Mercury Use in Artisanal Small-scale Gold Mining Threatens Human Health

.................................................................................................................................... vi Zusammenfassung ..................................................................................................................... ix 1 Background ........................................................................................................................ 1 2 Current state of research ..................................................................................................... 3 3 Objectives and research questions ..................................................................................... 9 4 Materials and methods ..................................................................................................... 12 4.1 Literature review ........................................................................................................ 12 4.2 Statistical and epidemiological data analyses ............................................................ 13 4.3 Environmental Burden of Disease (EBD) .................................................................. 16 4.4 Expert elicitation and health-related quality of life (HRQoL) ................................... 18 4.5 Practical testing of a mercury-free gold extraction procedure ................................... 19 5 Main Results..................................................................................................................... 19 5.1 Children as particularly vulnerable subgroup at risk ................................................. 20 5.2 The mercury body burden in artisanal small-scale gold mining (ASGM) ................. 22 5.3 The health burden from exposure to mercury used in ASGM ................................... 24 5.3.1 The epidemiology of chronic mercury intoxication in ASGM .......................... 24 5.3.2 The EBD of chronic mercury intoxication in ASGM ........................................ 26 5.3.3 HRQoL and disease profiles .............................................................................. 27 5.4 Mercury-free gold extraction ..................................................................................... 28 6 Discussion ........................................................................................................................ 29 7 Conclusions ...................................................................................................................... 40 References ................................................................................................................................ 41 Acknowledgments .................................................................................................................... 58 Declaration of originality ..................................................................................................... 59