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Biogeochemical,
Health, and
Ecotoxicological
Perspectives on
Gold and
Gold Mining
CRC PRESS
Boca Raton London New York Washington, D.C.
Ronald Eisler, Ph.D.
Biogeochemical,
Health, and
Ecotoxicological
Perspectives on
Gold and
Gold Mining

This work is a reprint of a publication of the United States government (Patuxent Wildlife Research
Center internal report,

Gold and Gold Mining: Biogeochemical, Medical, and Ecotoxicological Perspec-
tives

; available from Librarian, USGS, PWRC, Laurel, MD 20708). Reasonable efforts have been made
to publish reliable data and information; however, neither the United States Government nor the publisher
makes any warranty, express or implied, or assumes any legal liability or responsibility for the accuracy,
completeness, or usefulness of any information, apparatus, product, or process disclosed, or represents
that its use would not infringe privately owned rights. Reference herein to any specific commercial
products, process, or service by trade name, trademark, manufacturer, or otherwise does not necessarily
constitute or imply its endorsement, recommendation, or favoring by the United States Government or
the publisher. The views and opinions expressed herein do not necessarily reflect those of the United
States Government or the publisher and shall not be used for advertising or product endorsement purposes.


This book contains information obtained from authentic and highly regarded sources. Reprinted material
is quoted with permission, and sources are indicated. A wide variety of references are listed. Reasonable
efforts have been made to publish reliable data and information, but the author and the publisher cannot
assume responsibility for the validity of all materials or for the consequences of their use.
Neither this book nor any part may be reproduced or transmitted in any form or by any means, electronic
or mechanical, including photocopying, microfilming, and recording, or by any information storage or
retrieval system, without prior permission in writing from the publisher.
The consent of CRC Press does not extend to copying for general distribution, for promotion, for creating
new works, or for resale. Specific permission must be obtained in writing from CRC Press for such
copying.
Direct all inquiries to CRC Press, 2000 N.W. Corporate Blvd., Boca Raton, Florida 33431.

Trademark Notice:

Product or corporate names may be trademarks or registered trademarks, and are
used only for identification and explanation, without intent to infringe.

No claim to original U.S. Government works
International Standard Book Number 0-8493-2898-5
Library of Congress Card Number 2004051932
Printed in the United States of America 1 2 3 4 5 6 7 8 9 0
Printed on acid-free paper

Library of Congress Cataloging-in-Publication Data

Eisler, Ronald, 1932–
Biogeochemical, health, and ecotoxicological perspectives on gold and gold mining.
Ronald Eisler.
p. cm.
Includes bibliographical references and index.

ISBN 0-8493-2898-5 (alk. paper)
1. Gold mines and mining—Health aspects. 2. Gold mines and mining—Environmental
aspects. 3. Gold—Toxicology. 4. Gold—Physiological effect. I. Title.
RC965.M48E35 2004
615.9



02—dc22 2004051932

2898_C00.fm Page iv Friday, September 24, 2004 10:38 AM
Visit the CRC Press Web site at www.crcpress.com

Dedication

To Jeannette, Renée, David, Charles, Julie, and Eb

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Preface

Over the past several decades I have been tasked by environmental specialists
of the U.S. Fish and Wildlife Service with the preparation of risk assessment doc-
uments of chemical and biological hazards of various compounds to wildlife. For
the most part, these documents involved analysis of measurable risks associated with
agricultural, industrial, municipal, military, and industrial chemicals and their wastes.
Risk assessment — still an inexact science — depends heavily on well-documented
databases that include the compound’s source and use; its physical, chemical, and
metabolic properties; concentrations in field collections of abiotic materials, plants,
and animals; lethal and sublethal effects, including effects on survival, growth,

reproduction, metabolism, mutagenicity, carcinogenicity, and teratogenicity; pro-
posed regulatory criteria for the protection of human health and sensitive natural
resources; and recommendations for additional research when databases are incom-
plete. However, this approach was only partially successful in attempting to evaluate
gold and gold mining practices because none of the preceding reports — unlike the
present account on gold — relied significantly on social, political, economic, med-
ical, or psychological variables in assessing risk to the biosphere. For the past several
years — through literature analysis, visits to operating gold mines, and consultations
with colleagues — I have tried to evaluate critically the enormous effort expended
by society in producing gold mainly for coinage, bullion, and personal jewelry,
regardless of environmental damage. This book is the result; however, all interpre-
tations are my own and do not necessarily reflect those of the U.S. Geological Survey
or any other federal agency. Moreover, mention of trade names or commercial
products is not an endorsement or recommendation for use by the U.S. government.

