The Hidden Toll of Occupational Health Hazards: A Qualitative Study of Workers from Small-Scale Illegal Miners in Ghana

Background: Small-scale illegal gold mining, or “Galamsey”, is an important livelihood in Ghana but exposes workers to serious occupational health risks. This study aimed to explore the lived experiences, perceptions of health hazards, and coping strategies of workers from illegal small-scale gold mines in the Atwima Mponua District to inform context-specific interventions and policies. Methods: This qualitative study employed a phenomenological design to explore the occupational health experiences of workers from illegal small-scale gold mines in the Atwima Mponua District. A total of 16 purposively selected workers, ten men and six women, aged 27 to 44 years, with mining experience ranging from 3 to 12 years, working across roles including excavators, washers/panners, chemical processors, ore grinders, and support workers, were interviewed in depth, using a semi-structured interview guide. Thematic analysis was used to analyse the data according to Braun and Clarke’s model. Findings: There were four dominant themes: (1) normalization of risk and fatalistic attitudes about mining risks; (2) Respiratory Manifestations and Dust-Related Ailments; (3) chemical exposures and dermatological conditions; and (4) traumatic injuries from pit collapses, mining equipment accidents, and heavy physical labour. Participants demonstrated low levels of knowledge about long-term health outcomes and reported substantial obstacles to accessing healthcare, including fear of legal action, financial constraints, and geographic isolation. Conclusions: Workers from illegal small-scale gold mines in the Atwima Mponua District bear a serious, hidden occupational health burden normalized by poverty and criminalization. Urgent, comprehensive interventions are needed that address legal protection, economic alternatives, accessible healthcare, and harm reduction.