- Open Access
Reducing disease and death from Artisanal and Small-Scale Mining (ASM) - the urgent need for responsible mining in the context of growing global demand for minerals and metals for climate change mitigation
Environmental Health volume 21, Article number: 78 (2022)
Artisanal and small-scale mining (ASM) takes place under extreme conditions with a lack of occupational health and safety. As the demand for metals is increasing due in part to their extensive use in ‘green technologies’ for climate change mitigation, the negative environmental and occupational consequences of mining practices are disproportionately felt in low- and middle-income countries. The Collegium Ramazzini statement on ASM presents updated information on its neglected health hazards that include multiple toxic hazards, most notably mercury, lead, cyanide, arsenic, cadmium, and cobalt, as well as physical hazards, most notably airborne dust and noise, and the high risk of infectious diseases. These hazards affect both miners and mining communities as working and living spaces are rarely separated. The impact on children and women is often severe, including hazardous exposures during the child-bearing age and pregnancies, and the risk of child labor. We suggest strategies for the mitigation of these hazards and classify those according to primordial, primary, secondary, and tertiary prevention. Further, we identify knowledge gaps and issue recommendations for international, national, and local governments, metal purchasers, and employers are given. With this statement, the Collegium Ramazzini calls for the extension of efforts to minimize all hazards that confront ASM miners and their families.
Artisanal Small-Scale Mining (ASM) is one of the world’s most dangerous occupations. The World Bank estimates that 100 million children, women and men work in ASM worldwide, mostly in remote rural areas of low-income and lower-middle-income countries. These miners often work under extreme conditions, the communities where they and their families live are heavily polluted, and ASM is responsible for high, but preventable rates of disease, injury, and premature death. ASM is increasing rapidly. Paradoxically, a key driver of this growth is climate change mitigation.
Climate change mitigation increases the demand for metals used for low-carbon-technologies, such as cobalt and lithium. The increased demand of such minerals will increase large-scale mining as well as ASM activities in the sector. Large quantities of global cobalt are mined in the DR Congo, where 20–30% originates from ASM. It is widely recognized that mineral demand will continue to increase in the coming decades.
The goals of this statement, which the Collegium Ramazzini issued during the United Nations COP 26 meeting on Climate Change in November 2021 are to:
Provide updated information on the neglected health hazards of ASM and on strategies for mitigation of these hazards in the context of rapidly growing global demand for minerals and metals to meet the urgent need for climate change mitigation;
Raise awareness of ASM hazards among policy-makers and the public; and
Call for urgent interventions against the grave dangers of ASM by international organizations, governments, employers, and minerals and metals purchasers.
The Collegium Ramazzini notes the gross injustice of ASM. While most ASM takes place in the Global South, in the same countries already suffering the most serious consequences of climate change, most who benefit from ASM are in the Global North and thus have a shared responsibility to encourage their governments to contribute to reducing ASM hazards. We cannot achieve climate change mitigation through the use of “blood minerals”.
Artisanal and Small-Scale Mining (ASM) is highly dangerous work associated with multiple occupational and environmental hazards. In most mines little consideration is given to health and safety. Governmental oversight is rare, especially in areas where ASM is illegal. Severe injuries such as falls from heights, crush injuries from cave-ins, and lacerations and amputations from unguarded machinery are common. Because there is little separation between working and living areas in ASM, miners, their families, and residents in mining communities are at risk of exposure to hazards associated with mining for 24 h each day, every day, throughout the year, often under very primitive conditions.
“Small-Scale Mining” is defined as mining conducted by small companies with limited financial resources and limited numbers of miners. These mines typically use some forms of technology – mainly low-end and inexpensive technologies.
“Artisanal Mining” is defined as mining conducted by an individual miner and family members. It is smaller than small-scale mining, involves mainly manual labor, has no financial support, and is usually not formalized.
Both Artisanal and Small-Scale Mining take place mainly in Low- and Lower-middle income countries.
Artisanal and small-scale miners are exposed in their work to multiple toxic hazards, most notably mercury, lead, cyanide, arsenic, cadmium, and cobalt:
Mercury exposure occurs mainly in gold mining, where milled ore is mixed with mercury to form an amalgam, and the amalgam is then vaporized and produces highly toxic mercury vapor. Mercury exposure also occurs in mercury mining. Extensive exposure to both metallic and organic mercury occurs in ASM. Along with coal combustion, ASM is one of the world’s two largest sources of mercury pollution. Elemental, organic and inorganic mercury are toxic substances, all to be found in ASM, causing severe damage to the neurological, renal, digestive and immunological system. Many miners show symptoms of a chronic inorganic mercury vapor intoxication, which can also be found in affected communities.
