Dataset Information

Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study.

ABSTRACT: BACKGROUND:In Zimbabwe, an estimated 500,000 people work in the sector of artisanal and small-scale gold mining (ASGM). Two million Zimbabweans are dependent on this sector. Using mercury is common to extract gold from ore. Long term exposure to mercury can cause various adverse health conditions including chronic mercury intoxication. The influence of these adverse health effects on the health-related quality of life (HRQoL) is still unknown. The aim of this study is to assess the HRQoL of people who identify themselves as miners, and to analyze potential influencing factors, such as age, years of working with mercury and health conditions caused by mercury exposure. METHODS:This cross-sectional study assessed the HRQoL using the standardized EQ-5D?+?C (3?L) questionnaire and collected human specimens (blood, urine) of people living and possibly working in ASGM areas in Zimbabwe. Factors such as age, years of working with mercury and adverse health conditions possibly caused by mercury exposure were analyzed with regards to their influence on the HRQoL. RESULTS:The 207 participants (82% male, mean age 38?years) reported 40 different health states. Of the study participants 42.5% reported to be in complete good health while 57.5% reported being unwell in different ways. Nine participants (4.3%) were identified with chronic mercury intoxication, whereas 92 participants (33.3%) had mercury levels above the "Alert" threshold in at least one specimen. Having chronic mercury intoxication has a significant negative influence on the HRQoL, when taking into account age, gender and years of working with mercury. Cognitive problems were the most reported in the questionnaire, however, the association between this domain separately and the HRQoL was not verified. CONCLUSION:This study shows that adverse health effects caused by chronic exposure to mercury, have a negative influence on the HRQoL among people living in ASGM areas.

SUBMITTER: Butscher FM

PROVIDER: S-EPMC7437047 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study.

Butscher Friederike-Marie FM Rakete Stefan S Tobollik Myriam M Mambrey Viola V Moyo Dingani D Shoko Dennis D Muteti-Fana Shamiso S Steckling-Muschack Nadine N Bose-O'Reilly Stephan S

Health and quality of life outcomes 20200818 1

<h4>Background</h4>In Zimbabwe, an estimated 500,000 people work in the sector of artisanal and small-scale gold mining (ASGM). Two million Zimbabweans are dependent on this sector. Using mercury is common to extract gold from ore. Long term exposure to mercury can cause various adverse health conditions including chronic mercury intoxication. The influence of these adverse health effects on the health-related quality of life (HRQoL) is still unknown. The aim of this study is to assess the HRQoL ...[more]

PMID: 32811504

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Project description:BACKGROUND: Artisanal small-scale gold mining (ASGM) is a poverty-driven activity practiced in over 70 countries worldwide. Zimbabwe is amongst the top ten countries using large quantities of mercury to extract gold from ore. This analysis was performed to check data availability and derive a preliminary estimate of disability-adjusted life years (DALYs) due to mercury use in ASGM in Zimbabwe. METHODS: Cases of chronic mercury intoxication were identified following an algorithm using mercury-related health effects and mercury in human specimens. The sample prevalence amongst miners and controls (surveyed by the United Nations Industrial Development Organization in 2004 and the University of Munich in 2006) was determined and extrapolated to the entire population of Zimbabwe. Further epidemiological and demographic data were taken from the literature and missing data modeled with DisMod II to quantify DALYs using the methods from the Global Burden of Disease (GBD) 2004 update published by the World Health Organization (WHO). While there was no disability weight (DW) available indicating the relative disease severity of chronic mercury intoxication, the DW of a comparable disease was assigned by following the criteria 1) chronic condition, 2) triggered by a substance, and 3) causing similar health symptoms. RESULTS: Miners showed a sample prevalence of 72% while controls showed no cases of chronic mercury intoxication. Data availability is very limited why it was necessary to model data and make assumptions about the number of exposed population, the definition of chronic mercury intoxication, DW, and epidemiology. If these assumptions hold, the extrapolation would result in around 95,400 DALYs in Zimbabwe's total population in 2004. CONCLUSIONS: This analysis provides a preliminary quantification of the mercury-related health burden from ASGM based on the limited data available. If the determined assumptions hold, chronic mercury intoxication is likely to have been one of the top 20 hazards for population health in Zimbabwe in 2004 when comparing with more than 130 categories of diseases and injuries quantified in the WHO's GBD 2004 update. Improving data quality would allow more accurate estimates. However, the results highlight the need to reduce a burden which could be entirely avoided.

Project description:BackgroundThe 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. Besides limited epidemiological data, no data about the self-reported health-related quality of life (HRQoL) of artisanal and small-scale gold miners exist. The aim of the project was to access HRQoL of ASGM workers to improve the data base and compare the data to the urban Zimbabwean population.MethodsData from 83 artisanal and small-scale gold miners in Kadoma, Zimbabwe was analysed. The HRQoL was assessed using the EuroQol dimensions (mobility, self-care, usual activities, pain/discomfort, anxiety/depression) accompanied by the cognition add-on questionnaire (EQ-5D-3L+C) and associated visual analogue scale (VAS). We described the EQ-5D dimensions and VAS values and computed health utility (HU) values using the Zimbabwean tariff. The proportions of miners reporting no problem in each EQ-5D dimension were compared with corresponding proportions reporting any problem (moderate or severe), and mean HU and VAS values were analysed across subgroups of the sample. To test differences between subgroups, Fisher's exact test was used and between urban and mining population, Student's t-test was used.ResultsThe reported health states of miners were homogenous, with a large amount (42%) reporting 'full health'. Mean (SD) VAS and HU values were 81.0 (17.5) and 0.896 (0.13), respectively. Subgroup analysis showed that miners with a lower education reported significantly more problems in the dimension of daily activities and miners with mercury contact had more problems in the dimensions of pain/discomfort and cognition. Comparison between mining and urban population showed that in the oldest age group, self-rated VAS values of miners were significantly higher than of their urban counterparts.ConclusionsThere were no significant differences in the HRQoL of mining and urban populations. However, the reason might be adverse health effects faced by the urban population that do not apply to rural mining areas. A higher education level of miners can improve the HRQoL, which is especially impaired by problems in the cognition dimension.

Dataset Information

Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study.

Publications

Health-related quality of life (EQ-5D + C) among people living in artisanal and small-scale gold mining areas in Zimbabwe: a cross-sectional study.

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