Gold mining and acute respiratory infection in children : a retrospective cohort study in Vatukoula, Fiji.
Thesis DisciplineHealth Sciences
Degree GrantorUniversity of Canterbury
Degree NameMaster of Health Sciences
Air pollution exposure contributed to an alarming death toll of 7 million people yearly, making it the world’s most significant single environmental health risk. Gold mining emission consists of some of the most harmful and toxic air pollutants. However, studies on the effect of gold mining air pollution on respiratory health are few, with none ever conducted in Fiji. With the unavailability of reliable air quality data, this retrospective cohort study assessed the prevalence of acute respiratory infection (“ARI”), and compared the ARI-free survival rates of children born and living in a mining region and those born and living in a non-mining region, as a way of generalising the possible effects of gold mining-related air pollution on child health. This study also assessed the effectiveness of air pollution control programs conducted in the Vatukoula Gold Mine and Fiji.
Respiratory records and vital statistics of a cohort of children born in 2011 in both the regions were retrospectively followed up from birth until their fifth birthdays in 2016. Two groups were identified from the ARI dataset collected, those that had acute upper respiratory tract infection (“AURI”) and those that had pneumonia. The incidence of AURI and pneumonia in the groups were estimated. The prevalent odds ratios were estimated for the exposed and the non-exposed cohorts, and their ARI-free survival rates were analysed using survival analysis. Key informant interviews and a focus group discussion were conducted to assess the effectiveness of air pollution management in Vatukoula Gold Mine.
Living in non-gold-mining region (Odds Ratio = 48) and children of Indo-Fijian race were at higher risk of AURI (Odds Ratio = 2.4) Further multivariable logistic regression showed living in non-gold-mining region as an independent risk factor for AURI (OR 39.6, 95% CI: 5.36 - 292; p < 0.001); while living in gold mining region was the single independent risk factor for pneumonia in this study (p <0.05). Kaplan-Meier estimator showed living in gold mining region and I-taukei children having statistically significant AURI-free survival rates while living in the non-mining region had a statistically significant pneumonia-free rate at the end of first five years of life. Multivariable cox regression analysis showed living in the non-mining region was a statistically significant risk factor for AURI. Living in gold mining region was the only statistically significant risk factor for pneumonia after the univariate Cox proportional hazard analysis. While gold mining is the dominant activity in the gold mining region, the non-gold mining region is dominated by sugarcane farming. Air pollution from these two main activities may provide the possible explanations for the occurrence of the two acute respiratory infections (AURI and pneumonia) in the two regions.
Air pollution management and control activities by the management of Vatukoula Gold Mine are yet to meet the standards required to adequately sustain the environment and health of those living within its proximity. The unresolved air pollution issues of sulphur dioxide and dust at Vatukoula over the last eight decades are yet to be resolved. Those who have legal authority over the operation of the mine have done little to resolve these outstanding air pollution issues. The health of those residing near Vatukoula Gold Mine continues to be at risk from the effects of air pollution, as highlighted by previous studies, as well as this study