Institute and Clinic for Occupational, Social and Environmental Medicine, LMU University Hospital, Munich, Germany.
University of Copenhagen, Department of Public Health, Copenhagen, Denmark.
Environ Res. 2021 Jun;197:111081. doi: 10.1016/j.envres.2021.111081. Epub 2021 Mar 26.
The role of artisanal and small-scale gold mining (ASGM) as a source of income is rapidly gaining importance in the economically difficult times in Zimbabwe. Small-scale miners are now responsible for over 50% of the Zimbabwean gold production. However, the sector is still characterised by high labour-intensity, low productivity and capital, limited mechanisation and outdated technologies. Since increasing efforts in recent years to improve miners' health while reducing the exposure to mercury have not been effective, a more sustainable approach is needed to identify interventions targeting the health of artisanal and small-scale miners and the mining communities.
The main objective of this study was the accurate and extensive empirical identification of the determinants of health in ASGM and of the miners' health needs. In tandem with these needs, topics which generate more effective, sustainable, and feasible future health interventions targeting occupational health should be identified.
Based on the identification of determinants of health, a health needs assessment (HNA) was used to conduct miners' needs by applying a mixed methods approach and triangulation. This included qualitative and quantitative interviews with individuals, group interviews, focus group discussions, observations and informal conversations.
There were 85 structured and 84 semi-structured interviews, a focus group discussion, and observations conducted. Six main themes were identified around which miners' health needs can be aggregated as follows: living conditions, nutrition and hygiene; safe work environment and mining processes; financial support; health care services; formalisation and education.
The following aspects were considered most important for sustainable interventions: possible health impacts, feasibility, value for miners and their willingness to adapt. Accordingly, interventions aiming at increasing education, knowledge and awareness of miners were identified as most promising in improving occupational health.
在津巴布韦经济困难时期，手工和小规模采金（ASGM）作为收入来源的作用迅速凸显。小型矿工现在负责津巴布韦 50%以上的黄金产量。然而，该行业仍然以劳动强度高、生产力和资本低、机械化程度有限和技术过时为特征。由于近年来为改善矿工健康而减少接触汞的努力并未取得成效，因此需要采取更可持续的方法来确定针对手工和小规模矿工及其矿区社区健康的干预措施。
本研究的主要目的是准确和广泛地确定 ASGM 中的健康决定因素以及矿工的健康需求。与这些需求并行，应确定产生更有效、可持续和可行的未来职业健康干预措施的主题。
基于健康决定因素的识别，采用混合方法和三角剖分进行健康需求评估（HNA）来确定矿工的需求。这包括对个人进行定性和定量访谈、小组访谈、焦点小组讨论、观察和非正式对话。
共进行了 85 次结构化访谈和 84 次半结构化访谈、一次焦点小组讨论和观察。确定了六个围绕矿工健康需求的主要主题，如下所示：生活条件、营养和卫生；安全工作环境和采矿过程；财政支持；医疗保健服务；正规化和教育。
以下方面被认为对可持续干预措施最重要：可能的健康影响、可行性、对矿工的价值以及他们适应的意愿。因此，旨在提高矿工教育、知识和意识的干预措施被认为是改善职业健康最有前途的措施。
