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  • Declining blood lead levels among small-scale miners participating in a safer mining pilot programme in Nigeria

    Gottesfeld, P; Meltzer, G; Costello, S; Greig, J; Thurtle, N; Bil, K; Mwangombe, BJ; Nota, MM (The BMJ, 2019-09-05)
    Objectives Our objective was to monitor blood lead levels (BLLs) of miners and ore processors participating in a pilot programme to reduce lead poisoning and take-home exposures from artisanal small-scale gold mining. A medical surveillance programme was established to assess exposures as new methods aimed at reducing lead exposures from ore were introduced in a community in Nigeria where children experienced substantial lead-related morbidity and mortality. Methods Extensive outreach and education were offered to miners, and investments were made to adopt wet methods to reduce exposures during mining and processing. We conducted medical surveillance, including a physical exam and repeated blood lead testing, for 61 miners selected from among several hundred who participated in the safer mining pilot programme and consented to testing. Venous blood lead concentrations were analysed using the LeadCare II device at approximately 3-month intervals over a period of 19 months. Results Overall geometric mean (GM) BLLs decreased by 32% from 31.6 to 21.5 µg/dL during the 19-month project. Women had a somewhat lower reduction in GM BLLs (23%) compared with men (36%). There was a statistically significant reduction in log BLLs from baseline to the final test taken by each participant (p<0.001). Conclusions The observed reductions in GM BLLs during the pilot intervention among this representative group of miners and ore processors demonstrated the effectiveness of the safer mining programme in this community. Such measures are feasible, cost-effective and can greatly improve health outcomes in mining communities.
  • Reducing Lead and Silica Dust Exposures in Small-Scale Mining in Northern Nigeria.

    Gottesfeld, P; Tirima, S; Anka, SM; Fotso, A; Nota, MM (2019-01-07)
    An ongoing health crisis across a large area of Northern Nigeria has resulted in hundreds of deaths and thousands of cases of lead poisoning from artisanal small-scale gold mining. Occupational Knowledge International (OK International) and Doctors Without Borders/Médecins Sans Frontières (MSF) have formed a partnership to conduct a pilot project to introduce safer mining practices in selected communities. The primary objective was to reduce lead exposures among artisanal small-scale miners and minimize take home exposures by reducing dust contamination on clothing and body surfaces.
  • The Evolving Role of CSR in International Development: Evidence from Canadian Extractive Companies’ Involvement in Community Health Initiatives in Low-Income Countries

    Lamb, S; Jennings, J; Calain, P (Elsevier, 2017-05-31)
    Overseas development agencies and international finance organisations view the exploitation of minerals as a strategy for alleviating poverty in low-income countries. However, for local communities that are directly affected by extractive industry projects, economic and social benefits often fail to materialise. By engaging in Corporate Social Responsibility (CSR), transnational companies operating in the extractive industries ‘space’ verbally commit to preventing environmental impacts and providing health services in low-income countries. However, the actual impacts of CSR initiatives can be difficult to assess. We help to bridge this gap by analysing the reach of health-related CSR activities financed by Canadian mining companies in the low-income countries where they operate. We found that in 2015, only 27 of 102 Canadian companies disclosed information on their websites concerning health-related CSR activities for impacted communities. Furthermore, for these 27 companies, there is very little evidence that alleged CSR activities may substantially contribute to the provision of comprehensive health services or more broadly to the sustainable development of the health sector.
  • Association of Blood Lead Level with Neurological Features in 972 Children Affected by an Acute Severe Lead Poisoning Outbreak in Zamfara State, Northern Nigeria

    Greig, J; Thurtle, N; Cooney, L; Ariti, C; Ahmed, A O; Ashagre, T; Ayela, A; Chukwumalu, K; Criado-Perez, A; Gómez-Restrepo, C; et al. (Public Library of Science, 2014)
    In 2010, Médecins Sans Frontières (MSF) investigated reports of high mortality in young children in Zamfara State, Nigeria, leading to confirmation of villages with widespread acute severe lead poisoning. In a retrospective analysis, we aimed to determine venous blood lead level (VBLL) thresholds and risk factors for encephalopathy using MSF programmatic data from the first year of the outbreak response.
  • What is the relationship of medical humanitarian organisations with mining and other extractive industries?