Cyanide exposure is another very serious hazard of gold mining and occurs when cyanide is used as an alternative to mercury in the separation of gold from ore. Cyanide adversely affects respiratory and cardiovascular health and is known to adversely affect the central nervous system.
Lead, arsenic, and cadmium exposure occurs in mines where lead, arsenic, cadmium, gold and other metals occur together in the mineral ore. Lead is a neurotoxic substance, negatively affecting the pre- and postnatal cognitive development. Lead is a human carcinogenic substance. Lead exposure in ASM causes severe clinical symptoms such as anemia, abdominal pains, seizures, encephalopathy up to increased mortality. Arsenic is a carcinogenic substance which causes dermatological, pulmonary, and cardiovascular diseases. Cadmium is a carcinogenic substance. Exposure to cadmium negatively affects the renal function, immune responses, cardiovascular and skeletal health.
Cobalt exposure occurs in cobalt mining. Exposure to cobalt can cause negative effects to the pulmonary, hematological, endocrine, and nervous system.
All those exposures have multiple adverse health outcomes, including serious social implications.
Artisanal and small-scale miners are occupationally exposed to physical hazards, most notably accidents, airborne dust, and noise:
Accidents in ASM are the main hazards for miners’ health. Miners lack safety equipment and training. Many mines are extremely unsafe workplaces due to the fact that safety regulations are lacking, neither enforced nor implemented by governments. This results in a variety of occupational hazards that are not controlled, thereby placing the health and safety of miners at risk.
Levels of silica-laden dust tend to be especially high in hard rock ASM mines, and silica exposure increases the risk of death from respiratory diseases including silicosis, tuberculosis, lung cancer, and COVID-19.
Noise levels in artisanal and small-scale mines are typically far above acceptable levels due to the poorly regulated use of dynamite and heavy machinery. Sustained noise exposure can lead to hearing loss, as well as cognitive and behavioral disabilities.
Artisanal and small-scale miners are at high risk of infectious diseases:
The COVID-19 pandemic affects disproportionately ASM miners and their communities because hand washing facilities, face masks and provisions for physical distancing are rarely available.
Silica exposure, which is widespread in ASM, weakens the immune response thus increasing vulnerability to tuberculosis and COVID-19 infections.
Rates of enteric diseases are high due to frequent lack of hygiene and sanitation facilities in the mines and insufficient access to clean water and food.
Sexually transmitted diseases including HIV/Aids are common among mobile men with money (MMM), including miners.
Women and children in ASM and in ASM communities face unique and severe risks. Pre- and postnatal exposure to neuro-developmental toxins pose a specific risk for women at childbearing age and/or infants. Well known neuro-developmental toxins that are common in ASM are mercury, lead, and arsenic. Women may be subjected to sexual assault, violence, and psychological abuse, and they often face discriminatory work practices. Child workers are at risk of exploitation, physical and psychological abuse, and are subjected to working conditions where physical strain and chemical exposures may result in lifelong disabilities.
Artisanal and small-scale miners’ health and the health of their families are further eroded by corruption, malnutrition, violence, lack of access to health care and lack of education. Poverty is the main driving force for ASM, and its impacts are worsened by a lack of adequate and collaborative formalization efforts in the ASM sector.
Demand for metals: Strong and rising global demand for metals is the major driver of increases in ASM, and mineral demand is expected to continue to increase by as much as 450% until 2050. Climate change is a critical factor in this increased demand, because vast quantities of key minerals are needed for low-carbon energy technologies such as solar and wind power, e-vehicles, and new-generation batteries. The impacts of this increased demand are expected to be massive in countries such as the Democratic Republic of Congo, which holds roughly half of the world’s cobalt reserves (Appendix, Table 10). The rising price of metals, notably gold where the prices doubled in the last decade, will further fuel increases in ASM. Nevertheless, novel technologies to foster low-carbon technologies are on the rise, which may require a reduced amount of these critical minerals or use recycled material. The World Bank estimates the recycled content rate for cobalt at 32%. This proportion is projected to stay constant until 2050.
