Teachers on the margins: How low-income public schools burden our teachers.

BACKGROUND: Teachers experience high work-related stress, which can lead to missed workdays and lower quality of life. OBJECTIVE: The objective of this exploratory pilot study was to assess occupational and environmental stressors in public school districts by income level to examine the influence these stressors have on teachers perceived stress and biological stress response. METHODS: Fifty-nine teachers were recruited from four school districts in Michigan (three low-income and one high-income). Participants completed a self-administered survey on teaching stressors, health, and demographics. Stress response was measured through blood pressure, heart rate, and salivary cortisol. Six salivary cortisol measurements were collected for each participant; three in the afternoon and three in the evening. Each teacher's classroom and school underwent an environmental assessment on quality and proximity to environmental hazards. RESULTS: Teachers at low-income school districts had significantly higher afternoon cortisol levels, lower self-reported health, higher body mass index, higher perceived teaching stressors, and worked at schools within one km of a greater number of environmentally-contaminated sites, in comparison to their high-income school district counterparts. CONCLUSIONS: This research aims to inform future interventions that could lessen occupational and environmental stressors for teachers, improve teacher health outcomes and retention, and impact student success rates.

Socioeconomic and racial disparities of sidewalk quality in a traditional rust belt city.

Neighborhood walkability is key to promoting health, accessibility, and pedestrian safety. The Accessible, Connected Communities Encouraging Safe Sidewalks (ACCESS) project was developed to assess sidewalks throughout an urban community in Pontiac, Michigan. Data were collected from 2016 to 2018 along eighty miles of sidewalk for tripping hazards, cracking, vegetation, obstructions, overhead coverage, street lighting, buffers, and crosswalks. Data were mapped in ArcGIS with sociodemographic characteristics by U.S. Census block group. The majority of sidewalks had moderate (57.6%) or major (29.4%) sidewalk quality issues, especially maintenance-related impediments (68.6%) and inadequate street lighting or shade coverage (87.2%). The majority of crosswalks had a curb ramp to improve access for people with disabilities (84.4%), however over half lacked a detectable warning strip (55.8%). Degraded sidewalk quality was associated with lower neighborhood socioeconomic status and a higher proportion of Black and Latinx residents. Equity-centered pedestrian infrastructure improvement plans can address these disparities by increasing accessible, safe active transport options that promote physical activity and reduce health disparities. Evaluations like ACCESS can connect public health professionals with municipal planners to advance Complete Streets plans and promote healthy living.

Pulmonary function and respiratory health of rural farmers and artisanal and small scale gold miners in Ghana.

The recent increase in artisanal and small scale gold mining (ASGM) worldwide has elicited a number of public health concerns for miners and mining communities, including respiratory health. The two primary inhalational exposures of concern are crystalline silica expected to be present in gold ore and smoke from biomass fuels used in cooking. Here, measurements of pulmonary function and of respiratory symptoms were performed in an ASGM community, Kejetia, and a comparison agricultural community, Gorogo, in the Upper East Region of Ghana in May-July 2011. Of 172 participants, 159 performed spirometry, yielding 119 and 95 valid measurements for FEV1 and FVC, respectively. Percent predicted FEV1, FVC and FEV1/FVC, which were lower than predicted for a healthy population, were not significantly different between Kejetia and Gorogo or by mining status in Kejetia. Abnormal lung function was elevated for predicted FEV1 (15.0%) and FEV1/FVC (22.0%) beyond an expected five percent in healthy populations. This first examination of pulmonary function in an ASGM community in Ghana (and possibly worldwide) did not show an obvious relationship between mining involvement and lung function abnormality, but did show associations between the use of biomass fuels, adverse respiratory symptoms, and reduced pulmonary function in both populations. A number of factors including age differences between the populations and the required lag time after silica exposure for the onset of respiratory disease may have affected results. Additional research is needed with larger sample sizes and with more detailed questionnaires to further assess the impact of multiple stressors on respiratory health in ASGM communities.

Mercury Exposure Assessment and Spatial Distribution in A Ghanaian Small-Scale Gold Mining Community.

Mercury is utilized worldwide in artisanal and small-scale gold mining (ASGM) and may pose a risk for miners and mining communities. While a number of studies have characterized mercury in ASGM communities, most have focused on a single media and few have taken a holistic approach. Here, a multiple media exposure assessment and cross-sectional study of mercury was conducted in 2010 through 2012 in northeast Ghana with a small-scale gold mining community, Kejetia, a subsistence farming community, Gorogo, and an urban ASGM gold refinery in Bolgatanga. The objective was to assess mercury in a range of human (urine and hair) and ecological (household soil, sediment, fish, and ore) samples to increase understanding of mercury exposure pathways. All participants were interviewed on demographics, occupational and medical histories, and household characteristics. Participants included 90 women of childbearing age and 97 adults from Kejetia and 75 adults from Gorogo. Median total specific gravity-adjusted urinary, hair, and household soil mercury were significantly higher in Kejetia miners (5.18 µg/L, 0.967 µg/g, and 3.77 µg/g, respectively) than Kejetia non-miners (1.18 µg/L, 0.419 µg/g, and 2.00 µg/g, respectively) and Gorogo participants (0.154 µg/L, 0.181 µg/g, and 0.039 µg/g) in 2011. Sediment, fish, and ore Hg concentrations were below guideline values. Median soil mercury from the Bolgatanga refinery was very high (54.6 µg/g). Estimated mean mercury ingestion for Kejetia adults from soil and dust exceeded the U.S. Environmental Protection Agency reference dose (0.3 µg Hg/kg·day) for pica (0.409 µg Hg/kg·day) and geophagy (20.5 µg Hg/kg·day) scenarios. Most participants with elevated urinary and household soil mercury were miners, but some non-miners approached and exceeded guideline values, suggesting a health risk for non-mining residents living within these communities.

