Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Radboud Institute for Health Sciences, Radboud University Medical Center, P.O. Box 9101, 6500 HB Nijmegen, The Netherlands.
Environ Int. 2019 Jan;122:142-150. doi: 10.1016/j.envint.2018.10.059. Epub 2018 Nov 16.
The use of mercury in artisanal and small-scale gold mining has negative effects on human health and the environment. In Suriname, the current gold rush resulted in estimated mercury emissions up to 63t per year. To reduce the use of mercury and the subsequent health impact to gold miners and local inhabitants, knowledge and awareness in the community should be increased.
This study evaluated the effects of a health education programme (HEP) on the levels of knowledge and awareness among local inhabitants and small-scale gold miners in active gold mining areas in the interior of Suriname, South-America. Baseline knowledge levels were assessed with a survey prior to the implementation of the HEP. Thereafter, the exact same questions were asked to evaluate the effects. A total of 959 local inhabitants and 140 gold miners completed the survey including five topics: general knowledge on mercury, potential routes of exposure, health risks for children versus adults, mercury related health effects, and reproductive risks. Additionally, participants were asked in a separate survey (n = 107) about potential exposure reduction techniques and their willingness to be involved in a future human biomonitoring programme.
The HEP influenced knowledge on exposure routes of mercury (increase from 64% to 78% of respondents who could name the relevant exposure routes) and on health effects attributed to mercury (increase from 48% to 70% of respondents who were able to list the correct health effects). After the HEP, 70% of the respondents affirmed the higher sensitivity of children, while knowledge on reproductive health effects increased from 39% to 63%. Self-estimated levels of knowledge also increased, indicating lower anxiety regarding potential risks of mercury. Gold miners reported to be willing to improve their work procedures (e.g. burning amalgam with a retort), although suitable tools were not always available. Consistent results were found for individuals included in both surveys, before and after the health education programme. Almost all respondents in the separate survey reported to be willing to give consent for participation in a future human biomonitoring programme, for themselves and their children.
The implementation of a health education programme within an existing local healthcare structure proved effective and levels of knowledge and awareness improved. Most improved was the knowledge on health effects attributable to mercury, more specifically reproductive health effects.
在手工和小规模采金业中使用汞会对人类健康和环境造成负面影响。在苏里南,目前的淘金热导致每年估计有 63 吨汞排放。为了减少汞的使用以及随后对金矿工人和当地居民的健康影响,应该提高社区的知识和意识。
本研究评估了健康教育计划(HEP)对南美洲苏里南内陆活跃采金区当地居民和小规模金矿工人的知识和意识水平的影响。在实施 HEP 之前,通过调查评估了基线知识水平。此后,通过相同的问题来评估效果。共有 959 名当地居民和 140 名金矿工人完成了调查,内容包括五个主题:汞的一般知识、潜在的暴露途径、儿童与成人的健康风险、汞相关的健康影响以及生殖风险。此外,在一项单独的调查中(n=107),参与者被问及潜在的减少暴露技术及其参与未来人体生物监测计划的意愿。
HEP 影响了关于汞暴露途径的知识(能够说出相关暴露途径的受访者比例从 64%增加到 78%)和汞相关健康影响的知识(能够正确列出健康影响的受访者比例从 48%增加到 70%)。HEP 之后,70%的受访者肯定了儿童的敏感性更高,而关于生殖健康影响的知识从 39%增加到 63%。自我估计的知识水平也有所提高,这表明人们对汞潜在风险的焦虑程度降低。金矿工人报告说愿意改进他们的工作程序(例如,用蒸馏器燃烧汞齐),尽管并非总是有合适的工具。在健康教育计划前后的两次调查中,个人都得到了一致的结果。几乎所有在单独调查中报告的受访者都表示愿意同意参与未来的人体生物监测计划,包括他们自己和他们的孩子。
在现有的当地医疗保健结构内实施健康教育计划被证明是有效的,知识和意识水平有所提高。提高最明显的是关于汞归因的健康影响的知识,特别是生殖健康影响。