ENVIRONMENTAL RESEARCH, SECTION A 77, 91—97 (1998)
ARTICLE NO. ER983835
Mercury Exposure of Maroon Workers in the Small Scale Gold Mining
in Suriname1
Julius F. M. de Kom,* Gijsbert B. van der Voet,- and Frederik A. de Wolff-
*Diakonessen Hospital, Department of Pharmacy, P.O. Box 1814, Paramaribo, Suriname; and - Toxicology Laboratory,
Leiden University Medical Centre, P.O. Box 9600, 2300 RC Leiden, The Netherlands
Received August 19, 1997
Suriname is experiencing a revival of small scale
gold mining activities, with about 10,000 to 15,000
workers involved in 1996. The estimated production
in 1995 is at least 10,000 kg crude gold. Gold is extrac-
ted with mercury and methods used are comparable
with those described for gold mining in the Amazon
Basin. Since no data exist on the internal mercury
exposure of workers in Suriname a study was per-
formed. A group of mercury-exposed Maroons, who
are principally involved in the mining located in the
tropical rainforest, is compared with nonexposed
Maroons living in a non-gold mining area. Blood
and urine samples of both groups were analyzed for
total mercury using an atomic absorption spectrom-
eter with an FIAS hydride system. In the study 28
exposed and 17 controls with a comparable mean
age (P 5 0.544; exposed 2767.2 years, n 5 26; controls
2667.7 years, n 5 17), all males, participated. The
urine levels for both groups differ statistically sig-
nificantly from each other (P < 0.001; exposed mean
27.5621.1 lg/g creatinine; controls mean 5.262.9 lg/g
creatinine). This is, however, not the case with the
blood levels (P 5 0.036: exposed mean 18.1611.0 lg/L,
n 5 25; controls mean 26.8614.6 lg/L, n 5 16). In con-
trast with blood the urine total mercury levels in
this study confirm, on a group basis, exposure to
mercury as described for individuals working in the
gold mining in the Amazon Basin. ( 1998 Academic Press
Key Words: mercury; gold mining; internal expo-
sure; occupational exposure; maroon gold miners.
1
Funding sources supporting the work described in the manu-
script were received from Diakonessen Hospital, Paramaribo,
Suriname; Medical Mission, Paramaribo, Suriname; Pan Ameri-
can Health Organization, Paramaribo, Suriname; and Toxicology
Laboratory, Leiden University Medical Center, Leiden, The Neth-
erlands. The study described in the manuscript involving humans
was approved by the board of directors of the Diakonessen Hospi-
tal and conducted in accordance with national and institutional
guidelines for the protection of human subjects.
91
INTRODUCTION
In Suriname (population 400,000) gold mining on
a small scale exists since 1876 (Polak, 1908) result-
ing in the coming into existence of a gold industry
during the beginning of this century. At its height
the industry in 1908 produced 1209 kg gold (Anony-
mous, 1922). During the recession in the 1930s, the
industry collapsed, but the small scale gold mining
survived with a yearly production of less than 200 kg
during the forties till the 1970s. In the 1990, a re-
vival of the small scale gold mining activities is seen
resulting really in a gold rush, as a result of the poor
economical situation in Suriname characterized by
hyperinflation in 1995. At present it is estimated
that 10,000 to 15,000 workers are involved in gold
mining activities; of these a majority participate, in,
often very illegal, small scale mining activities.
Brazilian workers also take part in these activities
because of their expertise in small scale gold mining.
Their number is speculating to be as high as 8000
and most of them are illegal in Suriname (Ram-
charan, 1996). In 1994, and 1995 officially a year
production of at least 800 and 3000 kg crude gold are
registered, respectively (Anonymous, 1995; Ram-
charan, 1996). It is estimated by officials that these
figures reflect approximately 30% of the year pro-
duction. A substantial part is sold illegally, used as
a means of payment, or smuggled out of the country;
in 1995 the latter accounted for at least 3600 kg.
Estimating the yearly production of crude gold in
1995 creates a great deal of speculation resulting in
figures ranging from 9000 to 20,000 kg (Ramcharan,
1996). With the above mentioned data a proper as-
sumption for the year production in 1995 is at least
10,000 kg crude gold.
The gold is extracted with mercury, and the
methods used are principally the same as those used
in the beginning of this century in Suriname and
0013-9351/98 $25.00
Copyright ( 1998 by Academic Press
All rights of reproduction in any form reserved.
