title: Disability Weights for Chronic Mercury Intoxication Resulting from Gold Mining Activities: Results from an Online Pairwise Comparisons Survey.
abstract: In artisanal small-scale gold mining, mercury is used for gold-extraction, putting miners and nearby residents at risk of chronic metallic mercury vapor intoxication (CMMVI). Burden of disease (BoD) analyses allow the estimation of the public health relevance of CMMVI, but until now there have been no specific CMMVI disability weights (DWs). The objective is to derive DWs for moderate and severe CMMVI. Disease-specific and generic health state descriptions of 18 diseases were used in a pairwise comparison survey. Mercury and BoD experts were invited to participate in an online survey. Data were analyzed using probit regression. Local regression was used to make the DWs comparable to the Global Burden of Disease (GBD) study. Alternative survey (visual analogue scale) and data analyses approaches (linear interpolation) were evaluated in scenario analyses. A total of 105 participants completed the questionnaire. DWs for moderate and severe CMMVI were 0.368 (0.261-0.484) and 0.588 (0.193-0.907), respectively. Scenario analyses resulted in higher mean values. The results are limited by the sample size, group of interviewees, questionnaire extent, and lack of generally accepted health state descriptions. DWs were derived to improve the data basis of mercury-related BoD estimates, providing useful information for policy-making. Integration of the results into the GBD DWs enhances comparability.
authors.affiliation: Unit Paediatric Environmental Epidemiology, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ziemssenstr. 1, Munich 80336, Germany. nadine.steckling@med.uni-muenchen.de.|Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard Wallnoefer Center I, Hall in Tyrol 6060, Austria. nadine.steckling@med.uni-muenchen.de.|Department of Environment & Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 33615, Germany. nadine.steckling@med.uni-muenchen.de.
authors.forename: Nadine
authors.initials: N
authors.lastname: Steckling
authors.affiliation: Department of Public Health and Surveillance, Scientific Institute of Public Health (WIV-ISP), Rue Juliette Wytsmanstraat 14, Brussels 1050, Belgium. brechtdv@gmail.com.
authors.forename: Brecht
authors.initials: B
authors.lastname: Devleesschauwer
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 33615, Germany. julia.winkelnkemper@uni-bielefeld.de.
authors.forename: Julia
authors.initials: J
authors.lastname: Winkelnkemper
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 33615, Germany. f.fischer@uni-bielefeld.de.
authors.forename: Florian
authors.initials: F
authors.lastname: Fischer
authors.affiliation: Pure Earth, Formerly Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA. bret@pureearth.org.
authors.forename: Bret
authors.initials: B
authors.lastname: Ericson
authors.affiliation: Department of Public Health Medicine, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 33615, Germany. alexander.kraemer@uni-bielefeld.de.
authors.forename: Alexander
authors.initials: A
authors.lastname: Krämer
authors.affiliation: Department of Environment & Health, School of Public Health, Bielefeld University, Universitätsstr. 25, Bielefeld 33615, Germany. claudia.hornberg@uni-bielefeld.de.
authors.forename: Claudia
authors.initials: C
authors.lastname: Hornberg
authors.affiliation: Pure Earth, Formerly Blacksmith Institute, 475 Riverside Drive, Suite 860, New York, NY 10115, USA. fuller@pureearth.org.
authors.forename: Richard
authors.initials: R
authors.lastname: Fuller
authors.affiliation: Section Exposure Assessment and Environmental Health Indicators, German Environment Agency, Corrensplatz 1, Berlin 14195, Germany. dietrich.plass@uba.de.
authors.forename: Dietrich
authors.initials: D
authors.lastname: Plass
authors.affiliation: Unit Paediatric Environmental Epidemiology, WHO Collaborating Centre for Occupational Health, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital Munich, Ziemssenstr. 1, Munich 80336, Germany. stephan.boeseoreilly@med.uni-muenchen.de.|Department of Public Health, Health Services Research and Health Technology Assessment, Institute of Public Health, Medical Decision Making and Health Technology Assessment, UMIT-University for Health Sciences, Medical Informatics and Technology, Eduard Wallnoefer Center I, Hall in Tyrol 6060, Austria. stephan.boeseoreilly@med.uni-muenchen.de.
authors.forename: Stephan
authors.initials: S
authors.lastname: Bose-O'Reilly
mesh_terms: D000328:Adult; D000368:Aged; D000393:Air Pollutants / Q000633:toxicity*; D002908:Chronic Disease; D017281:Cost of Illness; D006233:Persons with Disabilities; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D006046:Gold; D000075322:Heavy Metal Poisoning; D006801:Humans; D008297:Male; D008628:Mercury / Q000633:toxicity*; D008875:Middle Aged; D008906:Mining; D011041:Poisoning; D011795:Surveys and Questionnaires; D064232:Visual Analog Scale; D055815:Young Adult
chemical_list: D000393:Air Pollutants; D006046:Gold; D008628:Mercury
keywords: artisanal small-scale gold mining; burden of disease; chronic metallic mercury vapor intoxication; disability weights; mercury; pairwise comparison; visual analogue scale