Mary Baldwin

Manganese cumulative exposure and symptoms : A follow-up study of alloy workers

Long-term exposure to manganese (Mn) particulates through inhalation can be neurotoxic, with deficits in neuromotor and cognitive domains. Mn-exposed individuals also report symptoms, including fatigue, mood changes, irritability, concentration difficulties, and sweating in the absence of physical effort. The long-term course of Mn-related symptoms after cessation of exposure has never been examined. Male workers from a Mn-alloy production plant participated in a study on nervous system functions (initial examination), and were followed-up 14 years after plant closure. The relation between self-reported symptoms and Mn cumulative exposure index (CEI) was examined among 71 Mn-alloy workers and 71 referents. Symptoms from the questionnaire were grouped into categories, and the reported frequency was compared between referents and Mn-alloy workers in each Mn CEI tertile using General Linear Models, controlling for age, education, and alcohol consumption. A gradual increase in symptoms frequency was observed for complaints related to hearing and movement control both at initial and follow-up examination, and fatigue and autonomic nervous system only at initial examination. In addition, an exposure-effect relation was apparent for symptoms related to memory, concentration and balance reported at both examinations, with Mn-workers in the highest CEI tertile reporting the highest level of symptomatology. Sleeping complaints were not associated with exposure to Mn, while musculoskeletal pain and muscular weakness were reported more often by Mn-workers than referents but were not clearly related to CEI. The findings suggest that former Mn-alloy workers continue to perceive symptoms many years after cessation of exposure. Despite the limitations of self-reported symptoms, subjective complaints are an important part of a health assessment since they relate directly to perceived health status and day-to-day functioning.

Ecosystem matters: Fish consumption, mercury intake and exposure among fluvial lake fish-eaters

Many studies use the number of fish meals as an estimate of Hg intake, although fish Hg concentrations, even within the same species, can greatly vary. Furthermore, most freshwater advisories only refer to local catch, while market fish advisories only focus on market fish, although both can contribute to Hg body burden. The present study, carried out in lakeside communities from 2 ecosystems in Quebec, Canada, sought to (i) estimate Hg intake from local freshwater sources, hunted waterfowl and market fish and seafood, and (ii) examine the relations between fish consumption, estimated Hg intake and biomarkers of exposure. A total of 238 adults (18-74 years), who had consumed local catch within the past three months, responded to an extensive interview-administered fish and waterfowl frequency questionnaire. Anthropometric measures were taken and a self-administered questionnaire was used to obtain socio-demographic information. Hg intake was estimated as microg Hg/kg body weight/day. Blood and hair samples were analyzed for Hg content. Results showed that persons from one ecosystem ate significantly more fish compared to those from the other (median: 52.1 g/day vs 38.9 g/day), but presented significantly lower concentrations of hair Hg (median: 448.0 ng/g vs 730.5 ng/g), blood organic Hg (median: 1.1 microg/L vs 3.4 microg/L) and inorganic Hg (median: 0.4 microg/L vs 0.8 microg/L). Median daily total Hg intake was 0.080 microg/kg bw/day for the former community and 0.141 microg/kg bw/day for the latter. Overall, 59.5% from the first ecosystem and 41.0% from the other, exceeded the US EPA RfD (0.1 microg/kg bw/day), while 13.2% and 6.0%, respectively, exceeded the Canadian tolerable daily intake (0.47 microg/kg bw/day) for adults. For the two groups, freshwater fish consumption frequency, but not total fish, was positively associated with bioindicators of Hg while estimated Hg intake from freshwater catch as well as from total fish consumption were positively related to Hg biomarkers. There was a positive relation between consumption and estimated Hg intake from freshwater fish and blood inorganic Hg. These findings indicate that the number of fish can be a poor surrogate for Hg exposure. The differences observed here for Hg intake and exposure reflect ecosystem disparities in fish diversity and Hg bioaccumulation. Studies and advisories need to consider Hg fish concentrations and fish-eating patterns in different ecosystems, as well as the contribution of market fish. The relation between fish consumption and inorganic Hg exposure, reported as well in other studies, needs to be further investigated.