As climate change impacts become more severe, economic uncertainty increases, and metal prices remain high, more people in low-income and lower-middle-income countries will turn to ASM in search of livelihoods. Spikes in metal prices have been associated with large-scale environmental and occupational health tragedies in the past in Zamfara (Nigeria), Dakar (Senegal), and the DR Congo. In the absence of decisive action by governments and metal purchasers, these tragedies will multiply.
Knowledge gaps: The full number of artisanal and small-scale miners globally is not known and may be substantially greater than the current World Bank estimate of 100 million, given that a lot of ASM takes place in remote rural areas of Low-income and Lower-middle-income countries and is illegal in some places. For artisanal and small-scale gold mining the number of miners is estimated to be between 10 and 19 million. For all the different sectors of ASM accurate information on the number, gender distribution, and age distribution of artisanal and small-scale miners and on the numbers of people living in ASM communities in all countries are lacking but would be useful for planning health and social services.
Patterns of disease, injury and premature death in artisanal and small-scale miners are poorly defined. The contribution of ASM to the global burden of disease is inadequately charted. Consequently, the health impact of interventions in the field of ASM can also not be measured adequately.
Little is known about the local economic factors that impel populations to shift from subsistence agriculture to subsistence mining for their livelihood. ASM is a source of income diversification in many regions where farming is seasonal. In regions experiencing reduced crop yields as a result of climate-change-related alterations in weather patterns, it is possible that agricultural communities are already shifting to ASM for income stability. In Latin America, many native communities started to deforest and obtain minerals with local miners. However, it is controlled by the community. Better understanding of these relationships is needed, especially in supporting local development on top of governmental actions to improve climate adaptation strategies.
Artisanal and small-scale gold mining are the world’s largest sources of anthropogenic mercury pollution. UNEP’s “Minamata Convention on Mercury” supports programs to reduce and replace mercury in Artisanal and Small-scale Gold Mining (ASGM). The supply of mercury for ASGM areas is widely uncontrolled, including illegal trade and informal mercury mining. More information is needed on the production, supply, and market for mercury used in gold extraction (Appendix, Table 11).
Generations of children in ASM villages are exposed prenatally to mercury, lead, arsenic, cadmium, cobalt, manganese or other toxic pollutants generated by mining. Children ingest these toxic materials in breast milk; they play and grow up in polluted, dusty areas contaminated by metals and other hazards; and they start to work as miners even before they reach puberty. The lifelong health consequences of those exposures are very different from the health effects for healthy adult workers. Because they eat more food, drink more water, and breathe more air per Kg body weight compared to adults, children are disproportionately heavily exposed to hazardous materials. Too little is known about the pre- and postnatal health hazards for occupationally exposed children. Clinical and epidemiological studies of children in ASM communities are urgently needed.
The Collegium Ramazzini calls urgently for extended efforts to minimize all hazards related to ASM. International organizations, governments at all levels – national, state or provincial, and local - and all employers - large and small, public and private - must fulfill their responsibilities to protect the health of all workers in ASM and to create occupational health and safety programs that will reduce risks of disease, injury and premature death among artisanal and small-scale miners. This call becomes particularly urgent in the context of growing global demand for minerals and metals for climate change mitigation. The Collegium Ramazzini urges non-governmental organizations to accept the challenge of reducing the grave hazards that confront artisanal and small-scale miners and their families.
Responsibilities of the International Community: As the world increases its reliance on renewable energy and demand grows accordingly for minerals and metals, the Collegium Ramazzini calls upon UN agencies and the international community to give special attention to the issue of ASM and to urge actors in the global supply chain to adopt codes of conduct that document and declare that all metals in commerce have been extracted under conditions that assure safety and health. Specifically:
We urge the United Nations to adopt a Convention on the Safety and Health of ASM, in which member nations commit to establishing both domestic and international protections against the abuse of ASM workers and their families.
We urge WHO and ILO to launch an international movement focused on quantifying and reducing the health hazards that arise from ASM.
The World Bank and all other intergovernmental organizations engaged in facilitating global trade, including the International Trade Organization and the Organization for Economic Cooperation and Development, should continue to support countries managing their resources and promote decent and ethical supply chains.
Responsibilities of Governments
It is imperative that governments put systems and processes for safeguarding the health and safety of artisanal and small-scale miners in place. Chief among these is the need to improve the access to occupational health and safety services.
Governments should develop transparent ASM management systems that include meaningful participation from all relevant stakeholders.
Governments should decriminalize ASM in areas where it is illegal and forge collaborative partnerships to improve access to health services. They should support communities in developing a formalization framework that is protective of human and ecological health, and that protects both vulnerable groups and sensitive ecosystems.
