Exploring the broader health and well-being outcomes of mining communities in low- and middle-income countries: A systematic review

Mineral wealth paradox: health challenges and environmental risks in African resource-rich areas

BACKGROUND

Africa is blessed with vast arable land and enriched with valuable natural resources encompassing both renewable (like water, forests, and fisheries) and non-renewable (such as minerals, coal, gas, and oil). Under the right conditions, a natural resource boom should serve as an important driver for growth, development, and the transition from cottage industry to factory output. However, despite its wealth, Africa is often associated with the notion of a resource curse. Negative outcomes are often linked with mineral wealth. This paper investigates the causes of adverse health outcomes in resource-rich regions. The study provides empirical support for the natural resource curse with particular emphasis on the environmental health risks in Africa. We explore the multifaceted connections among mineral deposits, environmental risks, conflict events and population dynamics, shedding light on the complexities of resource-rich areas.

RESULTS

We amalgamate georeferenced data pertaining to 22 specific mineral deposits with information on the prevalence of reliance on compromised infrastructures at a spatial resolution of 0.5∘ × 0 . 5 ∘ for all of Africa between 2000 and 2017. Through comprehensive econometric analysis of environmental health risk factors, including reliance on contaminated water sources, open defecation, unimproved sanitation, particulate matter concentration, and carbon concentration, we uncover the intricate pathways through which mineral deposits impact public health. Our findings revealed the significant role of in-migration in mediating environmental health risks. Moreover, we found that the activities of extractive companies amplify certain environmental risks including reliance on unimproved sanitation and practices and particulate matter concentration. Conflict events emerge as a key mediator across all environmental health risks, underlining the far-reaching consequences of instability and violence on both local communities and the environment.

CONCLUSION

The study contributes to the discourse on sustainable development by unraveling the nuanced associations between mineral wealth and health challenges. By drawing attention to the intricate web of factors at play, we provide a foundation for targeted interventions that address the unique environmental and health challenges faced by mineral-rich communities.

Establishing the health and wellbeing needs of mining host community in Brazil, Chile and Peru: a mixed-method approach to identify priority areas for action to help communities meet their SDG3 targets

BACKGROUND

The global mining industry is an important partner in advancing the 2030 Agenda for Sustainable Development. In 2018, Anglo American plc published their Sustainable Mining Plan, containing a goal for improving health and wellbeing aligned with the Sustainable Development Goal 3 (SDG3) targets. Having formed an independent multidisciplinary research consortium, we designed and implemented a mixed-methods approach to attain a deeper understanding of SDG3 priorities within the local context of communities hosting Anglo American mining operations located in Latin America.

METHODS

In 2019, within the host communities of three mining operations in Chile, three in Brazil, and one in Peru, we conducted a qualitative study which included stakeholder workshops and key informant interviews. We also quantitatively appraised existing health data. Findings emerging from the qualitative and quantitative assessments were compared to identify health and wellbeing priority areas for action relevant to each community.

RESULTS

Across the three countries, 120 people took part in workshops and 35 in interviews. In these workshops and interviews, non-communicable diseases (SDG3.4), harmful alcohol consumption (SDG3.5), and pollution, particularly air pollution (SDG3.9), were consistently identified as areas for priority action. There were similarities in the reporting of individual, interpersonal, community, societal, and structural factors underlying these priority areas across the different communities. The availability of quantitative data was generally good at the state level, becoming increasing sparse as we focused on smaller geographies. The priorities identified in the quantitative assessments generally aligned with those highlighted in the qualitative data.

CONCLUSIONS

We highlight the importance of engaging with local populations to understand and address health needs. To address the priorities identified, intervention packages tailored to the specific needs of host communities, that tackle associated upstream societal level factors, are required. To facilitate this, appropriate monitoring systems and epidemiological investigations should be implemented to better understand the local context and quantify health issues. In the host communities, it is essential for the mining sector to be a key health partner in promoting integrated programmes that contribute to achieving the priority objectives and targets aligned with the SDG3 agenda.

