an approach to estimating the contribution of mining and metals processing to the overall global burden of disease from legacy and artisanal pollution. The health of more than seven million people was found to be at risk from mining locations globally. This risk was posed by 131 ASGM and 275 industrial mining and ore processing locations in 45 different countries. Sites were evaluated during visits carried out by investigators hired and trained by Blacksmith Institute. The investigation instrument, the ISS, captured data at each site in a uniform way, allows for comparison between different types of sites. The ISS is well suited for its intended purpose of prioritizing sites for further investigation or remedial activity. The ISS is focused on health risks,