92 DE KOM, VAN DER VOET, AND DE WOLFF
comparable with those described for gold mining in
the Amazon Basin (Branches et al., 1993; Lacerda
et al., 1995). An increase in the yearly gold produc-
tion is sustained by official figures of mercury import
from the General Bureau of Statistics in Suriname
and figures from major importers. Since 1990 an
increase in imported mercury is seen from 70, to-
ward 1200 in 1993 and 4000 in 1995, to an estimate
of at least 5000 kg in 1996. It is believed that sub-
stantial amounts of mercury are also brought illegal-
ly into the country mainly by Brazilian gold miners.
Concern has been expressed on the recent dis-
covery of human exposure and environmental con-
tamination of mercury throughout the Amazon
Basin (Nriagu et al., 1992; Grandjean et al., 1993;
Branches et al., 1993; Aks et al., 1995). In the Ama-
zon Basin the miners are basically immigrants
(garimpeiros); the indigenous people are often the
exposed group (Nriagu et al., 1992; Branches et al.,
1993; Lacerda et al., 1995). In Suriname Maroons,
descendants of runaway slaves, are principally in-
volved in the small scale gold mining located in the
tropical rainforest, besides some Brazilian miners
and residents from the capital Paramaribo. The
Maroons account for 90% of the inhabitants in the
tropical rainforest in Suriname, the remaining 10%
are indigenous Amerindians.
Gold mining has become an important means of
existence for Maroons, but considering the methods
used for gold mining there is a high risk for occu-
pational exposure to mercury. Since no data exist
on the internal mercury exposure of miners in
Suriname a study was performed. A group of Maroon
miners occupationally exposed to mercury was com-
pared with a group of nonexposed Maroons living in
a non-gold mining area. The mercury levels in blood
and urine were monitored as indicators for exposure.
MATERIALS AND METHODS
Location. Traditionally in Suriname three prin-
cipal mining areas can be distinguished in the tropi-
cal rainforest, east and southeast of the Brokopondo
Reservoir toward the Marowijne River, northwest of
the reservoir on both sides of the Saramacca River,
and west of the Lawa River near Benzdorp (Fig. 1).
Most of the gold concessions in Suriname are located
in areas where goldplacers exist. Goldplacers often
consist of a layer of gravel enriched with gold, buried
under more or less a sterile overburden of sand or
clay layers (Bosma et al., 1973).
Workers. A group of mercury-exposed Maroons,
who are principally involved in the mining located in
the tropical rainforest, were compared with a group
of nonexposed Maroons living in a non-gold mining
area. The mercury-exposed Maroons were selected
from the remote and logistic difficult accessible open
gold mines near the Sillakreek, a stream which flows
into the Tapanahony River in the southeast part of
Suriname (Fig. 1). The selection was first of all based
on disturbing reports by local health workers of nu-
merous people working as small scale miners in the
Sillakreek mining area. The openness of the miner’s
group to participate facilitated this study. Twenty-
eight small scale miners, all males, were selected for
the study. This type of gold mining is very informal
and the most feasible criteria used for the selection
of the miners were that they had to actually have
worked in the mines with exposure to mercury for at
least 1 week and that they be frequently involved in
mining activities. In the exposed group three sub-
groups were identified based on the period working
in the mines prior to sampling. Subgroup I worked
shorter than 1 month, subgroup II, between 1 and 12
months, and subgroup III, longer than 12 months.
For the controls a matching group of Maroons, living
in the non-gold mining area of the village Djumu at
the Boven Suriname River and not actually exposed
to mercury was selected within 1 month after the
expedition to the Sillakreek area. Seventeen men
participated.
Informed consent. Consent was obtained from all
the individuals in both groups participating in the
study after the purpose of the study had been ex-
plained in full detail.
Samples collection. Blood and urine samples
from exposed and control group were collected in
polycarbonate tubes (Sarstedt Nümbrecht Germany
No. 554685, 13 ml tubes) and stoppered with stand-
ard polyethylene caps. Blood samples were taken
from the cubital vein. The skin was cleaned with
ethanol 70% (v/v) prior to collection. Prior to collec-
tion of the blood samples (10 ml) 0.05 ml heparin
preserved with methylparahydroxybenzoate was ad-
ded to the tubes. During this process contact of the
hand with the interior of the tubes and caps was
avoided. Midstream spot urine samples were col-
lected in polyethylene containers. Immediately after
the collection a volume of 10 ml was transferred into
the tubes containing 0.05 ml of the preservative 10%
thymol in isopropanol. The optimum preservation to
prevent bacterial growth of the urine was tested
before sampling in the laboratory under conditions
comparable to those in the field.
Taking advantage of the opportunity, a limited
number of frequently consumed fish samples were
 MERCURY EXPOSURE FROM GOLD MINING 93

FIG. 1. Map of Suriname indicating the principal mining areas and the location of the Sillakreek open gold mines.