Natural occurring radioactive materials (NORMs) from mining sites in Nigeria: A systematic review of geographical distribution and public health concern

Solid mineral mining activities have contributed to the distribution and uptake of radionuclides. This has increased the active concentration of naturally occurring radioactive materials NORMs in different environmental media with increased human health risks. This systematic review was aimed at assessing data on active concentration of naturally occurring radioactive materials in mining sites in Nigeria. Articles available on recognized data bases such as Google scholar, PubMed, Cochrane Library and Science Direct were used. Thirty-two studies were used for this systematic review after meeting the inclusion criteria. Reports of studies according to Geopolitical zones revealed 0% North-east, 4% for Southeast, 8% for South-South, 16% in North-West, 20% in South-West, and 52% from North-Central Nigeria. 50%, 45.2%, 50%, and 38.5% of included studies reported elevated active concentration of 232Th, 40K, 238U and 226Ra in soil above world regulatory standards of the ICRP, UNSCEAR and IAEA. Gross-alpha and gross-beta activity concentrations reference dose level (RDL) were exceeded in 83.3% and 80% of studies respectively with the highest values recorded in water 10.12Bq/l, and 14.63Bq/l from an artisanal gold mine in North-West Nigeria. These data agree with reports from other African countries, but lower than reports from China and India. NORMs may be of public health concerns notwithstanding the lean data from clinical and epidemiological studies in Nigeria. This study recommends a One Health approach on the radiological implications of mining sites in Nigeria.

Occupational Factors Affecting Women Workers' Sexual and Reproductive Health Outcomes in Oil, Gas, and Mining Industry: A Scoping Review

Objectives: Globally, female workers workforce in Oil, Gas, and Mining (OGM) industry have increased significantly. The complexities of the OGM operations and the extensive exposure to workplace hazards potentially affect the health status of workers, including sexual and reproductive health (SRH) outcomes of female workers. Yet, the current state of knowledge on SRH issues in OGM contexts seems to be limited and fragmented. This scoping review aims to identify the occupational factors that influence women's SRH outcomes in OGM industry. Methods: This scoping review followed the Joanna Briggs Institute's guidelines (PRISMA) and was conducted in five databases, including the citation chaining via Google Scholar and manual search through relevant organisations and Government websites. Sixteen articles met the inclusion criteria and were analysed. Results: Despite the scarcity of evidence, chemical and physical are found to be the predominant factors greatly influencing women workers' SRH outcomes in OGM. Most studies showed menstrual and cycle disorders, and risky pregnancy as key SRH issues. However, menstruation disorder was considerably linked with psychological and organisational factors. Conclusion: This review suggests further empirical research on the relationship between OGM occupational hazards and women workers' SRH. This will contribute to improvements in workplace safety legislations, measures, policies, and management systems taking into account women's needs.

Assessing the effects of mining projects on child health in sub-Saharan Africa: a multi-country analysis

Background

The African continent hosts many industrial mining projects, and many more are planned due to recent prospecting discoveries and increasing demand for various minerals to promote a low-carbon future. The extraction of natural resources in sub-Saharan Africa (SSA) represents an opportunity for economic development but also poses a threat to population health through rapid urbanisation and environmental degradation. Children could benefit from improved economic growth through various channels such as access to high-quality food, better sanitation, and clean water. However, mining can increase food insecurity and trigger local competition over safe drinking water. Child health can be threatened by exposure to mining-related air, noise, and water pollution. To assess the impact of mines on child health, we analyse socio-demographic, health, and mining data before and after several mining projects were commissioned in SSA.

