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Mercury Exposure Among Artisanal Gold Miners in Madre De Dios, Peru: a Cross-Sectional Study

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Mercury Exposure Among Artisanal Gold Miners in Madre De Dios, Peru: a Cross-Sectional Study J. Med. Toxicol. DOI 10.1007/s13181-012-0252-0 CDC/ATSDR TOXICOLOGY REPORT Mercury Exposure Among Artisanal Gold Miners in Madre de Dios, Peru: A Cross-sectional Study Ellen E. Yard & Jane Horton & Joshua G. Schier & Kathleen Caldwell & Carlos Sanchez & Lauren Lewis & Carmen Gastaňaga # American College of Medical Toxicology (outside the USA) 2012 Abstract Results One third (34.0 %) of participants were gold miners. Introduction Exposure to mercury, a toxic metal, occurs All participants had detectable urine total mercury (GM, primarily from inhaling mercury vapors or consuming 5.5 μg/g creatinine; range, 0.7–151 μg/g creatinine) and methylmercury-contaminated fish. One third of all anthro- 91 % had detectable blood methylmercury (GM, 2.7 μg/L; pogenic mercury emissions worldwide are from artisanal range, 0.6–10 μg/L); 13 participants (13 %) reported having gold mining, which uses mercury to extract gold. Although kidney dysfunction or a neurological disorder. Urine total recent reports suggest that the Madre de Dios region in Peru mercury concentrations were higher among people who (with >30,000 artisanal miners) has extensive mercury con- heated gold–mercury amalgams compared with people tamination, residents had never been assessed for mercury who never heated amalgams (p<0.05); methylmercury con- exposure. Thus, our objective was to quantify mercury centrations were higher among fish consumers compared exposure among residents of an artisanal mining town in with nonfish consumers (p<0.05). Madre de Dios and to assess risk factors for exposure. Conclusion Our findings suggest that mercury exposure Methods We conducted a cross-sectional assessment of 103 may be widespread in Huaypetue. residents of an artisanal gold mining town in July 2010. Each participant provided a urine and blood sample and Keywords Amazon . Mining . Amalgams . Gold . completed a questionnaire assessing potential exposures Methylmercury and health outcomes. We calculated geometric mean (GM) urine total mercury and blood methylmercury concentra- Abbreviations tions and compared log-transformed concentrations between GM Geometric mean subgroups using linear regression. SD Standard deviation LOD Limit of detection E. E. Yard CDC Centers for Disease Control and Prevention Centers for Disease Control and Prevention, EPA Environmental Protection Agency Epidemic Intelligence Service, Atlanta, GA 30333, USA : : : : E. E. Yard (*) J. Horton J. G. Schier K. Caldwell L. Lewis Introduction Centers for Disease Control and Prevention, National Center for Environmental Health, 4770 Buford Highway, MS F-57, Mercury is a toxic metal that can cause a variety of Chamblee, GA 30341, USA adverse health effects depending on the form of mercury e-mail: [email protected] (elemental, inorganic, or organic) and the pathway, quan- tity, and duration of exposure. Chronic exposure to small C. Sanchez United States Medical Research Center Detachment, amounts of elemental or inorganic mercury occurs primar- Lima, Peru ily through inhalation of mercury vapors and can cause tremors, kidney dysfunction, and various neurocognitive ň C. Gasta aga and behavioral disturbances [1]. Acute exposure to ele- Ministry of Health, National Institute of Health, National Center for Occupational Health and Environmental Protection, mental or inorganic mercury can occur in specific occu- Lima, Peru pational settings or during acute poisoning events and can J. Med. Toxicol. result in severe lung injury or death. Chronic exposure to among residents of an artisanal mining community in Madre methylmercury, a common type of organic mercury, de Dios, (2) to assess risk factors for exposure, and 3) to occurs primarily through eating contaminated fish. It can investigate the relationship between mercury exposure and damage the central nervous system, causing impaired potential health outcomes. vision and hearing [1]. Methylmercury exposure is of particular concern to the developing fetus who is more susceptible to adverse neurological effects [2]. Methods It is estimated that one tenth of all anthropogenic mercury emissions world-wide are from artisanal gold Study Site mining [3]. World-wide, an estimated 10–20 million people mine gold in “artisanal” conditions and an es- This investigation represented a joint collaboration between timated 80–100 million individuals are economically the Peru Centro Nacional de Salud Ocupacional y Protec- dependent on this way of life [4]. Although artisanal cion del Ambiente para la Salud (CENSOPAS) and the US mining operations vary in size, production, and legali- Centers for Disease Control and Prevention (CDC). Huay- ty, all rely on elemental