collected in the exposed and control group area.
Comparable small fish were caught downstream
from the gold mine at the first settlement in the
Sillakreek and in the control group area.
A certified cold chain cool box was used for the
storing of all samples in the field and the transporta-
tion to the capital. The whole blood, urine and fish
samples of each group were stored at 4, \ 0, and
\ 0°C, respectively, prior to transport for analysis in
the Netherlands. The samples of each group were
shipped within reasonable periods by airfreight on
carbon dioxide snow. On arrival the whole blood
samples were stored at 4°C, urine and fish samples
at !20°C at the Laboratories of Toxicology and
Clinical Chemistry, University Hospital, Leiden,
The Netherlands, until analysis.
Questionnaire. A standard questionnaire was
used to interview the individuals of both groups
after collecting the blood and urine samples. Rel-
evant data on the personal history (age, residence),
occupational history (number of months of gold min-
ing in the open gold mines near the Sillakreek, the
stated amount of mercury used per month in the
94 DE KOM, VAN DER VOET, AND DE WOLFF

extraction process), and life style (history of alcohol TABLE 1

use) were collected. In both groups the presence of Blood and Urine Total Mercury Levels in the Control
amalgam fillings was not recorded in view of the and Mercury-Exposed Groups Subdivided into Months
known preference for extraction or gold fillings. Working in the Gold Mines and Age

Analytical methods. The determination of total Control Exposed

Variable (mean$SD) n (mean$SD) n P
mercury (blood, urine) and creatinine was performed
at the Laboratories of Toxicology and Clinical Chem- Total mercury 26.8$14.6 16 18.1$11.0 25 0.036a
istry, University Hospital, Leiden, The Netherlands. Blood (lg/L)
Internal quality was controlled using BioRad I and Subgroup I 13.5$7.6 3 0.073b
II and SKZL reference materials (Dutch Pro- Subgroup II 13.8$5.9 10 0.010b
Subgroup III 22.9$13.3 12 0.623b
gramme). External quality was controlled by parti-
Urine (lg/g 5.2$2.9 17 27.5$21.1 28 \0.001a
cipation in the Trace Element Quality Assessment creatinine)
Scheme (TEQAS) organized by Guilford, UK, and Subgroup I 29.8$14.1 3 0.007b
the SKZL scheme. The analysis of total mercury in Subgroup II 25.9$16.6 10 \0.001b
blood and urine was performed on a Perkin Elmer Subgroup III 28.0$27.5 13 \0.001b
Age (years) 25.6$7.7 17 27.1$7.2 26 0.544a
atomic absorption spectrometer (AAS 3100) with
a FIAS 200 hydride system. Calibration curves be- a
Student’s t test parametric test.
tween 0 and 100 lg/L were established; a detection b
Wilcoxon two sample nonparametric test.
limit of 0.4 lg/L was established for urine and
10 lg/L for blood. Blood and urine samples were
numbered and analyzed in a single blind fashion.
each other (P"0.036), in contrast with the urine
Creatinine was analyzed on a Hitachi 747.
levels (P\ 0.001). When the subgroups were com-
The determination of total mercury in fish fillet
pared with the control group significant differences
was performed at the DLO-Netherlands Institute for
were detected for the blood levels in subgroup II
Fisheries Research, IJmuiden, The Netherlands.
(P"0.010) and urine levels in subgroup II
A Sterlab certified method was used for the analysis
(P\0.001) and III (P\0.001). Of the 28 miners 1 in-
of total mercury in fish fillets. After destruction us-
dividual (4%) had a urine mercury level exceeding
ing microwave technique and the addition of nitric
100 lg/g creatinine, 10 (35%), between 30 and
acid under high pressure and temperature, the speci-
100 lg/g creatinine, and 17 (61%), less than 30 lg/g
mens were analyzed by cold-vapor atomic absorption
creatinine. The mean ages for the control and
spectrometry, with a detection limit of 2 lg/kg wet
exposed group were comparable. No significant dif-
wt.
ference was detected for the mean age of the mer-
Statistical methods. Parametric (Student’s cury-exposed workers in subgroups I, II, and III.