Integrated Assessment of Artisanal and Small-Scale Gold Mining in Ghana-Part 2: Natural Sciences Review.

This paper is one of three synthesis documents produced via an integrated assessment (IA) that aims to increase understanding of artisanal and small-scale gold mining (ASGM) in Ghana. Given the complexities surrounding ASGM, an integrated assessment (IA) framework was utilized to analyze socio-economic, health, and environmental data, and co-develop evidence-based responses with stakeholders. This paper focuses on the causes, status, trends, and consequences of ecological issues related to ASGM activity in Ghana. It reviews dozens of studies and thousands of samples to document evidence of heavy metals contamination in ecological media across Ghana. Soil and water mercury concentrations were generally lower than guideline values, but sediment mercury concentrations surpassed guideline values in 64% of samples. Arsenic, cadmium, and lead exceeded guideline values in 67%, 17%, and 24% of water samples, respectively. Other water quality parameters near ASGM sites show impairment, with some samples exceeding guidelines for acidity, turbidity, and nitrates. Additional ASGM-related stressors on environmental quality and ecosystem services include deforestation, land degradation, biodiversity loss, legacy contamination, and potential linkages to climate change. Though more research is needed to further elucidate the long-term impacts of ASGM on the environment, the plausible consequences of ecological damages should guide policies and actions to address the unique challenges posed by ASGM.

An Investigation of Organic and Inorganic Mercury Exposure and Blood Pressure in a Small-Scale Gold Mining Community in Ghana.

There is increasing concern about the cardiovascular effects of mercury (Hg) exposure, and that organic methylmercury and inorganic Hg(2+) may affect the cardiovascular system and blood pressure differentially. In small-scale gold mining communities where inorganic, elemental Hg exposures are high, little is known about the effects of Hg on blood pressure. In 2011, we assessed the relationship between Hg exposure and blood pressure (BP) in a cross-sectional study of adults from a small-scale gold mining community, Kejetia, and subsistence farming community, Gorogo, in Ghana's Upper East Region. Participants' resting heart rate and BP were measured, and hair and urine samples were provided to serve as biomarkers of organic and inorganic Hg exposure, respectively. Participants included 70 miners and 26 non-miners from Kejetia and 75 non-miners from Gorogo. Total specific gravity-adjusted urinary and hair Hg was higher among Kejetia miners than Kejetia non-miners and Gorogo participants (median urinary Hg: 5.17, 1.18, and 0.154 µg/L, respectively; hair Hg: 0.945, 0.419, and 0.181 µg/g, respectively). Hypertension was prevalent in 17.7% of Kejetia and 21.3% of Gorogo participants. Urinary and hair Hg were not significantly associated with systolic or diastolic BP for Kejetia or Gorogo participants while adjusting for sex, age, and smoking status. Although our results follow trends seen in other studies, the associations were not of statistical significance. Given the unique study population and high exposures to inorganic Hg, the work contained here will help increase our understanding of the cardiovascular effects of Hg.

Integrated assessment of artisanal and small-scale gold mining in Ghana--part 1: human health review.

This report is one of three synthesis documents produced via an integrated assessment (IA) that aims to increase understanding of artisanal and small-scale gold mining (ASGM) in Ghana. Given the complexities surrounding ASGM, an IA framework was utilized to analyze economic, social, health, and environmental data, and co-develop evidence-based responses with pertinent stakeholders. The current analysis focuses on the health of ASGM miners and community members, and synthesizes extant data from the literature as well as co-authors' recent findings regarding the causes, status, trends, and consequences of ASGM in Ghana. The results provide evidence from across multiple Ghanaian ASGM sites that document relatively high exposures to mercury and other heavy metals, occupational injuries and noise exposure. The work also reviews limited data on psychosocial health, nutrition, cardiovascular and respiratory health, sexual health, and water and sanitation. Taken together, the findings provide a thorough overview of human health issues in Ghanaian ASGM communities. Though more research is needed to further elucidate the relationships between ASGM and health outcomes, the existing research on plausible health consequences of ASGM should guide policies and actions to better address the unique challenges of ASGM in Ghana and potentially elsewhere.

Assessment of mercury exposure among small-scale gold miners using mercury stable isotopes.

Total mercury (Hg) concentrations in hair and urine are often used as biomarkers of exposure to fish-derived methylmercury (MeHg) and gaseous elemental Hg, respectively. We used Hg stable isotopes to assess the validity of these biomarkers among small-scale gold mining populations in Ghana and Indonesia. Urine from Ghanaian miners displayed similar Δ(199)Hg values to Hg derived from ore deposits (mean urine Δ(199)Hg=0.01‰, n=6). This suggests that urine total Hg concentrations accurately reflect exposure to inorganic Hg among this population. Hair samples from Ghanaian miners displayed low positive Δ(199)Hg values (0.23-0.55‰, n=6) and low percentages of total Hg as MeHg (7.6-29%, n=7). These data suggest that the majority of the Hg in these miners' hair samples is exogenously adsorbed inorganic Hg and not fish-derived MeHg. Hair samples from Indonesian gold miners who eat fish daily displayed a wider range of positive Δ(199)Hg values (0.21-1.32‰, n=5) and percentages of total Hg as MeHg (32-72%, n=4). This suggests that total Hg in the hair samples from Indonesian gold miners is likely a mixture of ingested fish MeHg and exogenously adsorbed inorganic Hg. Based on data from both populations, we suggest that total Hg concentrations in hair samples from small-scale gold miners likely overestimate exposure to MeHg from fish consumption.