location: nan, 'Thailand 
year: 2012 source: HSRI 
title: Development of processes in environmental and health surveillance on organization and community participation based in environmental health impact: a case study of Phichit Province 
abstract:According to the survey for gold deposits by the Ministry of Industry of Thailand, it has
attracted a private investment for further exploration and development of gold mines. In 1987,
several gold mining sites were opened for investment from the private sector including Chatree
Gold Mine located in Phichit Province. Mining is a large-scale enterprise that can potentially create
a number of negative health impacts. The health effects were concerned after the mine started
the operation, the villagers found they suffered from the increased incidents of illness. Therefore,
conflicts between the community and mining operation over environmental and health impacts
have become increasingly aggressive. The compiled evidence of contamination and filed
numerous complaints with authorities and the water quality was tested and found traces of
cyanide used in gold extraction, and heavy metals such as arsenic, iron, and manganese in the
underground water and tap water. People living near the mine site have suspected to have health
effects since the signs and symptoms of acute and chronic illnesses, especially skin rashes were
commonly found in children, and dust and noise nuisance. This study focused on the processes
undertaken to establish the community participation framework coordinated with environmental
and health agencies that could be implemented locally to the identification, collection and
analysis of environmental hazard, environmental exposure and health data.
The review of environmental and biological monitoring data was performed for computer
mapping and revealed that the key point of a cause of conflict is environmental and health data
have been collected and analyzed separately with little integration between governmental
agencies and community participation. Using the existing environmental data indicates the analysis
and mapping difficulties due to the validity and reliability of monitoring data. Biological monitoring
for the exposure of toxic contaminants has been carried out a few times only when the
complaints and concerns were addressed by the community through the government. The
appropriate health surveillance program was not provided to the community affected by mining.
Thus, the environmental health surveillance program has been established by the community
participating with local and regional government sectors response to environmental, health and
industry for the appropriate environmental health surveillance program and long-term financial
support. The networking of environmental health surveillance could initiate the community to
develop the environmental health surveillance program that could empower the community for
health impact assessment.
The environmental exposure related to health effects is difficult to identify for the
symptoms or diseases, especially chronic diseases due to limitations of biomarker specificity and
the various factors involved in symptom or disease endpoints. The linkage of environmental and
biological monitoring information such as environmental contaminations, exposure data, and
disease reports are needed to support environmental health statuses. In Thailand, very few
integration among responsible organizations was found for environment and health working group.
In this case, the difficulty of data interpretation for health consequences relating to environmental
contaminants resulted from the lack of environmental and health information as well as the data
quality used for database entry.The database of environmental and health is an effective tool and the quality of data is
required for a good surveillance system. Laboratory quality assurance and quality control (QA/QC)
in sampling and analysis are required for the accuracy of the results. The community participation
should be involved in all monitoring processes for conflict resolution. This case study indicated
that the resources of environmental data for the initiation of a database were mainly from EIA
process. The sampling and analysis had been done and sent to laboratory by mining company.
Therefore, it should be reconsidered that the monitoring process has to be reorganized and
community participation is required in all steps for a clear process.
Data on health had been retrieved from the conventional surveillance system used the
same database as other areas. Data collected by the number of morbidity and mortality which
can be obtained by health information flows from the registry of local health care. It
demonstrated that the system is not enough and suitable for the specific area having
environmental hazards. It is suggested that a special medical surveillance program is required for
to identify the environmental hazard exposure and health status, especially the early stage of the
diseases.
The appropriate environmental health surveillance is required with well-defined of the
parameters for both environmental and biological monitoring program. Indicators for the
assessment of environmental quality and contamination must be considered for the specificity
including the validation of the methodology. In this case the monitoring of cyanide for
environmental monitoring and exposure assessment is also considered for the uncertainty.
The networking of environmental health surveillance has been established based on a
concept of community participation. The concern issues of environmental health impacts were
discussed by community. Due to the limitations of budget and resource, the priority setting was
used for the investigation of environmental hazards and exposures. The community was trained
for parameter selections, environmental sampling and preservations. The quality laboratory was
also introduced for the selection of sample analysis to get the quality data. The outcomes of the
surveillance program consist of two sets of mapping, computer database and manual maps, that
are used to link the environmental and exposure data. The key persons were trained to input and
analyze the information from computer database and it shows an effective tool for the
assessment of environmental health status to the community. The manual map is also a
surveillance tool that has an advantage over the computer database in the number of people to
assess the data because of the limitation of computer skill in most population in the community.
The local health organizations and academic intuitions take action in supporting the knowledge,
specific skills and budget. The community could have a potential to be as its own environmental
health surveillance data center. However, the long-term financial funding is needed to be
resolved for the sustainable surveillance.