Past Occupational Exposure to Airborne Manganese in a Manganese Alloy Plant

A retrospective exposure assessment of a group of manganese (Mn) alloy workers was performed in conjunction with a 2004 follow-up study, 14 years after cessation of exposure, to evaluate the long-term effects of occupational Mn exposure on neurobehavioral functions. The ferro- and silico-Mn alloy plant opened in 1973 and closed in 1991. The airborne total Mn (TMn) exposures for job groupings were established using personal sampling data from a 1991 industrial hygiene survey. Historical short-term total dust (TDust) data were used to estimate past TDust exposure for job groupings and plant areas. Relationships between Mn content and TDust from the 1991 survey, supported by sparse historical data, were used to estimate TMn content in the historical TDust data. Results showed past personal TDust exposure levels much higher than those found in 1991. Changes in TDust levels and corresponding TMn levels were a function of changes in ventilation, work practices, and operations, not of product (ferro- or silico-Mn). Relationships between TMn and respirable Mn (RMn) from area sampling in 1991 were used to estimate RMn exposure for the job groups. Work histories for 112 workers were developed from payroll records, questionnaires, and interviews and combined with Mn exposure estimates to develop cumulative exposure indices (CEIs). The TMn CEI ranged from 0.27 mg/m 3 × years to 100.24 mg/m 3 × years, with an AM of 24.40 mg/m 3 × years and a GM of 14.06 mg/m 3 × years. The RMn CEI had an AM of 2.95 mg/m 3 × years and a GM of 1.78 mg/m 3 × years with a range of 0.05–12.03 mg/m 3 × years. Overall average TMn exposure intensity, the TMn CEI divided by time worked in years for each worker, had an AM of 1.6 mg Mn/m 3 , a GM of 1.0 mg Mn/m 3 , range 0.02–6.2 6 mg Mn/m 3 . The results of the 2004 follow-up study showed several concentration-response relationships between TMn CEI and neurobehavioral outcomes, which suggest that increase in cumulative TMn exposure level has long-term consequences on the nervous system.

Respiratory manganese particle size, time-course and neurobehavioral outcomes in workers at a manganese alloy production plant.

The progression of manganism with chronic exposure to airborne manganese (Mn) is not well understood. Here, we further investigate the findings on exposure and neurobehavioral outcomes of workers from a silico- and ferromanganese production plant and non-exposed workers from the same community in 1990 and 2004, using a variety of exposure metrics that distinguish particle size and origin within the range of respirable airborne exposures. Mn exposure matrices for large respirable particulate (Mn-LRP, dust) and small respirable particulate (Mn-SRP, fume), based on process origins, were used together with detailed work histories since 1973 (plant opening), to construct exposure metrics including burdens and cumulative burdens with various clearance half-lives. For three out of eight 1990 neurobehavioral tests analyzed with linear regression models, duration of Mn exposure was the best predictor: Luria-Nebraska Neuropsychological Battery - Motor Scale, Trail-Making B and Finger Tapping. The Luria-Nebraska Motor Scale had the strongest association (t ∼ 5.0, p < 10(-6)). For outcomes on three other tests, the duration and Mn-SRP metrics were comparable: Trail Making Test A, Cancellation H and Stroop Color-Word Test (color/word subtest). Delayed Word Recall was best predicted by Mn-SRP (based on square root or truncated air-concentrations). The Word score on the Stroop Color-Word Test was the only outcome for which Mn-LRP was the leading predictor (t = -2.92, p = 0.003), while performance on the WAIS-R Digit Span Test was not significantly predicted by any metric. For outcomes evaluated in both 1990 and 2004, a mixed-effect linear regression model was used to examine estimates of within-individual trends. Duration and Mn-SRP were associated with performance on the Luria-Nebraska Motor Scale, as well as with other outcomes that appeared to have both reversible and progressive features, including Trail Making A and B, Cancellation H and Delayed Word Recall. With the mixed-effect model, Digit Span exhibited a significant irreversible association with exposure duration (t = -2.34, p = 0.021) and Mn-SRP (square root; t = -2.38, p = 0.019) metrics. The strong prediction using duration of exposure is consistent with effective homeostatic regulation of tissue-level Mn in the observed exposure range of respirable Mn (< 0.2mg/m(3)).