Trotman, Lall say all recommendations...
tion at the GGB and GGMC and they have no intention of repeating their mistakes.
Medical monitoring
Meanwhile, based on its assessments, the NIOSH also recommended that alternatives to mercury should be used for burning gold where possible.
“Eliminating potential for excessive mercury exposures should be a top priority. We recommend that where possible, alternatives to mercury should be used for mining, processing, burning, purifying, and testing gold,” it said, while noting the use of borax as an alternative.
In addition to the testing of work areas, the team conducted medical interviews with 115 GGMC/GGB employees from 25 different departments. Based on its findings, it has recommended that the GGMC implement a medical monitoring program for all employees after above normal blood mercury levels were found in the laboratory workers, as compared to non-laboratory workers, workers who routinely perform field work in the interior and those not performing field work.
When questioned about implementing the program, Trotman explained that he has asked the heads of the sister agencies and other stakeholders, including the chairman of the GGMC and its Commissioner Newell Dennison, and Lall to form a committee to work along with the Ministry of Public Health and the Ministry of Social Protection to have a monitoring mechanism.
He said that they are also discussing having an external consultant to the GGB to visit on a monthly basis to verify that their systems are working as they should. “So we are not going to leave it to ourselves to regulate ourselves. We will have an external agency,” Trotman said.
The team stated that while there is no indication for the average blood mercury level for the Guyanese population, and while it may vary for different countries, the CDC considers mercury levels under 10 micrograms per litre (μg/L) to be normal. It notes that the laboratory workers were found with an average of 12.6 μg/L compared to the non-laboratory workers who had an average of 8.5μg/L. However, GGMC workers who frequent the interior regions of the country were found with an average of 11.4μg/L as compared to the average of 7.5μg/L found in those not performing field work.
Additionally, it was also recorded that the average blood mercury levels increased with persons who consumed more fish regularly. The letter notes that it went from an average of 6.2μg/L for workers consuming fish less than once a month to an average 12.7μg/L for persons who consumed fish more than once a week.
“The medical history assessment included yes/no questions about 18 symptoms that could be related to mercury exposure. Employees reported an average of six symptoms with a range of 0-15 symptoms,” the letter said, while pointing out that the common symptoms included difficulty with sleep (61%), changes in personality and mood (57%), headaches (57%) and difficulty with thinking (56%).
It, however, did not recommend blood mercury testing for employees who have chronic mercury exposure since the half-life of the metal in the blood is one to five days, and the blood mercury levels could fluctuate more often.
“Additionally blood mercury cannot differentiate between organic (from fish consumption) and inorganic mercury and thus results are more difficult to interpret,” the letter states.
The team noted that homeopathic medications, nonvitamin dietary supplements or herbal supplements should not be used as treatments, which the letter stated that the employees said was included in their chelation therapy for diseases or preventive health measures including chelation therapy.
The letter went on to state that the team recommended that the GGMC implement a medical monitoring program for all its employees and it should include urine testing for mercury levels to determine if the workers are exposed to elemental or inorganic forms of mercury and it should be compared to the ACGIH Biological Exposure Index (BEI) of 20 micrograms per gram of creatinine, collected prior to a work shift. This level, it said, more accurately reflects exposures to elemental mercury and provides information for chronic exposure.
The team said baseline and periodic questionnaires with a focus on work practices and health effects, including symptoms and conditions that may be associated with mercury exposure, should also be included in the monitoring program along with physical examinations and other laboratory testing inclusive of urinalysis, complete blood count, blood urea nitrogen and creatinine, should also be administered by a provider with occupational health or toxicology knowledge and experience.
“If over-exposures to mercury are suspected, the provider should inform the local occupational safety and health team to evaluate the work site to assess exposures and to investigate interventions that can be made to reduce exposure. At the end of each examination, employees should be informed of their results, with a determination made about the employee’s ability to return to the work environment,” the letter added.
It also noted that the employees indicated that the current policy for the GGB employees is for only those with high mercury levels to be medically removed from the workplace for two weeks, temporarily. However, it noted that if the decision is made to medically remove employees exposed to mercury then they should be informed and sent to a provider with knowledge of occupational health or toxicology to discuss the findings and to determine if additional steps are required to protect their health.
The letter also recommended that there be an implementation of an employee assistance program that will encourage wellness and stress reduction services and to encourage them to seek help from a qualified health professional if they are experiencing symptoms of depression, anxiety, post-traumatic stress disorder or other stress-related symptoms that are interfering with their social, occupational, or other important areas function.
It added that there should be training and communication assessment since only 10% of the employees reported having training on the health effects of mercury. “We recommend initiating a hazard communication training program for employees of GGMC and the GGB that contained the following elements: types of mercury (elemental, inorganic, organic), ways employees could be exposed to mercury, health effects of mercury, testing for mercury and why it was chosen by GGMC and the GGB, what environmental exposure results mean and what the limits are, management plans to control mercury exposure and how employees can protect themselves from mercury exposure and personal protective equipment for employees working in job tasks that may result in exposure,” the letter said, while adding that improved communication between the employer and employees with regards to employee health and safety concerns is also recommended.