Health impacts of industrial mining on surrounding communities: Local perspectives from three sub-Saharan African countries

Andrea Leuenberger; Mirko S. Winkler; Olga Cambaco; Herminio Cossa; Fadhila Kihwele; Isaac Lyatuu; Hyacinthe R. Zabré; Andrea Farnham; Eusebio Macete; Khátia Munguambe

doi:10.1371/journal.pone.0252433

Peer Review History

Original SubmissionOctober 27, 2020
4 Jan 2021 Decision Letter - Juliet Kiguli, Editor PONE-D-20-33758 Health impacts of industrial mining on surrounding communities: Local perspectives from three sub-Saharan African countries PLOS ONE Dear Dr. Leuenberger, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process. Please submit your revised manuscript by Feb 18 2021 11:59PM. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. 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The following resources for replacing copyrighted map figures may be helpful: USGS National Map Viewer (public domain): http://viewer.nationalmap.gov/viewer/ The Gateway to Astronaut Photography of Earth (public domain): http://eol.jsc.nasa.gov/sseop/clickmap/ Maps at the CIA (public domain): https://www.cia.gov/library/publications/the-world-factbook/index.html and https://www.cia.gov/library/publications/cia-maps-publications/index.html NASA Earth Observatory (public domain): http://earthobservatory.nasa.gov/ Landsat: http://landsat.visibleearth.nasa.gov/ USGS EROS (Earth Resources Observatory and Science (EROS) Center) (public domain): http://eros.usgs.gov/# Natural Earth (public domain): http://www.naturalearthdata.com/ [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes ******** 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes ****** 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes ****** 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes ****** 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Greetings, I would like to acknowledge the authors in conducting this study. It is a very challenging research area and involves a huge planning and co-ordination which is a laborious task. Overall the study provides an in-depth insight to the health problems and other factors determining the health among the communities around the industrial mining sites. Abstract : Appropriately covers the content and well presented. Main Article: Introduction: Very elaborate and covers the required information with lacunae in existing literature also justifies the need Methodology: The methodology could be added with more details on how the sample size was achieved? Whether the study subjects included even those who were employed in the mining industries? If so whether there was any bias in the elicited impacts? How is it taken care? Results: Appropriate Discussion: Elaborate and appropriate Conclusion: The details on key determinants impacted could be included along with this sentence: ‘Community perspectives revealed various impacts on the wider determinants of health and health outcomes related to morbidity, mortality and well-being’ ****** 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes:** Dr. Shruthi M N [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. Attachments Attachment Submitted filename: PLOS REVIEW.docx https://doi.org/10.1371/journal.pone.0252433.r001
Revision 1
26 Jan 2021 Author Response Reviewer's Responses to Questions Comments to the Author 1. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes 2. Has the statistical analysis been performed appropriately and rigorously? Reviewer #1: Yes 3. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #1: Yes 4. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Response: We are grateful for the positive and concise appraisal of reviewer #1 regarding the questions from the editorial office. 5. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: Greetings, I would like to acknowledge the authors in conducting this study. It is a very challenging research area and involves a huge planning and co-ordination which is a laborious task. Overall the study provides an in-depth insight to the health problems and other factors determining the health among the communities around the industrial mining sites. Response: Dear reviewer #1, we thank you for your positive feedback regarding our work undertaken and its relevance for the field. Abstract : Appropriately covers the content and well presented. Main Article: Introduction: Very elaborate and covers the required information with lacunae in existing literature also justifies the need Response: Thank you again, reviewer #1. Methodology: The methodology could be added with more details on how the sample size was achieved? Whether the study subjects included even those who were employed in the mining industries? If so whether there was any bias in the elicited impacts? How is it taken care? Response: Many thanks for mentioning this interesting issue. The recruitment process was indeed complex and we have further elaborated the section in the manuscript. To state more clearly how the sample size was achieved, we have added the sentence that we planned to conduct two to four session with 6 - 10 participants in the communities identified, to read: In order to generate comparative data from the different settings and countries, two to