Ronald Eisler, Ph.D.

Senior Research Biologist
U.S. Geological Survey
Patuxent Wildlife Research Center
Laurel, Maryland

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Acknowledgments

I owe a special debt of gratitude to Judd A. Howell, the Director of the Patuxent
Wildlife Research Center (PWRC), and Harry N. Coulombe, Chief of Research at
PWRC, for their encouragement and financial support during the course of this five-
year effort. I thank Wanda Manning and Lynda J. Garrett for providing essential

library services, and my colleagues at PWRC for discussions and technical support,
specifically, Peter H. Albers, Thomas W. Custer, Gary H. Heinz, David J. Hoffman,
T. Peter Lowe, Glenn H. Olsen, Oliver H. Pattee, Matthew C. Perry, Barnett A.
Rattner, Graham W. Smith, and Nimish Vyas. Computer assistance was kindly
provided by PWRC specialists Kinard Boone and Henry C. Bourne. I am also
obligated to others for their insights on gold mining aspects, including David N.
Weissman (National Institute of Occupational Safety and Health), Stanley N. Wiem-
eyer (U.S. Fish and Wildlife Service), Rory E. Lamp (State of Nevada Department
of Wildlife), Roger D. Congdon and David J. Vandenberg (U.S. Bureau of Land
Management), David Gaskin (State of Nevada Bureau of Mining Regulation and
Reclamation), Michael L. Strobel (U.S. Geological Survey), Tom Jeffers (U.S. Forest
Service), Jeff White (Newmont Mining Corporation), and Ron A. Espell and Peter
G. Bodily (Barrick Goldstrike Mines, Inc.). Finally, I thank CRC staffers Randi
Cohen, Gail Renard, and Kathy Johnson for their professionalism in expediting
publication of this volume.

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About the Author*

Ronald Eisler received his B.A. degree from New York University in biology
and chemistry, and his M.S. and Ph.D. degrees from the University of Washington
in aquatic sciences and radioecology, respectively.
Eisler has been a senior research biologist since 1984 at the U.S. Geological
Survey, Patuxent Wildlife Research Center in Laurel, Maryland. Prior to 1984, he
held, in order, the following positions: bioscience advisor, U.S. Fish and Wildlife
Service, Washington, D.C.; research aquatic toxicologist, U.S. Environmental Pro-
tection Agency, Narragansett, Rhode Island; fishery research biologist, U.S. Fish
and Wildlife Service, Highlands, New Jersey; radiochemist, University of Washing-
ton Laboratory of Radiation Ecology; aquatic biologist, New York State Department

of Environmental Conservation, Raybrook, New York. During the Korean War, he
served in the U.S. Army Medical Service Corps.
He has held a number of special assignments and teaching appointments includ-
ing senior science advisor to the American Fisheries Society, adjunct professor of
zoology at American University in Washington, D.C., adjunct professor of ocean-
ography at the University of Rhode Island, and visiting professor of marine biology
and resident director of the Marine Biological Laboratory of Hebrew University in
Eilat, Israel. Since 1955, he has authored more than 135 technical articles and books
on contaminant hazards to living organisms, mainly on physiological and toxico-
logical effects of trace metals, as well as agricultural chemicals, municipal wastes,
crude oils and oil dispersants, and military and industrial wastes.
He resides in Potomac, Maryland, with his wife Jeannette, a teacher of French
and Spanish.

* Dr. Eisler retired in July 2004 after 45 years of federal service.

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Books by Ronald Eisler

Handbook of Chemical Risk Assessment: Health Hazards to Humans, Plants,
and Animals. Volume 1. Metals; Volume 2. Organics; Volume 3. Metalloids, Radia-
tion, Cumulative Index to Chemicals and Species.

Lewis Publishers, Boca Raton,
Florida, 2000.

Trace Metal Concentrations in Marine Organisms.

Pergamon Press, New York,

1981.