mercury to extract gold from petue, a gold mining town of approximately 7,000 persons, ore deposits [4, 5]. To mine gold, large amounts of is one of the largest gold mining towns in Madre de Dios elemental mercury are mixed with gold ore to form a and thus was the site chosen for this investigation [21]. gold–mercury alloy, called an amalgam. These amal- gams contain a mix of mercury and gold; to remove Sample Selection the mercury, they are typically heated in an amalgam furnace. The mercury vaporizes, while the gold stays We conducted a cross-sectional study in Huaypetue in July behind. During this process, mercury is often discarded 2010. Due to the lack of roads, electricity, and security, it into the environment. When it enters the water, it can was logistically difficult to apply a random selection strate- transform into organic mercury compounds, such as gy in Huaypetue. Thus, we nested the mercury assessment methylmercury, and bioaccumulate in fish. This process in a 3-day health campaign. This health campaign was presents three major potential routes of mercury expo- implemented by the local health directorate and provided sure: (1) miners can have dermal exposure when they free health assessments to all residents. Altogether, 292 mix elemental mercury with gold ore; (2) elemental residents took part in the health campaign. We invited a and inorganic mercury vapors can be inhaled when convenience sample of 103 of these 292 health campaign amalgams are heated; and (3) methylmercury can be attendants (35.3 %) to participate in the mercury assessment. consumed from contaminated fish. Inclusion criteria for the mercury assessment were age Residents of artisanal gold mining communities are at ≥3 years and residency in Huaypetue ≥6 months. Based on risk for mercury exposure [5]. Previous research found findings from a previous mercury assessment in southern elevated mercury exposure among residents of artisanal Peru [12], it was determined that this sample size would mining communities throughout Asia [6, 7], Africa [8, provide 80 % power to compare differences between expo- 9], and South America [10–17]. The Peruvian Amazon sure groups. is a growing hotbed for artisanal mining, and there is growing concern over the extensive environmental mer- Data Collection cury contamination that is occurring here [18–20]. One region in particular—Madre de Dios—is estimated to Participating individuals gave informed consent, provid- house approximately 30,000 artisanal miners [18]. How- ed one spot urine sample and one blood sample, and ever, many studies from this region have important completed a self-administered questionnaire that collect- laboratory limitations, with many not calculating ed demographical, dietary, occupational, and health out- creatinine-corrected urine mercury concentrations, and come information. The questionnaire contained a most not assessing blood methylmercury. Mercury levels standard health assessment form, as well as questions measured in urine best represents exposure to elemental developed specifically for this investigation to assess mercury, while mercury levels measured in blood best behaviors and risk factors associated with gold mining represents exposure to methylmercury; thus, without and mercury exposure. Most of the questions had cate- both, it is difficult to create a complete picture of gorical responses, as either yes/no, or frequency of a mercury exposure. behavior/symptom (daily, weekly, monthly, never). This Thus, our objective was to assess human mercury exposure remained true of the health outcome questions, where in Madre de Dios. Specifically, our aims were as follows: (1) participants were asked to respond yes/no to questions to quantify mercury exposure in urine and blood samples such as “Were you ever diagnosed with a kidney J. Med. Toxicol. problem?” Approval was obtained from the Institutional Results Review Board at the US CDC and the Peru Ministry of Health. Study Population Characteristics Laboratory Methods We had a 100 % participation rate among the persons invited to participate in the mercury assessment; 103 people Spot urine samples (i.e., urine samples collected at random (100 %) completed the questionnaire and provided a blood times during the day) and blood samples were collected and sample, and 102 (99.0 %) provided a urine sample. Partic- aliquoted using equipment certified for trace metal collection. ipants ranged in age from 3 to 70 years (mean033.9; stan- All biological specimens were analyzed at the US CDC’s dard deviation (SD)015.8), and slightly over half were male National Center for Environmental Health’s Division of Labo- (53.4 %). Number of years spent living in Huaypetue ranged ratory Sciences in Atlanta, Georgia. Total urine mercury was from 1 to 54 (mean013.6; SD011.7). Half of all participants analyzed using inductively coupled dynamic reaction cell plas- obtained
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