Accidents, Injuries, and Safety among Artisanal and Small-Scale Gold Miners in Zimbabwe

Artisanal and small-scale gold mining (ASGM) employs 14-19 million people globally. There is limited research on accidents, injuries, and safety in Zimbabwe's ASGM. This study investigates the prevalence of accidents and injuries, as well as the associated risks and existing safety practices. A cross-sectional survey was conducted among artisanal and small-scale gold miners. Data from 401 participants were analyzed using descriptive statistics and regression analysis. The prevalence of accidents and injuries was 35.0% and 25.7%. Accidents associated with experiencing injuries included mine collapses and underground trappings. The major injury risk factors were digging, blasting, being male, being 18-35 years old, crushing, and the underground transportation of workers and materials. Injuries were reported highest among the miners working 16 to 24 h per day. Participants had heard about personal protective equipment (PPE). There was training and routine inspections mainly on PPE use. Mine owners and supervisors were reported as responsible for OSH, which was mainly PPE use. Practices including the use of wire winch ropes and escape routes were rare. There was ignorance on underground mine shaft support. The mining regulations that had the potential to introduce comprehensive safety controls were not adaptable. We recommend applicable health and safety regulations for Zimbabwe's ASGM

Review of Occupational Health and Safety Organization in Expanding Economies: The Case of Southern Africa

Background: Globally, access to occupational health and safety (OHS) by workers has remained at very low levels. The organization and implementation of OHS in South Africa, Zimbabwe, Zambia, and Botswana has remained at suboptimal levels. Inadequacy of human resource capital, training, and education in the field of OHS has had a major negative impact on the improvement of worker access to such services in expanding economies. South Africa, Zimbabwe, Zambia, and Botswana have expanding economies with active mining and agricultural activities that pose health and safety risks to the working population. Methods: A literature review and country systems inquiry on the organization of OHS services in the 4 countries was carried out. Because of the infancy and underdevelopment of OHS in southern Africa, literature on the status of this topic is limited. Results: In the 4 countries under review, OHS services are a function shared either wholly or partially by 3 ministries, namely Health, Labor, and Mining. Other ministries, such as Environment and Agriculture, carry small fragments of OHS function. The 4 countries are at different stages of OHS legislative frameworks that guide the practice of health and safety in the workplace. Inadequacies in human resource capital and expertise in occupational health and safety are noted major constraints in the implementation and compliance to health and safety initiatives in the work place. South Africa has a more mature system than Zimbabwe, Zambia, and Botswana. Lack of specialized training in occupational health services, such as occupational medicine specialization for physicians, has been a major drawback in Zimbabwe, Zambia, and Botswana. Discussion: The full adoption and success of OHS systems in Southern Africa remains constrained. Training and education in OHS, especially in occupational medicine, will enhance the development and maturation of occupational health in southern Africa. Capacitating primary health services with basic occupational health knowledge would be invaluable in bridging the current skills deficit. Introducing short courses and foundational tracks in occupational medicine for general medical practitioners would be invaluable

Health and Safety Risk Mitigation among Artisanal and Small-Scale Gold Miners in Zimbabwe

Artisanal and small-scale gold mining (ASGM) is often associated with no or compromised attention to health and safety. Although headlines of fatal accidents in Zimbabwe characterise ASGM, little attention is paid to prevention strategies. This study, therefore, explores health and safety risk mitigation in ASGM in Zimbabwe to inform prevention strategies. A qualitative design was used with focus group discussions and in-depth interviews. Data were analysed using thematic analysis, coding, and descriptive statistics. Reported factors contributing to compromised health and safety included immediate causes, workplace factors, ASM related factors, and contextual factors, with interconnectedness between the causal factors. In addition, factors related to ASGM were significant. For risk mitigation, formalisation, organisation of risk reduction, behaviour change, and enforcement of prevention strategies is proposed. A multi-causal analysis is recommended for risk assessment and accident investigation. A multi-stakeholder approach could be considered for risk mitigation including community and public health interventions. However, risk mitigation has been characterised by gaps and weaknesses such as lacking ASM policy, lack of capital, poor enforcement, negative perceptions, and non-compliance. Therefore, we recommend addressing the threats associated with health and safety mitigation to ensure health and safety protection in ASGM

