Background:
Gold miners use mercury to extract gold from the ore. Liquid mercury is added to the crushed gold ore binding to an amalgam. This amalgam is smelted without any protection to extract the gold from the amalgam. The amalgam burners, who are directly exposed to mercury vapor, are extremely burdened.
Methods:
Gold miners were assessed in different small-scale gold mining areas in the Philippines, Mongolia, Tanzania, Zimbabwe and Indonesia (1-4). Urine, blood and hair samples were taken from each participant, (and also additional control groups), and consequently analyzed for mercury (n=1077). The participants were medically investigated, following a standardized protocol. In each country, volunteers from unburdened areas served as controls (n=143). Amalgam burners (n=418) and miners using mercury for panning (n= 179) are especially exposed, but also the general population in mining areas is seriously at risk (n=337). The medical data was statistically analyzed (Chi-square, Mann-Whitney test, Kruskal-Wallis test, correlation coefficient).
Results:
Mercury concentrations in all three specimens were elevated (control versus exposed groups p<0.001 Mann Whitney test, Kruskal Wallis test). In some cases very high mercury concentrations were found. Symptoms, characteristic for a chronic mercury vapor exposure were frequent. Ataxia of gait was found in 7% of the control group and 35% of the amalgam smelters (Chi-square p<0.001). Dysdiadochokinesia was found in 18% of the control group and 34% of the amalgam smelters (Chi-square p<0.001). Neuro-psychological tests such as the match-box test, a test for co-ordination, intentional tremor and concentration, show poorer results in comparison to the control group (significant correlation p<0.001). 74.3% of the amalgam burners were diagnosed as mercury intoxicated, compared to 0.8% within the control group (Chi-square p<0.001).
Conclusion:
Many of the miners have health problems related to the mercury exposure in the immediate environment. The most important conclusion is that the exposure has to be reduced. The use of mercury needs to be reduced as a first priority. Mining and housing areas need to be separated. Mercury free technologies have to be developed and used. Health care systems need to be prepared and trained for this new emerging “amalgam burner disease”.
1. Steckling STOTEN 2011;409:994-1000.
2. Bose-O’Reilly STOTEN 2010;408:796-805.
3. Bose-O’Reilly STOTEN 2010;408:713-25.
4. Drasch STOTEN. 2001;267(1-3):151-68.