Potential Link Between Hyperplastic Ovarian Cysts in Children - Exposure to Acid Mine Drainage: A Case Study from South Africa's East Rand

Mike Buchanan (2025)

Abstract

This paper explores the potential correlation between environmental exposure to contaminants associated with acid mine drainage (AMD) and the occurrence of hyperplastic ovarian cysts in a 12-year-old child in the East Rand region of South Africa. The study highlights the presence of endocrine-disrupting chemicals (EDCs) in both waterborne and airborne forms emanating from AMD-affected areas, such as the Cinderella Dam and the ERPM mineshaft in the vicinity. Given the established endocrine-disruptive properties of several heavy metals and the developmental sensitivity of children, this paper calls for comprehensive environmental health assessments and epidemiological studies to validate and understand the health implications.

1.      Introduction

 Hyperplastic ovarian cysts are uncommon in prepubescent children; their emergence warrants investigation into potential environmental or physiological causes. In the context of South Africa's East Rand, legacy gold mining operations have left a significant environmental footprint. This includes the persistent issue of AMD, which arises when sulfide-bearing rock is exposed to air and water, forming sulfuric acid and mobilizing heavy metals into surrounding ecosystems.

 

2.      Environmental Context

 The Cinderella Dam and adjacent mineshafts in the East Rand have been identified as key sites of AMD release. During the winter months, moisture plumes released from the Cinderella shaft interact with dry atmospheric conditions, potentially leading to the aerosolization of fine particulates and volatile compounds containing heavy metals and radionuclides (McCarthy, 2011; Hobbs & Cobbing, 2007). Surface waters, such as those in the Cinderella Dam, have also shown contamination from AMD, with elevated levels of iron, manganese, uranium, and other metals (Coetzee et al., 2006).

 

3.      Endocrine Disruption and AMD

EDCs can interfere with hormone biosynthesis, metabolism action. Heavy metals such as lead, cadmium, arsenic, and uranium, commonly found in AMD. Have been demonstrated to function as EDCs by mimicking or antagonising oestrogen and other hormones (Diamanti-Kandarakis et al., 2009). Studies have also demonstrated that exposure to contaminated water or air can lead to bioaccumulation and subsequent endocrine disruption in both humans and animals (Kavlock et al., 1996).

 

4.      Health Implications for Children

Children are particularly vulnerable to environmental toxicants due to higher rates of absorption and critical developmental stages (Landrigan et al., 2004). Inhalation of aerosolized particles or dermal/inadvertent oral exposure from swimming in contaminated waters may increase the risk of hormonal dysregulation. While direct causality between AMD exposure and ovarian cyst development in children has not been definitively established, this case aligns with the biological plausibility of EDC-induced pathophysiology.

 

5.      Long-Term Prognosis and Care Considerations

Following removal from the contaminated environment, the subject of this case underwent two surgeries to excise ovarian cysts. Since that time, she has gone on to live a healthy life in a clean setting and has successfully given birth to two children one female and one male, her current status as a thriving young adult supports the resilience of the endocrine and reproductive systems when early exposure to EDCs is eliminated.

A proposed long-term care outline includes:

  • Annual gynaecological evaluations, with imaging only if symptoms suggest cyst recurrence.
  • Routine endocrine assessments every 3–5 years or if hormonally suggestive symptoms appear.
  • General health monitoring for metabolic and thyroid function.
  • Environmental toxin avoidance, including filtered water and low-exposure household products.
  • Emotional wellness support, if needed, to address medical trauma or reproductive anxiety.
  • Paediatric considerations for her children, with environmental awareness in household choices.

The successful reproductive outcomes and current wellbeing of the subject reinforce the importance of early intervention, environmental detoxification, relocation and ongoing care. Her story may serve as a valuable point of advocacy for paediatric environmental health.

 

6.      Conclusion and Recommendations

This case highlights a potential public health concern regarding environmental contamination and paediatric reproductive health. Given the endocrine-disrupting potential of AMD-associated contaminants, there is a pressing need for:

  • Longitudinal epidemiological studies in AMD-affected regions.
  • Routine environmental monitoring of water and air quality.
  • Public health awareness campaigns in vulnerable communities.

References

  • Coetzee, H., Winde, F., & Wade, P. (2006). An Assessment of Sources, Pathways, Mechanisms and Risks of Current and Potential Future Pollution of Water and Sediments in Gold-Mining Areas of the Wonderfonteinspruit Catchment. WRC Report.
  • Diamanti-Kandarakis, E., et al. (2009). Endocrine-disrupting chemicals: an Endocrine Society scientific statement. Endocrine Reviews, 30(4), 293-342.
  • Hobbs, P., & Cobbing, J. (2007). A Hydrogeological Assessment of Acid Mine Drainage Impacts in the West Rand Basin, Gauteng Province. CSIR Report.
  • Kavlock, R. J., et al. (1996). Research needs for the risk assessment of health and environmental effects of endocrine disruptors: A report of the U.S. EPA-sponsored workshop. Environmental Health Perspectives, 104(Suppl 4), 715–740.
  • Landrigan, P. J., et al. (2004). Children's health and the environment: Public health issues and challenges for risk assessment. Environmental Health Perspectives, 112(2), 257–265.
  • McCarthy, T. S. (2011). The impact of acid mine drainage in South Africa. South African Journal of Science, 107(5/6), 1–7.

 

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