Results

Data of 90,951 children living around 81 mining sites in 23 countries in SSA were analysed for child mortality indicators, and 79,962 children from 59 mining areas in 18 SSA countries were analysed for diarrhoea, cough, and anthropometric indicators. No effects of the launch of new mining projects on overall under-five mortality were found (adjusted Odds Ratio (aOR): 0.88; 95% Confidence Interval (CI): 0.68–1.14). However, activation of mining projects reduced the mortality risk among neonates (0–30 days) by 45% (aOR: 0.55; 95% CI: 0.37–0.83) and risk for a child to develop diarrhoeal diseases by 32% (aOR: 0.68; 95% CI: 0,51–0.90). The timing analysis of observed changes showed that there is a significant decline in the risk for childhood diarrhoea (aOR: 0.69; 95% CI: 0.49–0.97), and the mean height-for-age z-scores by 28 percentage points, during the prospection and construction phase; i.e., within four years to the initiation of extraction activity. No effects were found for cough and weight-for-height.

Conclusion

The results presented suggest that the impacts of mining on child health vary throughout the mine’s life cycle. Mining development likely contributes positively to the income and livelihoods of the impacted communities in the initial years of mining operations, particularly the prospection and construction phase; these potential benefits are likely to be at least partially offset by food insecurity and environmental pollution during early and later mining stages, respectively. Further research is warranted to better understand these health impacts and to identify policies that can help sustain the positive initial health impacts of mining projects in the long term.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-022-00797-6.

Impact of mining projects on water and sanitation infrastructures and associated child health outcomes: a multi-country analysis of Demographic and Health Surveys (DHS) in sub-Saharan Africa

Background

Access to improved water and sanitation infrastructures are key determinants of health. The sub-Saharan African region in particular is lagging behind the ambitious goal of the 2030 Agenda for Sustainable Development to ensure universal access to improved and reliable water and sanitation for all (Sustainable Development Goal (SDG) 6). Large mining projects can promote economic growth and hence investments in water and sanitation infrastructures, but at the same time lead to rapid population growth and environmental degradation. In turn, these changes can pose risks and opportunities for child health (SDG 3). In this study we aim to quantify the impacts of mining projects on access to water and sanitation infrastructure as well as diarrhea and malnutrition among children using data from 131 Demographic and Health Surveys from sub-Saharan Africa.

Results

From a sample of around 1.2 million households, data within the proximity of 52 mine-panels were selected for longitudinal analyses, resulting in 41,896 households and 32,112 children. Improvements in access to modern water and sanitation infrastructures after mine opening were much larger in households near mining sites than in comparison areas located further away (adjusted relative risk ratio (aRRR) water: 18.60, 95 % confidence interval (CI): 13.08–26.46 and aRRR sanitation: 2.56, 95 % CI: 1.32–4.99). However, these associations were weaker among poorer households. In areas close to the mining sites, stunting and underweight prevalence decreased more strongly upon mine opening (adjusted odds ratio (aOR) stunting: 0.62, 95 % CI: 0.43–0.90; aOR underweight: 0.55, 95 % CI: 0.36–0.84). No differential changes were seen for wasting and diarrhea. Large impact heterogeneity was observed both within and across countries.

Conclusions

Our results suggest that the opening of mines is associated with improvements in access to modern water and sanitation infrastructures (SDG 6) as well as in some health outcomes (SDG 3). However, the large impact heterogeneity suggests that the assessment and management of mining-related impacts on communities should have an increased equity-focus, in order to “leave no one behind” in the work towards the 2030 Agenda for Sustainable Development. Overall, the findings of this study underscore that the resource extraction sector has the potential to make positive and substantial contributions towards achieving the SDGs.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12992-021-00723-2.

