Assessing health vulnerabilities through diet, stress, and noise exposure in a small scale-gold mining community of northeastern Ghana

摘要

Patterns in dietary diversity, biochemical (salivary cortisol) and physiological stress (heart rate), and noise exposures were assessed in a small-scale gold mining village in northeastern Ghana. A 2011 cross-sectional study of 106 participants showed dietary diversity score (DDS) ranging from 1- 17 (out of 22 food categories) with a mean (±SD) of 8.1 ± 3.0. DDS groupings based on the Ghana Demographics and Health Survey ranged from 1-12 (out of 12) with a mean (±SD) of 5.8 ± 2.1. Women showed a significantly higher level of total concerns related to money, food, environmental conditions, and illness than did than men. A 2013 cross-sectional study of salivary cortisol level changes between morning and evening among 22 subjects showed patterns consistent with chronic stress, i.e., a relatively low decline in cortisol through the day (-1.44 ± 4.27 nmol/L, n = 18). A multiple linear regression model pairing noise exposures measured through personal dosimetry with changes in cortisol from evening to morning revealed an increase of 0.45 nmol/L significantly associated with an increase in 1 dBA Leq (Adj. R2 = 0.188, n = 17). Similarly, multiple regression models showed variation in heart rate (HR), as measured by the standard deviation of the running average, significantly associated with variation in noise exposure over time, as measured by the standard deviation of Leq. Regardless of gender or involvement with small-scale mining, 95% of participants in 2013 were exposed to 24-hour noise levels over the World Health Organization’s guideline of 70 dBA. These findings suggest that small-scale mining community residents may face cumulative health risks from mining activities that are not yet well documented, including hearing loss and cardiovascular effects of stress and noise. By documenting baseline levels for dietary diversity, stress, and noise in this community, this study adds to the growing body of research linking noise with physiological stress responses and suggests that further research into determinants of health unique to these communities is warranted.