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List of Tables

2.1 Gold production in Canada in 1975, 1985, and 1992 by source 13
2.2 Total gold production in the United States, 1799–1965 16
2.3 Total placer gold production in the United States, 1792–1969 17
2.4 U.S. gold production by state: 1995 vs. 2000 18
4.1 Oxidation states of gold, examples, and stability in water 41
5.1 Gold concentrations in selected abiotic materials 52
5.2 Gold concentrations in selected plants and animals 57
6.1 Distribution of

198

Au

+

in anesthetized Sprague-Dawley rats 79
9.1 Gold thiolate compounds used medicinally 133
10.1 Metal concentrations (in

µ

g/L) in stream waters at Goldenville Gold
Mine, Nova Scotia 176
10.2 Average concentrations of Cd, Cu, Pb, and Zn in waters, soils, and

crops near Korean gold mining activities 176
10.3 Acute toxicity of aged gold mill effluent to marine fishes and
crustaceans 181
10.4 Tissue metal burdens of juvenile tanner crabs,

Chionoecetes



bairdi

181
10.5 U.S. Food and Drug Administration guidance for arsenic, cadmium,
lead, and nickel in shellfish 182
10.6 Drinking water limits and soil threshold values for protection of human
health 184
11.1 Cyanide and metals concentrations in water and sediments downstream
of Portovela-Zaruma cyanide-gold mining area, Ecuador; dry season,
1988 192
11.2 Single oral dose toxicity of sodium cyanide (mg NaCN/kg body weight)
fatal to 50% of selected birds and mammals 200
12.1 Arsenic concentrations in biota and abiotic materials collected near
gold mining and processing facilities 226
12.2 Lethal and sublethal effects of various arsenicals on humans and
selected species of plants and animals 231
12.3 Proposed arsenic criteria for the protection of human health and
selected natural resources 242
13.1 Total mercury concentrations in abiotic materials, plants, and animals
near active Brazilian gold mining and refining sites 259
13.2 Total mercury concentrations in abiotic materials, plants, and animals

near historic gold mining and refining sites in the United States 271
13.3 Lethal effects of mercury to sensitive species of aquatic organisms,
birds, and mammals 278
13.4 Proposed mercury criteria for the protection of selected natural
resources and human health 287
14.1 Metals and arsenic in tailings, soils, rice, and groundwater near an
abandoned gold-silver-copper-zinc mine, Dongil, Korea, 2000–2001 311

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Contents

Part 1

Gold and Gold Compounds 1

Chapter 1

Introduction 3
Literature Cited 5

Chapter 2

Geology, Sources, and Production 7
2.1 Geology 8
2.2 Sources and Production 10
2.2.1 Asia and Environs 12
2.2.2 Canada 12
2.2.3 Europe 13
2.2.4 Republic of South Africa (RSA) 14

2.2.5 South America 14
2.2.6 United States 14
2.3 Summary 19
Literature Cited 19

Chapter 3

Uses 23
3.1 Jewelry 23
3.2 Coinage 24
3.3 Electronics 26
3.4 Radiogold 26
3.5 Medicine 28
3.6 Dentistry 31
3.7 Delivery Vehicle 32
3.8 Electron Microscopy 32
3.9 Other 33
3.10 Summary 33
Literature Cited 33

Chapter 4

Properties 39
4.1 Physical Properties 39
4.2 Chemical Properties 41
4.3 Biochemical Properties 43
4.4 Summary 47
Literature Cited 48

Chapter 5


Gold Concentrations in Field Collections 51
5.1 Abiotic Materials 51
5.2 Plants 56
5.3 Animals 59
5.4 Summary 60
Literature Cited 61

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Chapter 6

The Effects of Gold on Plants and Animals 65
6.1 Aquatic Organisms 65
6.1.1 Monovalent Gold 65
6.1.2 Trivalent Gold 66
6.2 Accumulation 67
6.2.1 Microorganisms, Fungi, and Higher Plants 68
6.2.2 Aquatic Macrofauna 72
6.2.3 Animal Fibrous Proteins 73
6.3 Laboratory Mammals 73
6.3.1 Metallic Gold 73
6.3.2 Monovalent Gold: Obese Mouse Model 74
6.3.3 Monovalent Gold: Other 75
6.3.4 Trivalent Gold 80
6.4 Summary 81
Literature Cited 82

Part 2


Human Health Impacts 89

Chapter 7

Health Risks of Gold Miners 91
7.1 Historical Background 91
7.2 Health Risks: Underground Miners 93
7.2.1 Australia 93
7.2.2 North America 94
7.2.3 South America 95
7.2.4 Europe 96
7.2.5 Africa 96
7.3 Health Risks: Surface Miners Who Use Mercury 100
7.3.1 Case Histories 101
7.3.2 Mercury in Tissues 102
7.3.3 Mercury in Air and in Fish Diet 104
7.4 Summary 105
Literature Cited 106