Health impacts of industrial mining on surrounding communities: Local perspectives from three sub-Saharan African countries

Industrial mining projects can play an important role in global sustainable development if associated health risks are minimised and opportunities maximised. While a broad body of evidence from quantitative studies exists that establishes the interlinkages between mining operations and effects on public health, little research has been conducted investigating health impacts from the perspective of affected communities. This is particularly true in sub-Saharan Africa, where about a third of the remaining global mineral resources are endowed and health-related indicators for sustainable development are lagging behind. In this multi-country qualitative study, we explore community perceptions regarding impacts of industrial mining on their health and well-being. In nine study sites in Burkina Faso, Mozambique and Tanzania, we conducted 83 participatory focus group discussions with a total of 791 participants (385 men, 406 women). Our findings reveal a broad range of perceived impacts on environmental, economic and social determinants of health, with secondary health implications related to morbidity, mortality and well-being. Overall, perceived negative impacts prevailed, mainly related to environmental pollution, change in livelihoods or social disruption. Perceived positive impacts on health and well-being were related to interventions implemented by the mines such as new or improved water sources, health care facilities, roads and schools. The consistency of these findings across countries and study sites suggests a structural problem and indicates a pressing need to address health by acting on the wider determinants of health in mining regions. Participatory health impact assessment should be strengthened in host countries to foster strategic interventions, include marginalised population groups, and protect and promote the health of local communities. By including community perspectives on health before and during project implementation, policymakers can take advantage of economic opportunities while avoiding the pitfalls, bringing their communities closer to achieving good health and well-being goals by 2030 and beyond.

A comparison of the prevalence of sexually transmitted infections among circumcised and uncircumcised adult males in Rustenburg, South Africa: a cross-sectional study

BACKGROUND

South Africa has a persistent burden of sexually transmitted infections (STIs). Male circumcision has been shown to be effective in preventing HIV and STIs, but data are scarce on the protective effect of circumcision in high-risk populations such as migrant miners. The objective of this study was to assess the effect of medical and traditional circumcision on the prevalence of STIs after adjusting for other risk factors in Rustenburg, a mining town in North West Province, South Africa.

METHODS

This cross-sectional study used baseline data collected from a cohort study. Adult males in a mining town were assessed for STIs (gonorrhea, chlamydia, and trichomoniasis) using syndromic assessment. Data on circumcision status and other risk factors for STI syndromes were collected using an interviewer-administered questionnaire. The following symptoms were assessed; penile discharge, painful urination, dyspareunia or penile sores. These symptoms indicate sexually transmitted infection in general since laboratory tests were not performed. Multivariable log binomial regression was used to assess the independent effect of circumcision on STI presence after adjusting for confounders.

RESULTS

A total of 339 participants with a median age of 25 years (IQR 22-29) were included in the study, of whom 116 (34.2%) were circumcised. The overall STIs prevalence was 27.4% (95% CI 22.8 to 32.6%) and was lower in the circumcised participants compared with those who were uncircumcised (15.5% vs 33.6%, respectively, p < 0.001). Both medical (OR 0.57, 95% CI 0.34-0.95, p = 0.030) and traditional circumcision (OR 0.34, 95% CI 0.13-0.86, p = 0.022) were strongly associated with a lower risk of STIs after adjustment for employment and condom use.

CONCLUSION

In this high-risk population in a mining town in South Africa, with a relatively high prevalence of STIs, and where one third of males are circumcised, both medical and traditional circumcision appear to be protective against STIs.

Level of Knowledge and Risk Factors for Visceral Leishmaniasis in a Mining Area of Minas Gerais State, Brazil

Aiming to optimize and adjust leishmaniasis prevention and control measures for the resident population of Pains, state of Minas Gerais, Brazil, a structured questionnaire containing conceptual questions and questions about household characteristics was used to evaluate knowledge level and exposure risk. A total of 396 individuals were interviewed revealing unscientific and fragmented knowledge about the subject for most of the studied population. The female population was found to have 1.68 times more chance of knowing about the disease than the male population, while highly educated individuals were found to have 2.92 times more chances of knowing about leishmaniasis compared to basic educated individuals. All of the respondents reported the presence of, at least, one risk factor, while ages ≥40 years were considered a protective factor compared to younger ages, indicating that older individuals are more likely to recognize risks and protect themselves against leishmaniasis. These results will contribute to the production of didactic materials for the population with respect to their previous knowledge and will provide a basis for control and prophylactic measures.

