Report References to occupational exposures Challenges faced by workers report notes that one-fifth of the children covered by an International Labour Organization (ILO) survey reported having a health problem since they took up gold mining, primarily aches in limbs and backbone, kidney and urinary tract diseases and exhaustion. In one country, over 400 children under the age of five reportedly died due to lead poisoning associated with gold miners grinding lead-containing rock at home in order to extract the gold, and leaving lead dust on the floors where children crawl. Health risks related to exposure to hazardous substances is exacerbated by children’s inclinations to more hand-to-mouth behaviour as well as the fact that personal protective equipment (PPE) is invariably made in adult sizes. Impacts on maternal health from exposure to hazardous substances, especially during the already immune-challenged gestation period, was also noted. The former Special Rapporteur expressed alarm at the discovery of elevated mercury levels in the breast milk of mothers in several countries. He expressed concerned that this may diminish the rights of infant children, reduce the practice of breastfeeding and increase the likelihood for women of diseases associated with exposure to these substances. The report notes how women experience the impacts of artisanal and small-scale mining(ASM) differently, either because of their sex — their biological characteristics as a female —, but more often because of their gender — their sociocultural definition as women. The former Special Rapporteur emphasizes that due to the harmful effects of mercury on the female reproduction function, international human rights law requires States parties to put in place preventive measures and programmes to protect women of childbearing age from mercury exposure. The former Special Rapporteur expressed concern about the extent of child slavery and child labour in the mining and quarrying industries and the impact on children as they face the same risks as adults, but lack the strength and judgment to protect themselves from sexual, moral, social and physical harm, including death and injuries resulting in disabilities. Poverty, lack of access to education, insufficient or non-existent legal frameworks, trafficking and debt bondage have been identified as root causes, manifestations and aggravating factors that lead to child slavery in the mining and quarrying sector. The former Special Rapporteur observed that unaccompanied minors are more likely to be exposed to harmful substances for want of parental protection in already exploitative environments. A/HRC/39/48 37