Estimating the mortality burden of large scale mining projects-Evidence from a prospective mortality surveillance study in Tanzania.

We set up a mortality surveillance system around two of the largest gold mines in Tanzania between February 2019 and February 2020 to estimate the mortality impact of gold mines. Death circumstances were collected using a standardized verbal autopsy tool, and causes of death were assigned using the InSilicoVA algorithm. We compared cause-specific mortality fractions in mining communities with other subnational data as well as national estimates. Within mining communities, we estimated mortality risks of mining workers relative to other not working at mines. At the population level, mining communities had higher road-traffic injuries (RTI) (risk difference (RD): 3.1%, Confidence Interval (CI): 0.4%, 5.9%) and non-HIV infectious disease mortality (RD: 5.6%, CI: 0.8%, 10.3%), but lower burden of HIV mortality (RD: -5.9%, CI: -10.2%, -1.6%). Relative to non-miners living in the same communities, mining workers had over twice the mortality risk (relative risk (RR): 2.09, CI: 1.57, 2.79), with particularly large increases for death due to RTIs (RR: 14.26, CI: 4.95, 41.10) and other injuries (RR:10.10, CI: 3.40, 30.02). Our results shows that gold mines continue to be associated with a large mortality burden despite major efforts to ensure the safety in mining communities. Given that most of the additional mortality risk appears to be related to injuries programs targeting these specific risks seem most desirable.