Abstract Artisanal and small-scale gold mining (ASGM) is a critical source of livelihood for millions of people globally who lack alternative economic opportunities. However, ASGM operates as a largely informal sector where hazardous working conditions and exposure to toxic chemicals pose serious threats to the health and wellbeing of miners and surrounding communities. Drawing on ecosocial theory’s rejection of single-cause explanations for health outcomes, this umbrella review aimed to characterize the health impacts associated with ASGM across the life course and examine the multi-level pathways through which ASGM affects health. A systematic search of Scopus, Web of Science, and Medline identified 22 English-language review articles meeting inclusion criteria. Following PRISMA-ScR guidelines, health impacts were analyzed across four domains: toxicological, occupational, infectious, and psychosocial. Results indicate that ASGM-related health impacts occur across multiple scales, ranging from neurological disorders associated with mercury contact to serious injury and death from occupational hazards. Mining-related environmental changes, including stagnant water at mining sites that can facilitate infectious disease transmission, together with broader societal impacts such as disputes over land, represent additional threats affecting ASGM communities. Distinct health risks were also identified across the life course, including fetal and early postnatal exposure to potentially toxic elements, as well as psychosocial harms and opportunity costs resulting from child labour and adolescent school dropout. By framing ASGM as a part of deeply interconnected and multi-scalar social, economic, and environmental pressures, this umbrella review documents the complex factors shaping health in ASGM contexts and may be used to inform policy, practice, and future research.
