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Neurobehavioral deficits and Parkinsonism in occupations with manganese exposure: a review of methodological issues in the epidemiological literature.

Authors
Park-RM
Source
Saf Health Work 2013 Sep; 4(3):123-135
NIOSHTIC No.
20043298
Abstract
Exposure to manganese (Mn) is associated with neurobehavioral effects. There is disagreement on whether commonly occurring exposures in welding, ferroalloy, and other industrial processes produce neurologically significant neurobehavioral changes representing parkinsonism. A review of methodological issues in the human epidemiological literature on Mn identified: (1) studies focused on idiopathic Parkinson disease without considering manganism, a parkinsonian syndrome; (2) studies with healthy worker effect bias; (3) studies with problematic statistical modeling; and (4) studies arising from case series derived from litigation. Investigations with adequate study design and exposure assessment revealed consistent neurobehavioral effects and attributable subclinical and clinical signs and symptoms of impairment. Twenty-eight studies show an exposure-response relationship between Mn and neurobehavioral effects, including 11 with continuous exposure metrics and six with three or four levels of contrasted exposure. The effects of sustained low-concentration exposures to Mn are consistent with the manifestations of early manganism, i.e., consistent with parkinsonism. This is compelling evidence that Mn is a neurotoxic chemical and there is good evidence that Mn exposures far below the current US standard of 5.0 mg/m3 are causing impairment.
Keywords
Epidemiology; Manganese-compounds; Humans; Neurological-diseases; Behavioral-disorders; Neurological-diseases; Neurological-reactions; Clinical-symptoms; Welders; Welding; Metal-compounds; Metallic-compounds; Exposure-assessment; Dose-response; Neuromuscular-system-disorders; Neurotoxins; Exposure-levels; Author Keywords: manganism; neurobehavioral signs and symptoms; neuropsychological tests; welding
Contact
R.M. Park, National Institute for Occupational Safety and Health, Risk Evaluation Branch, 4676 Columbia Parkway, G15, Cincinnati, OH 45226, USA
CAS No.
7439-96-5
Publication Date
20130901
Document Type
Journal Article
Email Address
rhp9@cdc.gov
Fiscal Year
2013
NTIS Accession No.
NTIS Price
Identifying No.
M112013
Issue of Publication
3
ISSN
2093-7911
NIOSH Division
EID
Priority Area
Construction; Manufacturing
Source Name
Safety and Health at Work
State
OH
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