four sessions were planned with 6 -10 participants per session (see revised manuscript lines 198-200). Further, we have specified in the description of the study population that only few participants (n = 13) were employed by the mines at the time point of data collection. It reads now as follows: Only few participants reported to be employed by the mining companies (n = 13) (see revised manuscript line 260). Notably, being employed or not was not a recruitment criterion to participate in the study. But the low number may reflects the restricted number of job opportunities that were mentioned by the participants. Against this background, this might have contributed to their rather negative attitude, which we point out to in the limitations. At the same time, we also like to emphasize that the consistency of the findings, including the low number of community members employed by the mines, indicates a systematic problem across the settings and countries. We have added this reflection to the limitations, to read: Additionally, the consistency of our qualitative findings from the different study sites indicates rather systematic challenges across the countries and settings (see revised manuscript lines 708-709). Results: Appropriate Discussion: Elaborate and appropriate Response: Thank you, reviewer #1 for considering the results and discussion section as appropriate. Conclusion: The details on key determinants impacted could be included along with this sentence: ‘Community perspectives revealed various impacts on the wider determinants of health and health outcomes related to morbidity, mortality and well-being’ Response: Thank your brining up this point. To be more specific about the wider determinants of health, we have specified the phrase to “environmental, economic and social determinants of health” (see manuscript line 717). 6. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes: Dr. Shruthi M N Response: We are delighted to see that reviewer #1 is willing to make the review available for the public. Thank you, Dr. Shruthi, for all your efforts on our piece! https://doi.org/10.1371/journal.pone.0252433.r002
21 Apr 2021 Decision Letter - Alok Deoraj, Editor PONE-D-20-33758R1 Health impacts of industrial mining on surrounding communities: local perspectives from three sub-Saharan African countries PLOS ONE Dear Dr. Leuenberger, Thank you for submitting your manuscript to PLOS ONE. After careful consideration, we feel that it has merit but does not fully meet PLOS ONE’s publication criteria as it currently stands. Therefore, we invite you to submit a revised version of the manuscript that addresses the points raised during the review process especially the review #-2. It is a very important and complex area of investigation in the field of environmental and occupational health and safety. Please submit your revised manuscript by Jun 05 2021 11:59PM. I look forward to your revised manuscript, and hope to have an expeditious decision. If you will need more time than this to complete your revisions, please reply to this message or contact the journal office at plosone@plos.org. When you're ready to submit your revision, log on to https://www.editorialmanager.com/pone/ and select the 'Submissions Needing Revision' folder to locate your manuscript file. Please include the following items when submitting your revised manuscript: A rebuttal letter that responds to each point raised by the academic editor and reviewer(s). You should upload this letter as a separate file labeled 'Response to Reviewers'. A marked-up copy of your manuscript that highlights changes made to the original version. You should upload this as a separate file labeled 'Revised Manuscript with Track Changes'. An unmarked version of your revised paper without tracked changes. You should upload this as a separate file labeled 'Manuscript'. If you would like to make changes to your financial disclosure, please include your updated statement in your cover letter. Guidelines for resubmitting your figure files are available below the reviewer comments at the end of this letter. If applicable, we recommend that you deposit your laboratory protocols in protocols.io to enhance the reproducibility of your results. Protocols.io assigns your protocol its own identifier (DOI) so that it can be cited independently in the future. For instructions see: http://journals.plos.org/plosone/s/submission-guidelines#loc-laboratory-protocols. Additionally, PLOS ONE offers an option for publishing peer-reviewed Lab Protocol articles, which describe protocols hosted on protocols.io. Read more information on sharing protocols at https://plos.org/protocols?utm_medium=editorial-email&utm_source=authorletters&utm_campaign=protocols. We look forward to receiving your revised manuscript. Kind regards, Alok Deoraj, PhD Academic Editor PLOS ONE [Note: HTML markup is below. Please do not edit.] Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: (No Response) ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes ****** 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: No ****** 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: No ******** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: PLOS ONE Review (PONE-D-20-33758) Health impacts of industrial mining on surrounding communities: Local perspectives from three sub-Saharan African countries. The manuscript is tackling very important public health issues regarding impact of mining on the surrounding populations in Burkina Faso, Mozambique, and Tanzania. The design of the study was well done. However, there are a number of missing information that may be instrumental in addressing these issues. First of all, the manuscript needs to be reviewed by a native English speaker or someone with excellent command of English. The missing information (that can be easily retrieved and hence enhance the quality of the manuscript) is noted in the following lines: 1. What is the role of the governments and the mining companies in this context? 2. Are there any environmental laws and regulations in these countries dealing with mining? 3. Do the three countries have ministries of labour, mining, environment, …? If we are to design preventive measures, there has to a government’s agency to go to in order to come up with ways to control/prevent the negative impact of mining on the surrounding populations. 4. What ILO, or WHO, … says about these issues? Any recommendations from these United Nations’ agencies, or from any international organization. 5. On Page 17, under “Environmental determinants”, what is the role of the governments regarding the reported impacts related to water, air, housing and living environment, soil and land and sanitation and hygiene? 6. On Page 21, under “Economic determinants”, could the reader know the position of the governments regarding displaced populations? What do laws (if they exist) say about this? 7. On Page 23, under “Social services and social organization”, if these governments and/or mining companies secured lending, they should abide by the World Bank IFC (International Finance Corporation) Equator principles* and performance standards. These are a set of voluntary social and environmental principles which must be met to satisfy the conditions of lending. 8. On Page 25, under “Interlinkages between health determinants and health outcomes”, are any policies from the mining companies that deal with these? ******* 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review?** For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No [NOTE: If reviewer comments were submitted as an attachment file, they will be attached to this email and accessible via the submission site. Please log into your account, locate the manuscript record, and check for the action link "View Attachments". If this link does not appear, there are no attachment files.] While revising your submission, please upload your figure files to the Preflight Analysis and Conversion Engine (PACE) digital diagnostic tool, https://pacev2.apexcovantage.com/. PACE helps ensure that figures meet PLOS requirements. To use PACE, you must first register as a user. Registration is free. Then, login and navigate to the UPLOAD tab, where you will find detailed instructions on how to use the tool. If you encounter any issues or have any questions when using PACE, please email PLOS at figures@plos.org. Please note that Supporting Information files do not need this step. https://doi.org/10.1371/journal.pone.0252433.r003
Revision 2
12 May 2021 Author Response Dear Dr. Deoraj We were delighted to receive your e-mail dated 21 April 2021, which provided encouraging feedback and constructive comments and suggestions from one external reviewer in connection with the aforementioned manuscript. After a first round of external peer-review, we were actually slightly surprised to receive an additional reviewer report that seems unrelated to the first revision. Yet, we revised our piece once more in light of the reviewer’s comments and tried our level best to address the concerns raised. Below, please find our point-by-point response, clearly indicating how and where in the manuscript changes have been made (line numbers). In order to readily assist you in tracking our changes, they have been highlighted using a yellow marker. We also enclose a “clean” version of the revised manuscript as supporting information. We very much hope that our revised manuscript is now suitable for publication for PLOS ONE and are looking forward to hearing from you. Yours sincerely, Andrea Leuenberger on behalf of all authors ________________________________________ Reviewers' comments: Reviewer's Responses to Questions Comments to the Author 1. If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #2: (No Response) ________________________________________ 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #2: Yes ________________________________________ 3. Has the statistical analysis been performed appropriately and rigorously? Reviewer #2: Yes ________________________________________ 4. Have the authors made all data underlying the findings in their manuscript fully available? The PLOS Data policy requires authors to make all data underlying the findings described in their manuscript fully available without restriction, with rare exception (please refer to the Data Availability Statement in the manuscript PDF file). The data should be provided as part of the manuscript or its supporting information, or deposited