t test) and nonparametric tests (Wilcoxon two The regression analysis for the age, months of gold
sample test) were used for comparing the blood and mining, the amount of mercury used per month, and
urine total mercury levels for the exposed and con- blood and urine total mercury levels in the exposed
trol group. The interdependence was explored for group produced in all these cases no significant cor-
the exposed group, using regression analysis, be- relations. It is notable that there is a negative trend
tween (i) the age of the worker and the months in the correlation coefficient of the monthly mercury
working in the gold mines, mercury use in a month, use and (a) the blood total mercury levels in sub-
the blood, or urine total mercury levels; (ii) the group II (P"!0.29, n"10) and subgroup III
amount of mercury used in a month and the months (P "!0.07, n " 12) and (b) the urine total mercury
working in the gold mines, the blood, or urine total levels in subgroup II (P"!0.033, n"10) and sub-
mercury levels; and (iii) the urine total mercury group III (P"!0.19, n " 13). The stated estimate
levels and the months working in the gold mines or of the amount of mercury used in a month by the
the blood total mercury levels. workers in the mines ranged from 0.1 to 1.5 kg
(mean"0.6$0.3 kg, n"26). For the history of al-
RESULTS cohol use no conclusive data were collected in both
groups.
The results for the total mercury levels in blood It was observed in the field that the individual
and urine and ages of the control and exposed group gold miners had a poor occupational hygiene. In
are listed in Table 1. The total mercury levels in general no preventive measures were taken by the
blood for both groups did not differ significantly from miners to minimize the exposure to mercury when
 MERCURY EXPOSURE FROM GOLD MINING
handling the mercury in the amalgamation process
or when heating of the gold-mercury amalgam on an
open fire takes place. Furthermore the heating of the
gold—mercury amalgam in the mines was performed
in the immediate neighborhood of other workers.
The fish fillet from the Cretochaves alfinius and
the Moenkhausia sp. fish caught in the exposed area
had total mercury levels of 0.14 and 0.10 lg/g wet wt.
Fillet from the Leporinas frederia caught in the con-
trol group area had a total mercury level of 0.05 lg/g
wet wt.
DISCUSSION
In recent years alarming reports have been pub-
lished on the environmental and human exposure to
mercury as a result of the use of mercury in gold
mining in the Amazon River Basin and studies exist
on the symptoms of mercury poisoning of gold re-
finers and miners (Nriagu et al., 1992; Grandjean
et al., 1993; Branches et al., 1993; Cordier and Gras-
mick, 1994; Lacerda et al., 1995). Because of the
extent of activity in the small scale gold mining
in Suriname, and the poor occupational condi-
tions observed in general, a similar environmental
and human exposure may be expected, albeit to
a lesser degree compared to the Amazon River
Basin.
Inhalation is the most important route of uptake
for elemental or metallic mercury, Hg(0), mercury
vapor is well absorbed and approximately 80% of
inhaled vapor is retained (IPCS, 1991). To a lesser
degree mercury vapor is absorbed through human
skin; it is estimated at about 2.6% of the mercury air
concentration and direct application of Hg(0) to the
human skin will likely cause an even higher absorp-
tion (Beliles, 1994). Mercury levels in blood and
urine can be used as indicators of exposure provided
that the exposure is recent and relatively constant,
long-term, and evaluated on a group basis (IPCS,
1991). The rapid rise of mercury levels in blood after
exposure to Hg(0) vapor makes blood mercury an
excellent indicator of recent peaks in Hg(0) expo-
sure. Dissolved Hg(0) vapor is rapidly oxidized to
divalent ionic mercury, Hg(II), partly in the blood
cells and in other tissues after diffussion, under the
influence of the enzyme catalase and excreted in the
urine (IPCS, 1991). Urine is the sample of choice for
biological monitoring of average long-term exposure
to Hg(0), because the rise in urine inorganic mercury
lags behind the increase in blood mercury (Bar-
rega> rd, 1993). The elimination half-life is 40 to 60
days (Beliles, 1994). The intraindividual variation of
urine mercury is relatively high, but when evaluated
95
on a group basis the average is only slightly affected
by this variation (Barrega> rd, 1993).
