Abstract
BACKGROUND: Tanzania has seen explosive development in small scale gold mining (SGM) operations. Recently, the use of cyanide has become more common in SGM, especially in the reprocessing of mercury-amalgamated tailings from artisanal mining sites. OBJECTIVES: The primary objective of this study was to examine the level of knowledge and adherence to the Cyanide Code among workers and managers at SGM operations in northwestern Tanzania that use cyanide for gold extraction, focusing on workers' safety. METHODS: A cross-sectional study of workers and managers at 17 selected SGM sites was conducted. A random-cluster approach was used to recruit 215 mine workers and 23 mine managers who worked at the same sites for more than three months. Individuals participated in structured face-to-face interviews. Site evaluation checklists were also administered to assess adherence. RESULTS: The majority of the SGM workers (61.4%, n=132) were not aware of the Cyanide Code. Among the mine managers, 64.2% (n=15) were aware of the Cyanide Code. Fifty-four percent of workers and 39.1% of managers did not adhere to the Cyanide Code. Workers who reported being trained on the Cyanide Code were significantly more likely to have knowledge about the Cyanide Code guidelines compared to untrained workers (adjusted odds ratio =20.3, confidence interval: 7.5 - 54.8). DISCUSSION: Wide variations in knowledge of and adherence to the Cyanide Code were found. A manager's knowledge of Cyanide Code was significantly associated with workers' knowledge. High worker and manager knowledge was associated with increased site safety performance. Even though all the SGM sites were physically visited, some potentially hazardous practices may not have been revealed by managers and workers because of fear of possible regulatory actions due to disclosure of concerns related to their operation's safety compliance. CONCLUSIONS: The limited knowledge of the Cyanide Code among workers and managers, combined with poor adherence to cyanide waste management practices, indicates that there is a need for education, health promotion and sensitization among workers and managers to improve worker safety and minimize environmental health impacts. PARTICIPANT CONSENT: Obtained. ETHICS APPROVAL: Ethical approval was obtained from the Conjoint Catholic University of Health and Allied Sciences and Bugando Medical Centre Research Review and Ethics Committee (Ref. BREC/001/35/2014). Permission to conduct research in Geita District was obtained from the respective authorities at the regional and district levels and from owners of the SGM sites.