A One Health scoping review of human health risks beyond heavy metal exposure in Ghana’s artisanal and small-scale gold mining sector

Artisanal and small-scale gold mining (ASGM) remains a vital economic activity in Ghana, supporting the livelihoods of thousands. However, the sector poses multifaceted risks to human health that extend beyond the well-documented exposure to heavy metals such as mercury and lead. This scoping review adopts a One Health framework to synthesise peer-reviewed literature on the broader spectrum of health impacts associated with ASGM in Ghana, recognising the interconnectedness of human, animal, and environmental health risk outcomes. Using a systematic search strategy across major academic databases (PubMed, Google Scholar, Web of Science) and manual reference screening, we identified and analysed 70 studies published from 2006 to 2025. The findings reveal a complex interplay of occupational, environmental, and public health hazards, including respiratory illnesses, musculoskeletal disorders, noise-induced hearing loss, mental health challenges, zoonotic and infectious diseases, and ecological degradation. Notably, we observed that heavy metal exposure is frequently conceptualised as a direct health outcome rather than a modulating factor influencing broader disease patterns in mining communities. This review highlights critical gaps in the literature, particularly the underrepresentation of specific communicable and non-communicable disease outcomes and the limited integration of animal and ecosystem health risk considerations. By moving beyond a narrow toxicological lens, we underscore the urgent need for integrated health interventions and policy reforms that align with One Health principles. Such approaches are essential for addressing the complex and interdependent risks faced by ASGM workers, residents of mining communities, and mineral-rich sub-Saharan contexts.