Case Report: Gold Miner’s Lung: A Case of Chronic Hypersensitivity Pneumonia in Amazonian Forest

Abstract

The hostile conditions at informal and illegal mining sites in the Amazonian forest erode the miner’s health, exposing workers to a broad range of diseases because most of the gold is extracted using mercury (Hg). The Hg vapor used daily at gold panning sites presents an environmental threat to the ecosystems and human health. We report the case of a 58-year-old man who has worked in gold panning for over 30 years, presented with diffuse interstitial pneumonia characterized by bilateral images of ground glass and mosaic opacities on the chest CT scan. Based on the negative differential diagnosis (cardiovascular, infectious, autoimmune or cancer), the context of chronic exposure to Hg in a patient who has been working for decades on illegal gold panning sites, we concluded to a chronic form of heavy metal hypersensitivity pneumonia. This hypothesis was supported by high levels of mercury in blood and urine. Mercury hypersensitivity pneumonia might be more frequent than presently thought with thousands of workers chronically exposed to high mercury concentrations among others pollutants. Medical practitioners should systematically seek for chronic respiratory illnesses associated with pollutants exposure in these vulnerable workers with poor health.

Panorama des pathologies infectieuses et non infectieuses de Guyane en 2022

“…Les poissons carnivores peuvent ainsi contenir des concentrations très élevées [ 197 ]. La contamination humaine peut se faire par inhalation de vapeurs de mercure métallique et peut entraîner des tableaux respiratoires à type de bronchite ou pneumopathie interstitielle, comme ce cas de pneumopathie hypersensible décrit au CHC en 2021 chez un orpailleur [ 13 ]. Mais la contamination reste majoritairement digestive, par consommation de poissons notamment piscivores comme l'aïmara ( Hoplias aimara ) (Fig.…”

Social determinants of health among people working on informal gold mines in French Guiana: a multicentre cross-sectional survey

“…6 Previous surveys have described that this population is exposed to vectorborne diseases, especially malaria (PCR-Plasmodium prevalence from 2.5% to 5.3% in 2019), zoonoses such as leptospirosis (28.1% (95% CI 23.5 to 32.7) in 2019), sexually transmitted diseases (prevalence of HIV, hepatitis C virus, hepatitis B virus and syphilis in 2019 were respectively 0.5% (95% CI 0.1 to 2.1), 2.1% (0.7 to 3.6), 1.6% (0.3 to 2.8) and 12.4% (9.0 to 15.7)), tobacco or alcohol addiction (41.2% and 57.3%, respectively in 2019) or heavy metal hypersensitivity pneumonia. [7][8][9][10] In 2013, a large outbreak of beriberi, a thiamine deficiency causing severe cardiac failure and neuropathies, was documented among gold miners, a disease that had disappeared from the territory since the end of the penal colony in the middle of the 20th century. 11 The question of gold mining in French Guiana is complex and poses many ecological, sanitary, societal and economic challenges.…”

“…Twothird of the participants reported having suffered an injury associated with wild fauna aggression in the past year (360/539=66.8%). These were mainly related to bat bites (308), scorpion stings (122), snake bites (19), spider (17) or centipede (10) stings, dog bites (7), caterpillar (6) or stingray (4). The presence of bats in the last gold mine was reported by 96.9% of the respondents.…”