Health risks of gold miners: a synoptic review.

Health problems of gold miners who worked underground include decreased life expectancy; increased frequency of cancer of the trachea, bronchus, lung, stomach, and liver; increased frequency of pulmonary tuberculosis (PTB), silicosis, and pleural diseases; increased frequency of insect-borne diseases, such as malaria and dengue fever; noise-induced hearing loss; increased prevalence of certain bacterial and viral diseases; and diseases of the blood, skin, and musculoskeletal system. These problems are briefly documented in gold miners from Australia, North America, South America, and Africa. In general, HIV infection or excessive alcohol and tobacco consumption tended to exacerbate existing health problems. Miners who used elemental mercury to amalgamate and extract gold were heavily contaminated with mercury. Among individuals exposed occupationally, concentrations of mercury in their air, fish diet, hair, urine, blood, and other tissues significantly exceeded all criteria proposed by various national and international regulatory agencies for protection of human health. However, large-scale epidemiological evidence of severe mercury-associated health problems in this cohort was not demonstrable.