The TSIP is focused entirely on low- and middle-income countries, as defined by the World Bank (2012). Within this group, further focus is placed on countries with large populations and industrial bases and with amenable political and security situations. To date, the TSIP has conducted and validated 406 mining-related waste sites in 45 countries (see Table 1). The sites are divided between 131 artisanal and small- scale gold mining (ASGM) sites and 275 industrial mining and ore processing sites. General observations on each group are supported by case studies at particular sites. The authors argue that the ISS provides an effective instrument for rapidly quantifying health risks posed at screened sites. The TSIP relies on locally hired investigators to identify potentially contaminated areas and carry out ISSs. Investigators are in-county nationals with advanced degrees in relevant environmental and health sciences. Investigators are overseen by country coordinators who manage the overall national program, including maintenance of government and private sector relationships. Where appropriate, government personnel accompany investigators on site visits and assist them in acquiring relevant data.