    Calain, P; Unité de Recherche sur les Enjeux et Pratiques Humanitaires, Médecins Sans Frontières, Genève, Switzerland. philippe.calain@geneva.msf.org (Public Library of Science, 2012-08-28)
    Philippe Calain discusses the health and environmental hazards of extractive industries like mining and explores the tensions that arise when medical humanitarian organizations are called to intervene in emergencies involving the extractive sector.
  • Outbreak of Fatal Childhood Lead Poisoning Related to Artisanal Gold Mining in Northwestern Nigeria, 2010.

    Dooyema, C A; Neri, A; Lo, Y-C; Durant, J; Dargan, P I; Swarthout, T; Biya, O; Gidado, S O; Haladu, S; Sani-Gwarzo, N; et al. (National Institute of Environmental Health Sciences, 2011-12-20)
    Background: In May 2010, a team of national and international organizations was assembled to investigate children's deaths due to lead poisoning in villages in northwestern Nigeria. Objectives: To determine the cause of the childhood lead poisoning outbreak, investigate risk factors for child mortality, and identify children aged <5 years in need of emergency chelation therapy for lead poisoning. Methods: We administered a cross-sectional, door-to-door questionnaire in two affected villages, collected blood from children aged 2-59 months, and soil samples from family compounds. Descriptive and bivariate analyses were performed with survey, blood-lead, and environmental data. Multivariate logistic regression techniques were used to determine risk factors for childhood mortality. Results: We surveyed 119 family compounds. One hundred eighteen of 463 (25%) children aged <5 years had died in the last year. We tested 59% (204/345) of children, aged <5 years, and all were lead poisoned (≥10 µg/dL); 97% (198/204) of children had blood-lead levels ≥45 µg/dL, the threshold for initiating chelation therapy. Gold ore was processed inside two-thirds of the family compounds surveyed. In multivariate modeling significant risk factors for death in the previous year from suspected lead poisoning included: the child's age, the mother performing ore-processing activities, community well as primary water source, and the soil-lead concentration in the compound. Conclusion: The high levels of environmental contamination, percentage of children aged <5 years with elevated blood-lead levels (97%, >45 µg/dL), and incidence of convulsions among children prior to death (82%) suggest that most of the recent childhood deaths in the two surveyed villages were caused by acute lead poisoning from gold ore-processing activities. Control measures included environmental remediation, chelation therapy, public health education, and control of mining activities.
  • Safe Water for the Aral Sea Area: Could it get Any Worse?

    Small, I; Falzon, D; van der Meer, J; Ford, N; Médecins Sans Frontières, Aral Sea Programme, Tashkent, Uzbekistan. (Published by Oxford University Press, 2003-03)
    The environmental adversities around the Aral Sea in Central Asia have been the subject of recent research. Attempts at sustainable provision of palatable drinking water in low chemical and microbial contaminants for the 4 million people in the two countries around the Aral littoral have been largely unsuccessful. In the last few years, severe drought has further depleted the amount of available water. This shortage has negatively impacted on agriculture, and accentuated the out migration of people. An appeal is made to assist the local population in this arid area to cope with the acute and chronic deterioration of water security.
  • DOTS in Aral Sea area.

    Shafer, J; Falzon, D; Small, I; Kittle, D; Ford, N (2001-12-08)
  • Not a drop to drink in the Aral Sea.

    Small, I; Falzon, D; van der Meer, J; Ford, N; Upshur, R (2001-11-10)
  • Acting on an Environmental Health Disaster: The Case of the Aral Sea.

    Small, I; van der Meer, J; Upshur, R; Uzbekistan/Turkmenistan and the Aral Sea Area Program, Medecins Sans Frontieres, Tashkent, Uzbekistan. msfh-tashkent@amsterdam.msf.org (Published by National Institute of Environmental Health Sciences, 2001-06)
    The Aral Sea area in Central Asia has been encountering one of the world's greatest environmental disasters for more than 15 years. During that time, despite many assessments and millions of dollars spent by large, multinational organizations, little has changed. The 5 million people living in this neglected and virtually unknown part of the world are suffering not only from an environmental catastrophe that has no easy solutions but also from a litany of health problems. The region is often dismissed as a chronic problem where nothing positive can be achieved. Within this complicated context, Medecins Sans Frontieres, winner of the Nobel Peace Prize in 1999, is actively trying to assess the impact of the environmental disaster on human health to help the people who live in the Aral Sea area cope with their environment. Medecins Sans Frontieres has combined a direct medical program to improve the health of the population while conducting operational research to gain a better understanding of the relationship between the environmental disaster and human health outcomes. In this paper we explore the health situation of the region and the broader policy context in which it is situated, and present some ideas that could potentially be applied to many other places in the world that are caught up in environmental and human health disasters.