to a public repository. For example, in addition to summary statistics, the data points behind means, medians and variance measures should be available. If there are restrictions on publicly sharing data—e.g. participant privacy or use of data from a third party—those must be specified. Reviewer #2: No ________________________________________ 5. Is the manuscript presented in an intelligible fashion and written in standard English? PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #2: No Response: We are grateful for the overall positive and concise appraisal of reviewer #2 regarding the questions from the editorial office and have noted that the language is a particular concern. Therefore, one co-author, who is a native English speaker, focused on language edits specifically. ________________________________________ 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #2: PLOS ONE Review (PONE-D-20-33758) Health impacts of industrial mining on surrounding communities: Local perspectives from three sub-Saharan African countries. The manuscript is tackling very important public health issues regarding impact of mining on the surrounding populations in Burkina Faso, Mozambique, and Tanzania. The design of the study was well done. However, there are a number of missing information that may be instrumental in addressing these issues. Response: Dear reviewer #2, we thank you for your positive feedback on the research undertaken and considering it a relevant contribution to the scientific literature. In light of your comments, we have further revised our paper based on the communities’ perspective in a concise manner as indicated below. First of all, the manuscript needs to be reviewed by a native English speaker or someone with excellent command of English. Response: We addressed the comments related to the content of the manuscript and paid particular attention to grammar and syntax. As mentioned above, one co-author, who is a native English speaker, focused on language edits specifically. The missing information (that can be easily retrieved and hence enhance the quality of the manuscript) is noted in the following lines: 1. What is the role of the governments and the mining companies in this context? 2. Are there any environmental laws and regulations in these countries dealing with mining? Response: We thank reviewer #2 for bringing up the role of governments and national laws or regulations in relation to industrial mining projects. To address the comment, we have integrated a sentence in the description of the study sites, to read: “In all study countries, environmental impact assessments (EIA) are required by law to obtain a mining license. Yet, specific national regulations for health impact assessment and the rigorous inclusion of health in other forms of impact assessment remain an unmet need [Winkler et al., 2013, Dietler et al., 2020]” (see revised manuscript lines 116-120). Based on our data, the role of the governments as well as the differences in governancebetween the countries were less evident. Only a few participants mentioned the government or national regulations in relation to perceived health impacts. Despite the fact that governmental issues were identified as secondary themes in our study, the need to incorporate health impacts in national regulations and the implementation thereof is discussed in last section of the discussion, (“Incorporating community perceptions in impact assessment”, see revised manuscript lines 652-691). 3. Do the three countries have ministries of labour, mining, environment, …? If we are to design preventive measures, there has to a government’s agency to go to in order to come up with ways to control/prevent the negative impact of mining on the surrounding populations. Response: This is very valid point and relates to the overarching aim of the large research initiative (HIA4SD Project) behind this paper, which is to promote the use and implementation of updated guidelines regarding health impact assessment (HIA) in the respective countries. The initiative collaborates with national stakeholders, including representatives from the public and private sector, such as ministries of mines and health. The current piece is, however, designed to focus on the voice of affected communities. While we acknowledge the importance of the public sector for national health strategies, it is beyond the scope of this manuscript to describe the different health policies and practices of the different countries. 