Chapter 8

Human Sensitivity to Gold 113
8.1 History 113
8.2 Adverse Reactions 115
8.2.1 Suicide Attempt 115
8.2.2 Teratogenicity and Carcinogenicity 115
8.2.3 Hypersensitivity 115
8.3 Case Histories 118
8.3.1 Hypersensitivity 118
8.3.2 Goldschlager Syndrome 121

8.3.3 Prostheses 122
8.3.4 Protective Effect of Gold Rings 123

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8.4 Dental Aspects 123
8.4.1 Allergic Reactions and Sensitization 123
8.4.2 Case Histories 125
8.5 Summary 126
Literature Cited 126

Chapter 9

Chrysotherapy 131
9.1 History 131
9.2 Proposed Modes of Action 134
9.2.1 Au

+

and Au

+

Metabolites 135
9.2.2 Immunomodulatory Activity 139
9.2.3 Tumor Necrosis Factor 141
9.2.4 Bone Resorption 142
9.2.5 Leukocyte Infiltration 142
9.2.6 Lysosomal Enzymes 142

9.2.7 Macrophages 143
9.2.8 Polymorphic Neutrophils 143
9.2.9 Sulfhydryl Binding Sites 143
9.2.10 Superoxide Ion 144
9.2.11 Thioredoxin Reductase 144
9.3 Treatment Regimes, Case Histories, and Adverse Effects 144
9.3.1 Treatment Regimes 145
9.3.2 Case Histories 146
9.3.3 Adverse Effects 148
9.4 Summary 154
Literature Cited 155

Part 3

Effects of Gold Extraction on Ecosystems 161

Chapter 10

Gold Mine Wastes: History, Acid Mine Drainage, and Tailings
Disposal 163
10.1 Overview 163
10.1.1 Lode Mining 165
10.1.2 Placer Mining 166
10.2 Acid Mine Drainage 168
10.2.1 Effects 169
10.2.2 Mitigation 170
10.3 Tailings 172
10.3.1 Freshwater Disposal 172
10.3.2 Marine Disposal 178
10.3.3 Terrestrial Storage 183

10.4 Waste Rock 183
10.5 Summary 183
Literature Cited 184

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Chapter 11

Cyanide Hazards to Plants and Animals from Gold Mining
and Related Water Issues 189
11.1 History of Cyanide Use in Gold Mining 189
11.2 Cyanide Hazards 195
11.2.1 Aquatic Ecosystems 195
11.2.2 Birds 199
11.2.3 Mammals 201
11.2.4 Terrestrial Flora 203
11.3 Cyanide Mitigation and Research Needs 203
11.4 Water Management Issues 206
11.4.1 Affected Resources 207
11.4.2 Pit Lakes 211
11.5 Water Quality and Management Research Needs 213
11.6 Summary 214
Literature Cited 215

Chapter 12

Arsenic Hazards from Gold Mining for Humans, Plants, and
Animals 221
12.1 Arsenic Sources to the Biosphere from Gold Mining 221
12.2 Arsenic Risks to Human Health 223

12.3 Arsenic Concentrations in Abiotic Materials and Biota near Gold
Extraction Facilities 225
12.4 Arsenic Effects on Sensitive Species 230
12.5 Proposed Arsenic Criteria 241
12.6 Summary 244
Literature Cited 245

Chapter 13

Mercury Hazards from Gold Mining for Humans, Plants, and
Animals 251
13.1 History of Mercury in Gold Mining 251
13.2 Ecotoxicological Aspects of Amalgamation 255
13.2.1 Brazil 255
13.2.2 South America Other than Brazil 265
13.2.3 Africa 267
13.2.4 People’s Republic of China 268
13.2.5 The Philippines 268
13.2.6 Siberia 269
13.2.7 Canada 269
13.2.8 The United States 270
13.3 Lethal and Sublethal Effects of Mercury 276
13.3.1 Aquatic Organisms 277
13.3.2 Birds 281
13.3.3 Mammals 284
13.3.4 Other Groups 286
13.4 Proposed Mercury Criteria 286

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13.5 Summary 292
Literature Cited 293

