Occupational Health Division, School of Public Health, University of the Witwatersrand, Johannesburg, South Africa.
Department of Neurology, Washington University School of Medicine, St Louis, Missouri.
Am J Ind Med. 2020 Jan;63(1):36-43. doi: 10.1002/ajim.23060. Epub 2019 Oct 24.
Manganese (Mn) neurotoxicity is associated with parkinsonism; the associated motor deficits can affect individuals' quality of life (QoL). We investigated associations between Mn exposure, parkinsonian signs, and QoL in Mn mine workers.
We assessed parkinsonian signs and QoL in 187 black South African Mn mine workers, using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3) and the Parkinson Disease Questionnaire (PDQ-39), respectively. We estimated cumulative Mn exposure in mg Mn/m -years using complete occupational histories and a job-exposure matrix. We investigated the cross-sectional association between cumulative Mn exposure and UPDRS3 score, and the UPDRS3 score and PDQ-39, adjusting for age, using linear regression.
Participants' mean age was 41.8 years (range, 21-67 years); 97.3% were male. Estimated mean cumulative Mn exposure at the time of examination was 5.4 mg Mn/m -years, with a mean of 14.0 years working in a Mn mine. The mean UPDRS3 score was 10.1 and 25.7% of the workers had a UPDRS3 score greater than or equal to 15. There was a U-shaped dose-response relation between cumulative Mn exposure and UPDRS3 score, with a positive association up to 15 mg Mn/m -years of exposure and an inverse association thereafter. Greater UPDRS3 scores were associated with poorer self-reported QoL.
In this cohort of employed Mn mine workers, parkinsonian signs were common and were associated with both estimated cumulative Mn exposure and poorer QoL.
锰（Mn）神经毒性与帕金森病有关；相关的运动障碍会影响个体的生活质量（QoL）。我们研究了 Mn 暴露、帕金森病迹象与 Mn 矿工人生活质量之间的关联。
我们使用统一帕金森病评定量表运动部分 3（UPDRS3）和帕金森病问卷（PDQ-39）分别评估了 187 名南非黑人 Mn 矿工人的帕金森病迹象和生活质量。我们使用完整的职业史和职业暴露矩阵来估计累积 Mn 暴露量（mg Mn/m-年）。我们调查了累积 Mn 暴露与 UPDRS3 评分之间的横断面关联，以及 UPDRS3 评分与 PDQ-39 之间的关联，调整了年龄因素，使用线性回归。
参与者的平均年龄为 41.8 岁（范围 21-67 岁）；97.3%为男性。检查时估计的平均累积 Mn 暴露量为 5.4mg Mn/m-年，平均有 14.0 年在 Mn 矿工作。UPDRS3 评分的平均值为 10.1，25.7%的工人 UPDRS3 评分大于或等于 15。累积 Mn 暴露量与 UPDRS3 评分之间存在 U 形剂量反应关系，暴露量在 15mg Mn/m-年以下时呈正相关，此后呈负相关。更高的 UPDRS3 评分与更差的自我报告生活质量相关。
在这组在职 Mn 矿工人中，帕金森病迹象很常见，与估计的累积 Mn 暴露量和较差的生活质量都有关。