4. What ILO, or WHO, … says about these issues? Any recommendations from these United Nations’ agencies, or from any international organization. Response: In the past decades, responsible business conduct has gained momentum in the extractive industry sector. For instance, the “United Nations Guiding Principles on Business and Human Rights” are a key international document to protect and respect the human rights. This can also include impact assessment practices, which are required either on a legal basis or by international organisations. We have specified this in the manuscript by adding the following phrases: “Impact assessment can be required by national regulations or as part of international standards or guiding principles of international organisations such as the International Finance Cooperation (IFC) or the Equator Principles [Winkler et al., 2013]. At present, different types of impact assessment exist, including environmental, social, health or gender impact assessment (EIA, SIA, HIA and GIA, respectively) as well as integrated approaches, such as environmental, social and health impact assessment (ESHIA) [Esteves et al., 2012; Harris-Roxas et al., 2012; Morgan, 2012; Hill et al., 2017]. HIA as a stand-alone approach or integrated in other forms of impact assessment was endorsed by WHO in 1999 as holding particular promise in addressing health and its wider determinants, given its comprehensive understanding of health [Leuenberger et al., 2019; Winkler et al., 2020; Winkler et al., 2021] ” (see revised manuscript lines 657-665). This paper reflects the perspective of communities affected by industrial mining as part of a larger research initiative aiming to strengthen HIA in sub-Saharan Africa. As this manuscript focuses on perspectives from the local level, opinions from other local, national or international stakeholders were not integrated. This is, however, done under the ‘governance research stream’ of the HIA4SD Project. 5. On Page 17, under “Environmental determinants”, what is the role of the governments regarding the reported impacts related to water, air, housing and living environment, soil and land and sanitation and hygiene? Response: The “environmental determinants” section reflects the communities’ perspectives of the impacts on the wider determinants of health, and as such the content is driven by the participants themselves. While reporting on perceived impacts on the environmental determinants of health, participants did not specifically mention the role of the government. During the analysis, statements related to the role of the government were categorized as social impacts. While investigating the (perceived) role of the government would be highly interesting, we prefer to report the communities’ perspectives in a unbiased and impartial manner. In addition to the current qualitative approach, we would like to mention the quantitative and mixed methods research pertaining to environmental health impacts, which is also associated with the framing research project and have been published recently: Dietler et al., 2021, Leuenberger and Dietler et al., 2021. 6. On Page 21, under “Economic determinants”, could the reader know the position of the governments regarding displaced populations? What do laws (if they exist) say about this? Response: Many thanks for pointing out role of the governments and laws in relation to displaced populations. As above, this is also part of the results section reporting the impacts as perceived by affected communities. While governance aspects are covered within the larger research initiative framing the manuscript at hand, an analysis of the national laws is beyond the scope of this manuscript. 7. On Page 23, under “Social services and social organization”, if these governments and/or mining companies secured lending, they should abide by the World Bank IFC (International Finance Corporation) Equator principles* and performance standards. *These are a set of voluntary social and environmental principles which must be met to satisfy the conditions of lending. Response: Thank you bringing up this important point. Indeed, international standards and principles are an important measure to ensure the well-being of affected communities. Our research group has produced several publications that reflect on these international performance standards and how they influence HIA practice (e.g. Winkler et al., 2013; Winkler et al, 2020). Hence, we are very familiar with the point raised by the reviewer here and fully concur on their importance. However, the present qualitative paper purely reflects the communities’ perspectives, which apparently seem to be in contrast with international standard principles and standards. The main objective of the paper is to raise the voice of the communities and not to judge the performance of mining companies or governments. Based on our data obtained from affected communities, we would not feel comfortable to judge the governments’ or mining companies’ performance on environmental and social indicators and hence, prefer not to discuss the justification of lending processes. 8. On Page 25, under “Interlinkages between health determinants and health outcomes”, are any policies from the mining companies that deal with these? Response: This section is part of the results and reports about the community’s perspective. During the focus group discussion, participants did not mention any policies from the mining companies to address the complexity of health impacts, meaning policies acting on health policies to ultimately improve health and well-being. In order to answer to the question raised by the reviewer, we would like to refer to the Good Practice Guidance on Health Impact Assessment (2010), which was issued by the International Council on Minerals and Metals (ICMM) in 2010. This guidance adopted by many mining projects specifically addressed the interlinkages between health determinants and health outcomes. ________________________________________ 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #2: No ________________________________________ References added: Dietler D, Lewinski R, Azevedo S, Engebretsen R, Brugger F, Utzinger J, et al. Inclusion of health in impact assessment: a review of current practice in sub-Saharan Africa. International Journal of Environmental Research and Public Health. 