Chapter 14

Abandoned Underground Gold Mines 307
14.1 Habitat for Biota 307
14.2 Land Development 309
14.3 Effects on Water Quality 310
14.4 Science Site Potential 312
14.5 Summary 312
Literature Cited 312

Part 4

Mining Legislation, Concluding Remarks, and
Indices 315

Chapter15

Selected Mining Legislation 317
15.1 United States 317
15.1.1 Federal Laws 317
15.1.2 Mining Public Lands in the Western United States 323
15.1.3 State Laws 327
15.1.4 Mining Law Reform 328
15.2 Foreign 328
15.3 Summary 330
Literature Cited 331


Chapter 16

Concluding Remarks 333

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And a river goes out from Eden to water the garden. And from there it divides and
becomes four branches. The name of the first is Pishon and is the one that winds
through all the land of Havilah,* where there is gold. And the gold of that land is
good ….

Hebrew Bible, Genesis II, 10-12**

* Havilah is in northern Arabia on the Persian Gulf. Arabia was famed in antiquity for its gold.
** Translation by R. Eisler.

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PART

1
Gold and Gold Compounds

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3

CHAPTER

1

Introduction

Since antiquity, gold has been valued for its scarcity, beauty, and resistance to
corrosion. Gold is the best known of all native elements and the most likely to be
found in a metallic state (Pough 1991). It is the universal standard of value and the
common medium of exchange in world commerce (Koschmann and Bergendahl
1968). Gold is almost everywhere considered to be the symbol of everything precious
and of enduring value because of the effort required to extract it from nature, and
because of its scarcity relative to other metals (Petralia 1996; Merchant 1998). Gold
was known and highly valued by the earliest civilizations: Egyptian, Minoan, Assyr-
ian, and Etruscan. Ornaments of great beauty and workmanship have survived from
these periods, many of them as perfect as when they were first made, several
thousands of years ago (Rose 1948). The earliest mining work of which traces remain
was on gold ores in Egypt; gold washing is depicted on Egyptian monuments of the
fourth dynasty, about 2000 BCE. The legend of the Golden Fleece may actually
describe an expedition around 1200 BCE to seize gold washed out from the river
sands by Armenians using sheepskins (Rose 1948). Financial investors regard gold
as an excellent hedge against inflation (Greer 1993). In recent years, the net buyers
of gold were central banks and government monetary agencies. In Asia, investment
demand for gold has risen sharply. In 1988, about 75% of new gold output went to
Taiwan, Japan, South Korea, Hong Kong, and Singapore as a store of wealth and
as adornment (Greer 1993).
Gold has produced deep political and social changes through the ages on entire
continents (Morteani 1999). Examples include the Spanish conquistadors who
destroyed indigenous cultures in Central and South America in their search for
“El Dorado”; the discovery of rich gold mines in Bohemia, Silesia, the northern
Carpathians, and northern Romania in the 12th and 13th centuries, which produced
a large immigration of miners; the settling of the American West, started mainly by
the California gold rush in 1849; the Australian gold rush of 1851, resulting in a
doubling of that population in seven years to one million; and the Alaskan gold rush

that started in 1897 (Morteani 1999). Unfortunately, the human costs of mining, extrac-
tion, refining, marketing, and accumulation of gold include war, slavery, conscripted

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4PERSPECTIVES ON GOLD AND GOLD MINING

and convict labor, unhealthy and shortened life span, and degraded living conditions
(Anikin 1983). Gold as an investment is difficult to justify (Greer 1993). The
intangibility of investor anxieties, the volatility of gold’s international market price,
and the infectious nature of the desire to hoard, all strongly indicate that complex
forces are involved in gold as an investment. Greer (1993) states that it is difficult
to justify the production of gold in view of society’s minimal need for it and the
shortfalls in, for example, food and timber production. However, the appeal of gold
has not diminished over the past century, nor has the damage caused by its extraction
(Greer 1993).
Long believed to be relatively benign, it is now known that gold is, in fact, a
relatively common allergen that induces dermatitis about the face and eyelids and
at other sites of direct skin contact (Ehrlich and Belsito 2000). In patch tests
worldwide the prevalence of gold allergy might be as high as 13%, with 9.5% the
most recent estimate in North America (Fowler 2001). The main exposure sources
of gold contact dermatitis are personal jewelry and dental alloys (Ahnlide et al.
2000; Suarez et al. 2000; Vamnes et al. 2000; Tsuruta et al. 2001). Occupations most
frequently causative of contact dermatitis due to gold include photography, chi-
naware or glass decorating, manufacturing of dental alloys, and crafting of jewelry
(Suarez et al. 2000). In humans, contact allergy to gold may be lifelong, or at least
extend for years, unlike in some strains of rodents that recover quickly when the
gold stimulus is removed (Lee and Maibach 2001). The growing evidence of human
health concerns related to gold, coupled with known adverse ecotoxicological aspects
of various gold extraction techniques, has prompted a critical review of gold in the

