The Kakamega gold belt's natural geological enrichment and artisanal and small-scale gold mining (ASGM) have resulted in food and environmental pollution, human exposure, and subsequent risks to health. This study aimed to characterise exposure pathways and risks among ASGM communities. Human hair, nails, urine, water, and staple food crops were collected and analysed from 144 ASGM miners and 25 people from the ASGM associated communities. Exposure to PHEs was predominantly via drinking water from mine shafts, springs and shallow-wells (for As>Pb>Cr>Al), with up to 366 µg L arsenic measured in shaft waters consumed by miners. Additional exposure was via consumption of locally grown crops (for As>Ni>Pb>Cr>Cd>Hg>Al) besides inhalation of Hg vapour and dust, and direct dermal contact with Hg. Urinary elemental concentrations for both ASGM workers and wider ASGM communities were in nearly all cases above bioequivalents and reference upper thresholds for As, Cr, Hg, Ni, Pb and Sb, with median concentrations of 12.3, 0.4, 1.6, 5.1, 0.7 and 0.15 µg L, respectively. Urinary As concentrations showed a strong positive correlation (0.958) with As in drinking water. This study highlighted the importance of a multidisciplinary approach in integrating environmental, dietary, and public health investigations to better characterise the hazards and risks associated with ASGM and better understand the trade-offs associated with ASGM activities relating to public health and environmental sustainability. Further research is crucial, and study results have been shared with Public Health and Environmental authorities to inform mitigation efforts.

中文翻译：

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使用多元素生物监测、饮食和环境评估对肯尼亚手工和小规模采金社区进行公共卫生评估

卡卡梅加金矿带的自然地质富集以及手工和小规模金矿开采 (ASGM) 导致了食品和环境污染、人类接触以及随后的健康风险。本研究旨在描述手工和小规模采金社区中的暴露途径和风险。我们收集并分析了 144 名 ASGM 矿工和 25 名来自 ASGM 相关社区的人的头发、指甲、尿液、水和主粮作物。接触板式换热器的途径主要是来自矿井、泉水和浅井的饮用水（As>Pb>Cr>Al），在矿工消耗的井水中测得砷含量高达 366 µg/L。除了吸入汞蒸气和灰尘以及直接皮肤接触汞之外，还通过食用当地种植的农作物（As>Ni>Pb>Cr>Cd>Hg>Al）进行额外暴露。 ASGM 工人和更广泛的 ASGM 社区的尿液元素浓度几乎在所有情况下都高于 As、Cr、Hg、Ni、Pb 和 Sb 的生物当量和参考上限，中位浓度为 12.3、0.4、1.6、5.1、0.7 和 0.15分别为 µg L。尿砷浓度与饮用水中的砷呈很强的正相关（0.958）。这项研究强调了多学科方法在整合环境、饮食和公共卫生调查方面的重要性，以更好地描述与 ASGM 相关的危害和风险，并更好地了解与公共卫生和环境可持续性相关的 ASGM 活动相关的权衡。进一步的研究至关重要，研究结果已与公共卫生和环境当局分享，为缓解工作提供信息。