2020;17(11):4155. WHO European Centre for Health Policy. Gothenburg Consensus Paper. Brussels, Belgium: World Health Organization Regional Office for Europe; 1999. Winkler MS, Viliani F, Knoblauch AM, Cave B, Divall M, Ramesh G, et al. Health impact assessment international best practice principles. Fargo, USA: International Association for Impact Assessment; 2021. https://doi.org/10.1371/journal.pone.0252433.r004
17 May 2021 Decision Letter - Alok Deoraj, Editor Health impacts of industrial mining on surrounding communities: local perspectives from three sub-Saharan African countries PONE-D-20-33758R2 Dear Dr. Leuenberger, We’re pleased to inform you that your manuscript has been judged scientifically suitable for publication and will be formally accepted for publication once it meets all outstanding technical requirements. Within one week, you’ll receive an e-mail detailing the required amendments. When these have been addressed, you’ll receive a formal acceptance letter and your manuscript will be scheduled for publication. An invoice for payment will follow shortly after the formal acceptance. To ensure an efficient process, please log into Editorial Manager at http://www.editorialmanager.com/pone/, click the 'Update My Information' link at the top of the page, and double check that your user information is up-to-date. 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If the authors have adequately addressed your comments raised in a previous round of review and you feel that this manuscript is now acceptable for publication, you may indicate that here to bypass the “Comments to the Author” section, enter your conflict of interest statement in the “Confidential to Editor” section, and submit your "Accept" recommendation. Reviewer #1: All comments have been addressed Reviewer #2: All comments have been addressed ******** 2. Is the manuscript technically sound, and do the data support the conclusions? The manuscript must describe a technically sound piece of scientific research with data that supports the conclusions. Experiments must have been conducted rigorously, with appropriate controls, replication, and sample sizes. The conclusions must be drawn appropriately based on the data presented. Reviewer #1: Yes Reviewer #2: Yes ****** 3. Has the statistical analysis been performed appropriately and rigorously? 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PLOS ONE does not copyedit accepted manuscripts, so the language in submitted articles must be clear, correct, and unambiguous. Any typographical or grammatical errors should be corrected at revision, so please note any specific errors here. Reviewer #1: Yes Reviewer #2: Yes ****** 6. Review Comments to the Author Please use the space provided to explain your answers to the questions above. You may also include additional comments for the author, including concerns about dual publication, research ethics, or publication ethics. (Please upload your review as an attachment if it exceeds 20,000 characters) Reviewer #1: (No Response) Reviewer #2: I am quite satisfied with the revisions to the manuscript. Indeed, you addressed all the concerns and questions that I had. Thanks ****** 7. PLOS authors have the option to publish the peer review history of their article (what does this mean?). If published, this will include your full peer review and any attached files. If you choose “no”, your identity will remain anonymous but your review may still be made public. Do you want your identity to be public for this peer review? For information about this choice, including consent withdrawal, please see our Privacy Policy. Reviewer #1: Yes:** Dr. Shruthi M N Reviewer #2: No https://doi.org/10.1371/journal.pone.0252433.r005
Formally Accepted
26 May 2021 Acceptance Letter - Alok Deoraj, Editor PONE-D-20-33758R2 Health impacts of industrial mining on surrounding communities: local perspectives from three sub-Saharan African countries Dear Dr. Leuenberger: I'm pleased to inform you that your manuscript has been deemed suitable for publication in PLOS ONE. Congratulations! Your manuscript is now with our production department. If your institution or institutions have a press office, please let them know about your upcoming paper now to help maximize its impact. If they'll be preparing press materials, please inform our press team within the next 48 hours. Your manuscript will remain under strict press embargo until 2 pm Eastern Time on the date of publication. For more information please contact onepress@plos.org. If we can help with anything else, please email us at plosone@plos.org. Thank you for submitting your work to PLOS ONE and supporting open access. Kind regards, PLOS ONE Editorial Office Staff on behalf of Dr. Alok Deoraj Academic Editor PLOS ONE https://doi.org/10.1371/journal.pone.0252433.r006

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