Bose-O'Reilly Stephan, Bernaudat Ludovic, Siebert Uwe, Roider Gabriele, Nowak Dennis, Drasch Gustav
University Hospital Munich, Munich, Germany (Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, WHO Collaborating Centre for Occupational Health).
United Nations Industrial Development Organization (UNIDO), Vienna, Austria (Vienna International Centre).
Int J Occup Med Environ Health. 2017 Mar 30;30(2):249-269. doi: 10.13075/ijomeh.1896.00715. Epub 2017 Mar 22.
Gold miners use mercury to extract gold from ore adding liquid mercury to the milled gold-containing ore. This results in a mercury-gold compound, called amalgam. Miners smelt this amalgam to obtain gold, vaporizing it and finally inhaling the toxic mercury fumes. The objective was to merge and analyze data from different projects, to identify typical signs and symptoms of chronic inorganic mercury exposure.
Miners and community members from various artisanal small-scale gold mining areas had been examined (Philippines, Mongolia, Tanzania, Zimbabwe, Indonesia). Data of several health assessments were pooled. Urine, blood and hair samples were analyzed for mercury (N = 1252). Questionnaires, standardized medical examinations and neuropsychological tests were used. Participants were grouped into: Controls (N = 209), living in an exposed area (N = 408), working with mercury as panners (N = 181), working with mercury as amalgam burners (N = 454). Chi test, linear trend test, Mann-Whitney test, Kruskal-Wallis test, correlation coefficient, Spearman's rho, and analysis of variance tests were used. An algorithm was used to define participants with chronic mercury intoxication.
Mean mercury concentrations in all exposed subgroups were elevated and above threshold limits, with amalgam burners showing highest levels. Typical symptoms of chronic metallic mercury intoxication were tremor, ataxia, coordination problems, excessive salivation and metallic taste. Participants from the exposed groups showed poorer results in different neuropsychological tests in comparison to the control group. Fifty-four percent of the high-exposed group (amalgam burners) were diagnosed as being mercury-intoxicated, compared to 0% within the control group (Chi p < 0.001).
Chronic mercury intoxication, with tremor, ataxia and other neurological symptoms together with a raised body burden of mercury was clinically diagnosed in exposed people in artisanal small-scale mining areas. The mercury exposure needs to be urgently reduced. Health care systems need to be prepared for this emerging problem of chronic mercury intoxication among exposed people. Int J Occup Med Environ Health 2017;30(2):249-269.
金矿开采者使用汞从矿石中提取黄金，即将液态汞添加到研磨后的含金矿石中。这会形成一种汞 - 金化合物，称为汞齐。矿工熔炼这种汞齐以获取黄金，汞齐蒸发后，他们最终会吸入有毒的汞蒸气。目的是合并和分析来自不同项目的数据，以确定慢性无机汞暴露的典型体征和症状。
对来自各个手工小规模金矿开采地区的矿工和社区成员进行了检查（菲律宾；蒙古；坦桑尼亚；津巴布韦；印度尼西亚）。汇总了多项健康评估的数据。对尿液、血液和头发样本进行了汞分析（N = 1252）。使用了问卷调查、标准化医学检查和神经心理学测试。参与者被分为：对照组（N = 209）、居住在暴露地区的人群（N = 408）、作为淘金者接触汞的人群（N = 181）、作为汞齐燃烧工接触汞的人群（N = 454）。使用了卡方检验、线性趋势检验、曼 - 惠特尼检验、克鲁斯卡尔 - 沃利斯检验、相关系数、斯皮尔曼等级相关系数以及方差分析检验。使用一种算法来定义慢性汞中毒的参与者。
所有暴露亚组中的汞平均浓度均升高且高于阈值，其中汞齐燃烧工的汞浓度最高。慢性金属汞中毒的典型症状为震颤、共济失调、协调问题、流涎过多和金属味。与对照组相比，暴露组的参与者在不同神经心理学测试中的表现较差。高暴露组（汞齐燃烧工）中有54%被诊断为汞中毒，而对照组中这一比例为0%（卡方检验p < 0.001）。
在手工小规模矿区的暴露人群中，临床诊断出慢性汞中毒，伴有震颤、共济失调和其他神经症状以及体内汞负荷增加。迫切需要减少汞暴露。医疗保健系统需要为暴露人群中出现的这种慢性汞中毒新问题做好准备。《国际职业医学与环境卫生杂志》2017年；30(2):249 - 269。
