title: A preliminary study on health effects in villagers exposed to mercury in a small-scale artisanal gold mining area in Indonesia.
abstract: Cisitu is a small-scale gold mining village in Indonesia. Mercury (Hg) is used to extract gold from ore, heavily polluting air, soil, fish and rice paddy fields with Hg. Rice in Cisitu is burdened with mercury. The main staple food of the inhabitants of Cisitu is this polluted rice. Villagers were concerned that the severe diseases they observed in the community might be related to their mining activities, including high mercury exposure. Case report of the medical examinations and the mercury levels in urine and hair of 18 people with neurological symptoms. Typical signs and symptoms of chronic mercury intoxication were found (excessive salivation, sleep disturbances, tremor, ataxia, dysdiadochokinesia, pathological coordination tests, gray to bluish discoloration of the oral cavity and proteinuria). Mercury levels in urine were increased in eight patients (>7µg Hg/L urine). All 18 people had increased hair levels (>1µg Hg/g hair). 15 patients exhibited several, and sometimes numerous, symptoms in addition to having moderately to highly elevated levels of mercury in their specimens. These patients were classified as intoxicated. The situation in Cisitu is special, with rice paddy fields being irrigated with mercury-contaminated water and villagers consuming only local food, especially mercury-contaminated rice. Severe neurological symptoms and increased levels of mercury in urine and hair support are possibly caused by exposure to inorganic mercury in air, and the consumption of mercury-contaminated fish and rice. The mercury exposure needs to be reduced and treatment provided. Further research is needed to test the hypothesis that mercury-contaminated rice from small-scale gold mining areas might cause mercury intoxication.
authors.affiliation: University Hospital Munich, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, Ziemssenstr. 1, d-80336 Munich, Germany; University for Health Sciences, Medical Informatics and Technology (UMIT), Department of Public Health and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, Eduard Wallnoefer Center I, A-6060 Hall i.T., Austria. Electronic address: stephan.boeseoreilly@med-uni-muenchen.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bose-O'Reilly
authors.affiliation: University Hospital Munich, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, Ziemssenstr. 1, d-80336 Munich, Germany. Electronic address: Rudolf.Schierl@med.uni-muenchen.de.
authors.forename: Rudolf
authors.initials: R
authors.lastname: Schierl
authors.affiliation: University Hospital Munich, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health, Ziemssenstr. 1, d-80336 Munich, Germany. Electronic address: Dennis.Nowak@med.uni-muenchen.de.
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
authors.affiliation: University for Health Sciences, Medical Informatics and Technology (UMIT), Department of Public Health and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, Eduard Wallnoefer Center I, A-6060 Hall i.T., Austria; Institute for Technology Assessment and Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Center for Health Decision Science, Department of Health Policy and Management, Harvard School of Public Health, Boston, MA, USA. Electronic address: uwe.siebert@umit.at.
authors.forename: Uwe
authors.initials: U
authors.lastname: Siebert
authors.affiliation: BaliFokus Foundation, Mandalawangi No. 5, Jalan Tukad Tegalwangi, Denpasar 80223, Bali, Indonesia; Medicuss Foundation, Ruko A45, Hypersquare, Jalan Pasirkaliki, Bandung 40114, Indonesia.
authors.forename: Jossep Frederick
authors.initials: JF
authors.lastname: William
authors.affiliation: Medicuss Foundation, Ruko A45, Hypersquare, Jalan Pasirkaliki, Bandung 40114, Indonesia.
authors.forename: Fradico Teorgi
authors.initials: FT
authors.lastname: Owi
authors.affiliation: BaliFokus Foundation, Mandalawangi No. 5, Jalan Tukad Tegalwangi, Denpasar 80223, Bali, Indonesia. Electronic address: medicuss.foundation@gmail.com.
authors.forename: Yuyun Ismawati
authors.initials: YI
authors.lastname: Ir
mesh_terms: D004781:Environmental Exposure; D005506:Food Contamination / Q000032:analysis*; D006197:Hair / Q000737:chemistry; D006801:Humans; D007214:Indonesia; D008628:Mercury / Q000378:metabolism* / Q000652:urine; D008906:Mining; D012275:Oryza / Q000737:chemistry*
chemical_list: D008628:Mercury
keywords: Artisanal small-scale gold mining; Indonesia; Intoxication; Mercury; Rice