Inclusion of Health in Impact Assessment: A Review of Current Practice in Sub-Saharan Africa

Natural resource extraction projects, including those in the mining sector, have various effects on human health and wellbeing, with communities in resource-rich areas in sub-Saharan Africa (SSA) being particularly vulnerable. While impact assessments (IA) can predict and mitigate negative effects, it is unclear whether and to what extent health aspects are included in current IA practice in SSA. For collecting IA reports, we contacted 569 mining projects and 35 ministries regulating the mining sector. The reports obtained were complemented by reports identified in prior research. The examination of the final sample of 44 IA reports revealed a heavy focus on environmental health determinants and included health outcomes were often limited to a few aspects, such as HIV, malaria and injuries. The miniscule yield of reports (1.6% of contacted projects) and the low response rate by the contacted mining companies (18%) might indicate a lack of transparency in the IA process of the mining sector in SSA. To address the shortcomings identified, policies regulating IA practice should strengthen the requirements for public disclosure of IA reports and promote a more comprehensive inclusion of health in IA, be it through stand-alone health impact assessment or more rigorous integration of health in other forms of IA.

The epidemiology of rape and sexual violence in the platinum mining district of Rustenburg, South Africa: Prevalence, and factors associated with sexual violence

Background

Estimates for the prevalence of rape and other forms of sexual violence (SV) vary in South Africa. This survey aimed to provide clarity by quantifying the prevalence of SV (forced sex or sexual acts) by 1) sexual partners, and 2) non-partners, and to describe factors associated with these outcomes among women (18–49 years) living in Rustenburg Municipality.

Materials and methods

We conducted a cluster-randomized household survey (November—December 2015). Women were asked about their experiences of SV, associated attitudes and behaviours, and access to services. Logistic regression was used to determine factors associated with partner and non-partner SV.

Results

Of eligible households, 83·1% (1700/2044) participated. Of 966 women invited, 836 participated (86·5%). Average age of participants was 31.6 years (95%CI: 30·9, 32·4) with 45% having completed at least secondary school, and 60% unemployed or looking for work.

Lifetime prevalence of SV was 24.9% (95%CI: 21·7–28·5), reaching 9.0% (95% CI: 6·6–12·1) by age 15. Almost one third told no one of their SV experiences. Factors related to financial dependence were associated with SV by a partner. History of termination of pregnancy increased the likelihood of SV by a non-partner as an adult. Women who experienced SV in childhood or as an adult were more likely to experience SV from a different type of perpetrator than those who did not.

Conclusions

We found a high prevalence of SV, including during childhood, in this setting, with limited access to care. This and the high morbidity attributed to SV calls for increased service provision.

A community-based intervention to build community harmony in an Indigenous Guatemalan Mining Town

The presence of large-scale mining operations poses many threats to communities. In a rural community in Guatemala, community leaders were motivated to address divisiveness and local conflict that have been exacerbated since the arrival of a mining company in the region. Prior research by our team identified spiritual and cultural strengths as important sources of strength and resilience in the community. We piloted a community-based intervention centred on spiritual and cultural practices in the region, to address divisiveness and build community harmony. One hundred and seventeen participants from over 18 villages in the municipality participated in the workshops and follow-up focus groups. Community leaders facilitated the intervention and partnered with the academic researcher throughout the research process. Overall, community members and facilitators expressed satisfaction with the workshop. Further, our analysis revealed three important processes important to the development of community harmony in the region: (a) mutual recognition and collectivisation; (b) affirmation of ancestral roots and connections to Mother Earth and (c) inspiring action and momentum towards solutions. These mechanisms, and the socio-political contexts that undermine them, have important implications for how global health programmes are developed and how collective processes for well-being are understood within an inequitable, conflict-laden world.