The Perception Of Local Residents And Response Of Local Health System To Heavy Metal Pollution And Health Risks In A Lead-Zinc Mining Area In Fenghuang County, Hunan Province

Objectives:To investigate the perception of local residents to heavy metal pollution and associated health risks, as well as the situation of how local health system responses to heavy metal pollution in a lead-zinc mining area in Ciyan Town, Fenghuang County, Hunan Province, China, we conducted a questionnaire survey among lead-zinc mining area residents and in-depth interviews with the staff of the health system. We also analyzed the prevalence of self-reported diseases of the mining area residents in order to determine health risks caused by heavy metal pollution, and the reasons that affect response of the local health system in order to inform local government in the prevention and control of heavy metal pollution and better utilization of mining resources and protection of the health of residents in lead-zinc mining areas.Methods:This study adopted qualitative and quantitative research methods, which included questionnaire survey and interview methods.Questionnaire survey:Designed a questionnaire to collect data about the perception of local residents to heavy metal pollution associated health risks, and used household survey to investigate174out of317households that had lived there more than10years, the rest of whom were out as migrant workers or reluctant to participate, and received170validated questionnaires.Qualitative Research:Conducted in-depth interview and group interview to gather necessary information from Fenghuang County Government, County Health Bureau, County Centers for Disease Control and Prevention, County Maternal and Child Health Hospital, County People’s Hospital, County Traditional Chinese Medicine Hospital, County Health Inspection Institute, and the Ciyan Township Hospital as well as the doctor from Guanzhai village clinic.Results:The results of questionnaire survey:The average age of respondents was51.54±14.31years old, the oldest was88, and the youngest was21. There were98females, accounting for57.6%;72males, accounting for42.4%. The education level of lead-zinc mining area residents was relatively low:Illiterate and elementary school graduates were120persons, accounting for70.6%, including minority people53persons, who are accounting for31.2%of the total respondents.Investigation showed residents in the mine area merely know the environmental pollution problems that can be felt by sense organs, such as tailings impoundment, water appearance changes, the reduction of cultivated land area, etc. But they had inadequate acknowledge of air quality, heavy metal pollution in crops, vegetation destruction, etc, which can not be easily felt by sense organs and can cause health risks to the residents, particularly, to the elderly, women, and children. The top three disease types of local residents in recent ten years are bone and joint disease, intestines and stomach disease, and cerebrovascular disease, accounting for74.4%. The symptoms of disease what self-reported by the mining area residents turned out characteristic of heavy metal pollution, but only17.6%of the residents thought there was an association between environmental pollution and health. The attention to health was the main factor that influences the perception of local residents to heavy metal pollution and health risk. And economy and medical service quality were the main factors that affect the utilization of health care service in the mining area.The interviews showed that the local health system ignored the problems of heavy metal pollution for several reasons. The whole county lacked heavy metal inspection equipments, funds, guidance and management from the upper. The consciousness and capacity of grassroots level health workers were insufficient due to no professional training for prevention and control of heavy metal pollution. And the information of those vertical systems were not circulated, shared and disclosed.Conclusion:Investigation shows mine exploitation can bring environmental pollution and cause health risks to local residents. However, residents in the mining area are in lack of enough knowledge about heavy metal pollution and health risks. Facing with the absence of subsidies, responsible institutions, action plans, coordination mechanism, and guidance to cope with heavy metal pollution, administrations of health system ought to take effective measures to prevent and control health problems caused by heavy metal pollution, such as reinforcing community preventive care, improving the consciousness and capacity of first-level health workers, enhancing the local environmental protection publicity, setting up health records and managing the health archives, increasing the utilization of health care services by residents in the mining area.