Disability Weights for Chronic Mercury Intoxication Resulting from Gold Mining Activities: Results from an Online Pairwise Comparisons Survey

Steckling N, Devleesschauwer B, Winkelnkemper J, et al. Disability Weights for Chronic Mercury Intoxication Resulting from Gold Mining Activities: Results from an Online Pairwise Comparisons Survey. International Journal of Environmental Research and Public Health. 2017;14(1): 57

Disability weights for chronic metallic mercury vapor intoxication to improve estimates of the burden of disease resulting from mercury use in gold mining

Steckling* N, Plaß D, Winkelnkemper J, et al. Disability weights for chronic metallic mercury vapor intoxication to improve estimates of the burden of disease resulting from mercury use in gold mining. In: Old and New Risks: Challenges for Environmental Epidemiology. ISEE Conference Abstracts. Vol 2016. Environmental Health Perspectives; 2016.Introduction: Chronic metallic mercury vapor intoxication (CMMVI) can result from the use of mercury in poverty-driven and globally widespread artisanal small-scale gold mining (ASGM). Although the burden of disease due to CMMVI can be assumed to be considerably high, the available estimates of disability-adjusted life years are limited because specific disability weights (DW) expressing the severities of CMMVIs are not available. The purpose of Disability Weights for Chronic Mercury Intoxication (DiWIntox) project was to derive DWs for CMMVI. Methods: The methods were chosen based on the current state of DW research and feasibility to derive DWs for CMMVI. Hence, psychometric rather than econometric methods were used. International scientists were invited to participate in a pretested web survey. PubMed searches were used to identify experts regarding mercury and DWs, which were requested to participate in the survey. Results: 153 and 93 corresponding authors of 188 and 121 articles published in the last 5 years covering mercury and DW research, respectively, were identified. These 246 scientists received an invitation to take part in the survey. 10 pairwise comparison experiments including 18 health state descriptions were analyzed with a probit regression. A visual analogue scale (VAS) was used to anchor the regression coefficients on a DW scale from 0-1. The DW of deafness derived for the Global Burden of Disease 2013 update was predefined on VAS. DWs were derived for moderate and severe CMMVI as well as for the further 16 health states. Conclusions: DWs for CMMVI were derived by using a DW of the GBD as anchor to enhance comparability. Access to the affected persons is limited due to the illegal character of ASGM. For this reason experts were used as proxies. The methodological strategy was useful to derive DWs for improving the data basis of BoD assessments necessary for policy-making