Occupational health barriers in South Africa : a call for Ubuntu

DATA AVAILABILITY STATEMENT: All data related to the manuscript is available within the manuscript.Many low- and middle-income countries (LMICs) grapple with shortages of health workers, a crucial component of robust health systems. The COVID-19 pandemic underscored the imperative for appropriate staffing of health systems and the occupational health (OH) threats to health workers. Issues related to accessibility, coverage, and utilization of OH services in public sector health facilities within LMICs were particularly accentuated during the pandemic. This paper draws on the observations and experiences of researchers engaged in an international collaboration to consider how the South African concept of Ubuntu provides a promising way to understand and address the challenges encountered in establishing and sustaining OH services in public sector health facilities. Throughout the COVID-19 pandemic, the collaborators actively participated in implementing and studying OH and infection prevention and control measures for health workers in South Africa and internationally as part of the World Health Organizations’ Collaborating Centres for Occupational Health. The study identified obstacles in establishing, providing, maintaining and sustaining such measures during the pandemic. These challenges were attributed to lack of leadership/stewardship, inadequate use of intelligence systems for decision-making, ineffective health and safety committees, inactive trade unions, and the strain on occupational health professionals who were incapacitated and overworked. These shortcomings are, in part, linked to the absence of the Ubuntu philosophy in implementation and sustenance of OH services in LMICs.The International Development Research Centre.https://www.annalsofglobalhealth.org/School of Health Systems and Public Health (SHSPH)SDG-03:Good heatlh and well-bein

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

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 \textquotedblAlert\textquotedbl 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

Analysis of the Mercury Distribution in Blood as a Potential Tool for Exposure Assessment - Results from Two Artisanal and Small-Scale Gold Mining Areas in Zimbabwe

People in artisanal and small-scale gold mining (ASGM) areas are frequently exposed to high levels of mercury (Hg). Hg analyses in urine and whole blood are the gold standard of biomonitoring, although this may not provide sufficient information about the source of exposure, e.g., due to the use of Hg for gold extraction or due to nutrition. To evaluate, whether the pharmacokinetic properties of individual Hg species may be useful for exposure assessment, we determined the Hg levels in different blood components from 199 participants. Therefore, whole blood was centrifuged on-site to yield erythrocytes and plasma. Globin was isolated from the erythrocytes by precipitation with ethyl acetate. Albumin was isolated from plasma by gradual precipitation with saturated ammonium sulfate solution. Hg levels in all samples were determined by using a direct Hg analyzer. Median Hg levels for whole blood, erythrocytes, and plasma were 2.7, 3.7, and 1.3 μg/l, respectively. In globin and albumin, median Hg levels were 10.3 and 7.9 μg/kg, respectively. The distribution of Hg was strongly correlated with whole blood Hg levels (p < 0.01) and the time between the last use of Hg and the date of the participation (p < 0.01). The results suggest that the distribution of Hg in blood is substantially affected by the extent and the frequency of the exposure to elemental Hg. Therefore, the analysis of Hg in erythrocytes and plasma may be a valuable tool for Hg exposure assessment in ASGM areas

Occupational health and safety in the Southern African Development Community

No abstract available.https://academic.oup.com/occmed2018-12-02hj2018School of Health Systems and Public Health (SHSPH

Biomonitoring of arsenic, cadmium and lead in two artisanal and small-scale gold mining areas in Zimbabwe

