Unsafe Occupational Health Behaviors: Understanding Mercury-Related Environmental Health Risks to Artisanal Gold Miners in Ghana

The relationships between environmental exposure and health outcomes are complex, multidirectional, and dynamic. Therefore, it is required to have an understanding of these linkages for effective health risk communication. Artisanal gold mining is widespread globally, in spite of its associated health hazards, with an estimated 30 million people engaged in it. In this study, the relationships between artisanal gold miners knowledge of environmental and health effects of mercury (Hg) and compositional, contextual and occupational factors were assessed using generalized linear models (GLM) (negative log-log regression). A cross-sectional survey in three urban gold mining hubs in Ghana (Prestea, Tarkwa and Damang), was carried out among 588 (482 male and 106 female) artisanal gold miners. The results showed that 89% of artisanal gold miners had very low to low levels of knowledge whereas 11% had moderate to very high levels of knowledge of deleterious health effects of Hg. Also, individuals who perceived their health-related working conditions to be excellent had very low to low levels of knowledge of environmental and health effects of Hg. Interestingly, artisanal gold miners who were still working were less likely to know the environmental and health effects of Hg compared with their counterparts who were currently unemployed. Similarly, artisanal gold miners who had attained either primary or secondary education were less likely to know the environmental and health effects of Hg compared with their counterparts who had no formal education. This finding, although counterintuitive, can be understood within the context that artisanal gold miners in Ghana without formal education tend to have considerably higher number of years of practical experience compared with their counterparts with formal education. Based on odds ratios (OR), female artisanal gold miners were 68% less likely to know the environmental and health effects of Hg compared with their male counterparts (OR = 0.32, p < 0.05). Artisanal gold miners who had previously encountered occupational health problems were significantly far more likely to know the environmental and health effects of Hg compared with their counterparts without any previous occupational health problems (OR = 4.86, p < 0.0001). Although artisanal gold miners who are 25-34 years old were more likely to know than their counterparts who are 18-24 years old, there were no differences in knowledge between those who are 35 years or older and their counterparts who are 18-24 years old. These results emphasize the complex relationships between compositional, contextual and occupational factors on the one hand, and artisanal gold miners' knowledge of environmental and health effects of Hg, on the other hand. Some policy implications of the findings suggest that a more systematic approach to the development and evaluation of interventions to phase out Hg use in artisanal gold mining is desirable, with clearer recognition of the interrelationships between compositional factors of artisanal gold miners and their persistent reliance on Hg in the gold extraction process.