Governments should adapt and enforce international conventions such as the Basel Convention, the Stockholm Convention, and the Minamata Convention on Mercury.
Governments should adopt and enforce all the ILO conventions and recommendations for health and safety in the mining industry such as the Safety and Health in Mines Convention (ILO No. 176), the Minimum Age Convention (ILO No. 138), or the Worst Forms of Child Labour Convention (ILO No. 182), the OECD’s Due Diligence Guidelines and develop and adopt legislation obliging enterprises to conduct environmental and human rights due diligence in cooperation with all stakeholders involved and affected.
Governments should adopt the basic occupational health services model that seeks to integrate occupational health to primary health services.
Governments should provide ASM communities with tools and resources to improve occupational health and safety, community health, environmental sustainability, and remediation needs.
Governments should establish systems that will enable miners to readily access markets for mercury-free, environmentally, and socially responsible mineral extraction.
Responsibilities of Employers
Employers have legal and moral responsibilities in all countries to provide a safe and healthy working environment to all miners in their employ.
Multinational companies must apply the same occupational health and safety standards and environmental standards in countries where they operate – in High-income countries as well as in Low- and Lower-middle-income countries.
Employers need to provide adequate access to remedy for victims of rights abuses and provide grievance mechanisms.
Responsibilities of Mineral Purchasers
Mineral purchasers have the responsibility to perform due diligence upstream the supply chain of minerals by diligently investigating the supply chain of minerals they buy. It is unacceptable to purchase minerals produced in environmentally or socially harmful conditions, and it is inadequate to defer accountability due to a lack of knowledge.
Policies for responsible mineral supply chains must be developed and followed, including traceability of minerals, refusal to do business with suppliers who cannot meet responsible production criteria, and consistent monitoring of suppliers.
Purchasers should publicly report all measures and due diligence steps, including their risk reduction strategies, their risk management plan, and their monitoring efforts. In line with OECD Due Diligence Guidance for Responsible Supply Chains of Minerals from Conflict-Affected and High-Risk Areas, companies should include those findings in their annual reports.
Purchasers should also disclose mineral supply information to consumers, including any knowledge or lack thereof of production or trade conditions, criteria met for sustainable and responsible ASM practices, and supply chain information about the minerals used in the product.
Further elaboration of these recommendations is provided in the attached Appendix and its Annexes.
Availability of data and materials
Artisanal and Small-scale Gold Mining
Artisanal and Small-scale Mining
26th UN Climate Change Conference in Glasgow
Coronavirus disease 2019
Human Immunodeficiency Virus
International Labour Organization
Mobile Men with Money
Organization for Economic Collaboration and Development
Personal Protection Equipment
World Health Organization
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The authors would like to acknowledge the Collegium Ramazani Fellows who in one way or another have contributed to this statement. The Collegium Ramazzini is an international scientific society that examines critical issues in occupational and environmental medicine with a view towards action to prevent disease and promote health. The Collegium derives its name from Bernardino Ramazzini, the father of occupational medicine, a professor of medicine of the Universities of Modena and Padua in the late 1600s and the early 1700s. The Collegium is comprised of 180 physicians and scientists from 35 countries, each of whom is elected to membership. The Collegium is independent of commercial interests.
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This review gives relevant details and elaboration on hazards confronting miners and mining communities. It is structured in eight boxes, each box containing information on a subsection of risks.
Table 1 presents a hierarchy of occupational health and safety standards for miners.
Table 2 describes the physical hazards and injuries of ASM.
Table 3 list the toxic hazards of ASM.
Tables 4, 5 and 6 describes the dust (Table 4), infectious diseases (Table 5), and noise (Table 6) hazards of ASM.
Tables 7 and 8 describes the psychosocial hazards of ASM (Table 7) and the particular hazards confronting women and children (Table 8).
Table 9 elaborates on the impact of climate change on ASM and on the impact of ASM on the environment.
Table 10 describes the rising demand for metals for climate change mitigation.
Table 11 discusses gaps in research and the need for more data on ASM and its hazards.
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Landrigan, P., Bose-O’Reilly, S., Elbel, J. et al. Reducing disease and death from Artisanal and Small-Scale Mining (ASM) - the urgent need for responsible mining in the context of growing global demand for minerals and metals for climate change mitigation. Environ Health 21, 78 (2022). https://doi.org/10.1186/s12940-022-00877-5
- Green energy transition
- Occupational health
- Environmental health
- Global south