People living and working in artisanal and small-scale gold mining (ASGM) areas are frequently exposed to elemental mercury (Hg), which is used for gold extraction. However, additional exposure to other toxic metals such as arsenic (As), cadmium (Cd) and lead (Pb) may result from mining-related activities and could be ingested via dust, water or food. In these areas, only limited biomonitoring data is available for toxic metals other than Hg. In particular, data about the exposure to As, Cd and Pb is unavailable for the Zimbabwean population. Therefore, we conducted a cross-sectional study in two ASGM areas in Zimbabwe to evaluate the internal exposure to these metals. In total, urine and blood samples from 207 people that identified themselves as miners were collected and analysed for As and Cd in urine as well as Pb in blood by GF-AAS. Median levels (interquartile ranges in μg/l) of As and Pb were 9.7 μg/l (4.0, 18.5) and 19.7 μg/l (12.5, 34.5), respectively. The 25th percentile and the median for Cd were below the limit of detection (0.5 μg/l); the 75th percentile was at 0.9 μg/l. The results were compared to reference values found for the general population in the USA and Germany, and a significant number of participants exceeded these values (As, 33 %; Cd, 27 %; Pb, 32 %), indicating a relevant exposure to toxic metals. Although not representative for the Zimbabwean population, our results demonstrate that the exposure to toxic metals is relevant for the public health in Zimbabwe and requires further investigation

Tuberculosis and Silicosis Burden in Artisanal and Small-Scale Gold Miners in a Large Occupational Health Outreach Programme in Zimbabwe.

Artisanal and small-scale miners (ASMs) labour under archaic working conditions and are exposed to high levels of silica dust. Exposure to silica dust has been associated with an increased risk of tuberculosis and silicosis. ASMs are highly mobile and operate in remote areas with near absent access to health services. The main purpose of this study was to evaluate the prevalence of tuberculosis, silicosis and silico-tuberculosis among ASMs in Zimbabwe. A cross-sectional study was conducted from 1 October to 31 January 2021 on a convenient sample of 514 self-selected ASMs. We report the results from among those ASMs who attended an outreach medical facility and an occupational health clinic. Data were collected from clinical records using a precoded data proforma. Data variables included demographic (age, sex), clinical details (HIV status, GeneXpert results, outcomes of chest radiographs, history of tuberculosis) and perceived exposure to mine dust. Of the 464 miners screened for silicosis, 52 (11.2%) were diagnosed with silicosis, while 17 (4.0%) of 422 ASMs were diagnosed with tuberculosis (TB). Of the 373 ASMs tested for HIV, 90 (23.5%) were sero-positive. An HIV infection was associated with a diagnosis of silicosis. There is need for a comprehensive occupational health service package, including TB and silicosis surveillance, for ASMs in Zimbabwe. These are preliminary and limited findings, needing confirmation by more comprehensive studies

The Triple Burden of Tuberculosis, Human Immunodeficiency Virus and Silicosis among Artisanal and Small-Scale Miners in Zimbabwe

Artisanal and small-scale mining is characterized by an excessive exposure to silica-containing dust, overcrowding, poor living conditions and limited access to primary health services. This poses a risk to tuberculosis, HIV infection and silicosis. The main purpose of the study is to evaluate the burden of tuberculosis, HIV and silicosis among artisanal and small-scale miners. We conducted a cross sectional study on 3821 artisanal and small-scale miners. We found a high burden of silicosis (19%), tuberculosis (6.8%) and HIV (18%) in a relatively young population, with the mean age of 35.5 years. Men were 1.8 times more likely to be diagnosed with silicosis compared to women, adjusted prevalence ratio [aPR = 1.75 (95% CI: 1.02-2.74)]. Artisanal and small-scale miners who were living with HIV were 1.25 times more likely to be diagnosed with silicosis compared to those who were negative, [aPR = 1.25 (1.00-1.57)]. The risk of silicosis increased with both duration as a miner and severity of exposure to silica dust. The risk of tuberculosis increased with the duration as a miner. Zimbabwe is currently experiencing a high burden of TB, silicosis and HIV among artisanal and small-scale miners. Multi-sectoral and innovative interventions are required to stem this triple epidemic in Zimbabwe