The results of this study for the total mercury
levels in urine confirm, on a group basis, exposure to
mercury as described for individuals working in the
gold mining in the Amazon Basin (Grandjean et al.,
1993; Branches et al., 1993; Aks et al., 1995; Lacerda
et al., 1995), in contrast with the results for the total
mercury levels in blood. If blood is used for the
biological monitoring of exposure to Hg(0) vapor and
total mercury in blood is measured, the confounding
exposure to methyl mercury (MeHg) from the con-
sumption of MeHg-contaminated fish, the major
source of exposure to MeHg, should be taken into
consideration (IPCS, 1991; Barrega> rd, 1993, Schütz,
1994). The problem of interference from MeHg is not
so important when analyzing urine since about 90%
of the total excretion of MeHg in man is by fecal
route (Berlin, 1986; IPCS, 1991). Fish consumption
was not recorded and total mercury was not
speciated in organic and inorganic mercury levels
making blood levels hard to interpret. In the absence
of consumption of fish with high concentrations of
MeHg the mean concentration of total mercury in
whole blood is probably of the order of 5—10 lg/L
(IPCS, 1991). In persons with occupational exposure
levels ranging from 20 to 100 lg/L are common and
they may be even increased to levels above 500 lg/L
with heavy consumption of contaminated fish
(Schütz, 1994). The higher total mercury levels ob-
served in the control group probably mainly reflect
a higher proportion of fish eaters in the control
group. When comparing the total mercury levels in
blood of both groups the possible inhibition of the
oxidation of Hg(0) vapor under the influence of the
enzyme catalase by moderate amounts of alcohol to
about 50% of normal values (IPCS, 1991) need to be
considered. The data collected for the history of alco-
hol use in both groups are not conclusive, but it was
observed that strong alcoholic beverages were ex-
cessively available in the local shops in the settle-
ment of the gold miners.
The lack of data on the history of alcohol use and
fish consumption and no specification of the mercury
is a possible explanation for the observation that no
difference between the total mercury levels in blood
of both groups exists. Therefore, comparison of urine
total mercury levels for the biological monitoring of
exposure to Hg(0) vapor is more appropriate than
blood total mercury.
The WHO has recommended standards for the
assessments of risks of mercury exposition; if the
mercury urine concentration is greater than
100 lg/g creatinine the probability of developing the
96 DE KOM, VAN DER VOET, AND DE WOLFF
classical neurological signs of mercury poisoning
(tremor, erethism) and proteinuria is high. When
the urine concentration is between 30 and 100 lg/g
creatinine subtle effects not leading to overt clinical
impairment, such as defects in psychomotor perfor-
mance, objectively detectable tremor, and evidence
of impaired nerve conduction velocity, are present in
particularly sensitive individuals. The occurrence of
several subjective symptoms, such as fatigue, irrit-
ability, and loss of appetite, is also increased. No
appropriate epidemiological data are available for
urine concentrations less than 30 lg/g creatinine
(IPCS, 1991).
It is to be expected from the mercury urine levels
found in this study and the recommended WHO
standards for mercury exposure that some of the
miners will develop overt clinical impairment,
subtle, or subjective symptoms.
No correlation was seen between the urine and
blood total mercury levels of the exposed group, al-
though in several studies a correlation has been
reported, but these results vary considerably (IPCS,
1991). The negative trend in the correlation coeffi-
cient of the monthly mercury use and the blood or
urine total mercury levels in subgroup II and III is
notable. Normally the opposite trend is expected and
this result may be an indication for the misstate-
ment of the mercury use by the gold miners. Know-
ing the monthly mercury use one can estimate the
gold production and this can be sensitive informa-
tion when mining is performed illegally or with com-
petition.
The main objective of this study was the documen-
tation of the Hg(0) vapor exposure of workers in the
small scale gold mining. Since the uncontrolled re-
lease of metallic mercury in the environment as
result of the gold mining activities will eventually
lead to environmental and human exposition as
mentioned, limited samples of frequently consumed
fish were collected as part of this study. Mercury
concentrations in the fish samples of the Sillakreek
are higher than the natural baseline levels of
0.02—0.04 lg/g wet wt total mercury for freshwater
fish used at the DLO-Netherlands Institute for Fish-
eries Research, but still they do not exceed the limit
of 0.5 lg/g wet wt used by several countries. These
results may be an indication for the mercury con-
tamination of the environment and likely accumula-
tion in the food chain.
Drawbacks of this study are the lack of data on the
fish consumption, speciation of mercury in blood,
the poor definition of the history of alcohol use, and
the limited number of fish samples. With the remote-
ness of the gold mining area, cultural barriers, and
limited funds it was not feasible to collect all these
data. In spite of these drawbacks the urine total
mercury levels confirm, on a group basis, exposure to
mercury as described for individuals working in the
gold mining in the Amazon Basin (Grandjean et al.,
1993; Branches et al., 1993; Aks et al., 1995; Lacerda
et al., 1995). The limited fish samples also indicate
the release of mercury into the environment. This
study gives the initial impetus to the description of
occupational exposure of miners in the small scale
gold mining and the environment to mercury in
Suriname. A solution of this problem will not be easy
and further studies are needed to collect more data
on the intensity of human and environmental expo-
sure, in order to implement effective preventive
measures.
ACKNOWLEDGMENTS
The authors are grateful to the local population for the support
they gave to the study and H. Pieters, of the DLO-Netherlands
Institute for Fisheries Research, IJmuiden, The Netherlands, for
the assistance in analyzing the fish samples.
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