environment.
This book reviews environmental aspects of gold, gold salts, and gold mining,
and is divided into four sections. The first section deals with the uses of gold and
gold salts, with emphasis on jewelry, bullion and coinage, medicine, dentistry, and
electronics; properties, including geological, physical, chemical, and biological;
sources and production; concentrations in field collections worldwide of abiotic
materials, flora, and fauna; and lethal and sublethal effects to plants and animals,
emphasizing effects on aquatic organisms and laboratory mammals. The second
section is devoted to human health aspects, including health risks to gold miners;
medical aspects of gold drugs, with special attention to the anti-inflammatory action
of gold thiol drugs in the treatment of rheumatoid arthritis; and human sensitivity
to gold, including contact dermatitis reactions and other concerns. The third section
evaluates ecotoxicological aspects of various gold extraction technologies, with
emphasis on mercury amalgamation, cyanidation technologies, and related water
management issues; environmental effects of gold mining wastes discharged into
the biosphere, including arsenic-containing tailings and acid mine drainage; and
impact of abandoned underground gold mines on human and natural resources. The
last section includes selected legislation governing disposal of gold mining wastes,
concluding remarks, and comprehensive indexes by subject and by biological species.

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INTRODUCTION 5

LITERATURE CITED

Ahnlide, I., B. Bjorkner, M. Bruze, and H. Moller. 2000. Exposure to metallic gold in patients
with contact allergy to gold sodium thiosulfate,

Contact Dermatitis


, 43, 344–350.
Anikin, A.V. 1983. Gold — the yellow devil. International Publ., New York, 244 pp.



Ehrlich, A. and D.V. Belsito. 2000. Allergic contact dermatitis to gold

, Cutis

, 65, 323–326.
Fowler, J.F., Jr. 2001. Gold,

Amer. Jour. Contact Dermatitis

, 12, 1–2.
Greer, J. 1993. The price of gold: environmental costs of the new gold rush,

The Ecologist

,
23 (3), 91–96.
Koschmann, A.H. and M.H. Bergendahl. 1968. Principal gold-producing districts of the United
States

,

U.S. Geol. Surv. Prof. Paper 610, 283 pp.
Lee, E.E. and H.L. Maibach. 2001. Is contact allergy in man lifelong? An overview of patch
test follow-ups,


Contact Dermatitis

, 44, 137–139.
Merchant, B. 1998. Gold, the noble metal and the paradoxes of its toxicology,

Biologicals

,
26, 49–59.
Morteani, G. 1999. History, economics and geology of gold, in

Gold: Progress in Chemistry,
Biochemistry and Technology

, H. Schmidbaur, (Ed.), John Wiley & Sons, New York,
39–63.
Petralia, J.F. 1996.

Gold! Gold! A Beginner’s Handbook and Recreational Guide: How &
Where to Prospect for Gold!

Sierra Outdoor Products Co., San Francisco, 143 pp.
Pough, F.H. 1991.

Peterson First Guide to Rocks and Minerals

. Houghton Mifflin, Boston,
128 pp.
Rose, T.K. 1948. Gold,


Encyclopaedia Britannica

, 10, 479-485.
Suarez, I., M. Ginarte, V. Fernandez-Redondo, and J. Toribio. 2000. Occupational contact
dermatitis due to gold,

Contact Dermatitis

, 43, 367–368.
Tsuruta, K., K. Matsunaga, K. Suzuki, R. Suzuki, H. Akita, Y. Washimi, A. Tomitaka, and
H. Ueda. 2001. Female predominance of gold allergy,

Contact Dermatitis

, 44, 55–56.
Vamnes, J.S., T. Morken, S. Helland, and N.R. Gjerdet. 2000. Dental gold alloys and contact
hypersensitivity,

Contact Dermatitis

, 42, 128–133.

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