Mercury exposure in female artisanal small-scale gold miners (ASGM) in Mongolia: An analysis of human biomonitoring (HBM) data from 2008.

BACKGROUND: Many poor in developing countries have turned to artisanal small-scale gold mining (ASGM) in an attempt to improve their situation. However, the mercury used to extract gold from ore is discharged in vaporized form into the environment, where it poses a hazard for human health. METHODS: As part of an environmental epidemiological study in Mongolia-to evaluate the burden of environmental mercury contamination-urine, blood and hair samples were collected from residents of areas with or without mercury contamination. A total of 200 blood, urine and hair samples were analyzed for mercury and divided into three subgroups according to mercury content: (1) occupational exposure (high/medium); (2) environmental exposure (low); and (3) no exposure. Internal mercury distributions of the subgroups were compared using the Kruskal-Wallis and Mann-Whitney U-test. The Chi-square test and likelihood ratio proportion were used to compare the findings with threshold limits. RESULTS: The highest values and greatest differences were seen in the urine samples (p<0.001, Kruskal-Wallis). The occupational group showing the highest exposure with a median mercury level of 4.36µg/l (control group: 0.10µg/l, p<0.001), 7.18µg/g creatinine and 12 results above the threshold limit HBM I (Human Biomonitoring I). Even participants from the low-exposure subgroup showed elevated mercury levels (median 2.88µg/l urine and 2.98µg/g creatinine, p<0.001), with 10 individuals above the HBM I threshold limits. DISCUSSION: The body burden resulting from the use of mercury in artisanal gold mining is high not only in the miners themselves, an increased mercury hazard was also found for inhabitants of mining areas who were not actively involved in mining. Public health support measures are urgently needed to alleviate the situation.

Continuous medical education (CME): do we need CME for paediatric environmental medicine in Europe?

The knowledge about the influence of environmental hazards on children's health is increasing enormously. European Ministers of Health and Environment, like many other stakeholders, identified the environmental hazards in Europe for the health of children as so serious, that they called for a "Children's Environment and Health Action Plan for Europe (CEHAPE)" approved in June 2004. The knowledge of paediatricians and other health care providers on children's health and environment in Europe is insufficient, due to the lack of training in environmental medicine for medical students, clinical trainees and postgraduates. Only continuous medical education in environmental medicine can help to fill this gap of knowledge and is thereby urgently needed. The World Health Organization developed a training package for health care providers for children's health and environment, containing excellent material for paediatric training events. The International Network on Children's Health, Environment and Safety (INCHES) developed additional training material for paediatricians within the Children's Health, Environment and Safety Training (CHEST) project. The German Network Children's Health and Environment offers training for paediatric doctors' assistants in primary prevention. To improve knowledge about children's health and environment at all levels in paediatric settings, greater efforts of national institutions, paediatric associations and other institutions are necessary. It is time to strengthen existing structures and to introduce, where necessary, new structures for training in environmental medicine.

Increase of renal excretion of organo-mercury compounds like methlymercury by DMPS (2,3-Dimercapto-1-propanesulfonic acid, Dimaval).

In a highly mercury-burdened, small scale gold mining area in the Philippines, spontaneous urine samples were taken from 75 Hg intoxicated volunteers before (U1), and 2-3 hours after (U2) the oral application of 200 mg DMPS (2,3-Dimercapto-1-propanesulfonic acid, Dimaval). In the urine samples, the concentrations of organic and inorganic bound mercury were determined separately by CV-AAS. In U1, median concentrations of 15.7 microg inorganic Hg/g crea. and 2.2 microg organic Hg/g crea. were found. In U2, these values increased to 262 for inorganic Hg and 14.5 for organic Hg. Maximum concentrations (microg/g crea.) as high as 7,593 for inorganic Hg and 2,011 for organic Hg were observed after DMPS. The mean (median) increasing factor (U2/U1) was 16.0 for inorganic Hg and 5.1 for organic Hg. There was a trend that females responded better to DMPS than males. It was concluded that DMPS increases the renal excretion of organic bound Hg as it does for inorganic Hg, but to a lesser extent.