Registration status, mercury exposure biomarkers, and neuropsychological assessment of artisanal and small-scale gold miners (ASGM) from the Western Region of Ghana

The artisanal and small-scale gold mining (ASGM) sector is estimated to be the largest anthropogenic source of mercury pollution worldwide, and not surprisingly human exposures in this sector are amongst the highest of all population groups. While formalization of the sector has been proposed as a solution to help improve health and safety within ASGM sites, there are few empirical studies in support of this notion. The objective of this study was to assess if individuals working in ASGM sites that are registered have reduced mercury exposures and better neuropsychological scores than workers from unregistered sites. To achieve this objective, we studied biological samples (urine, hair) and survey data from a study of 404 ASGM workers (of which, 295 worked in registered ASGM sites) conducted in Tarkwa (Ghana) in 2014. Between miners working in registered and unregistered sites, there were few differences in socio-demographic characteristics. Median urinary mercury concentration (specific gravity-corrected) among those from unregistered mines was nearly 3-fold higher than those from the registered mines (18.5 versus 6.6 mu g/L), and in the overall population the median concentration was 10.0 mu g/L, and ranged from 0.3 to 2499 mu g/L. Mercury biomarkers varied across ASGM work categories (e.g., those who burned or amalgamated had the highest) and users of personal protective equipment. Nearly 30% of the study population indicated having some challenges concerning, for example, reduced appetite, hair loss, or excess salivation. Ataxia and rigidity of gait were absent in most of the participants, and for those with slight, moderate, or marked responses, there were no differences between miners from registered and unregistered sites, across work groups, as well as in reference to mercury biomarker measures. For the pencil tapping, Frostig, matchbox, and Wechsler tests, no striking differences were found though a correlation was found between urinary mercury levels and matchbox scores among those who amalgamate and burn, and scores were similar to past studies using the same tests in ASGM sites. We believe this is the first study to compare mercury exposures and neuropsychological test results between miners from registered and unregistered ASGM sites. In doing so, the research findings provide the necessary evidence for stakeholders and parties of the Minamata Convention considering various response options to help fulfill their obligations.