Alfred Bogomir
authors.initials: AB
authors.lastname: Kobal
authors.affiliation: School of Public Health, Department of Public Health Medicine, Bielefeld University, Universitätsstraße 25, D-33615, Bielefeld, Germany. alexander.kraemer@uni-bielefeld.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Krämer
authors.affiliation: School of Public Health, Department of Environment & Health, Bielefeld University, Universitätsstraße, 25, D-33615, Bielefeld, Germany. claudia.hornberg@uni-bielefeld.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Hornberg
mesh_terms: D000328:Adult; D000395:Air Pollutants, Occupational / Q000009:adverse effects / Q000592:standards*; D003430:Cross-Sectional Studies; D006233:Persons with Disabilities / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008628:Mercury / Q000633:toxicity*; D008906:Mining; D016273:Occupational Exposure / Q000009:adverse effects / Q000592:standards*; D011788:Quality of Life / Q000523:psychology*; D011795:Surveys and Questionnaires / Q000592:standards*
chemical_list: D000395:Air Pollutants, Occupational; D008628:Mercury