Minnesota Department of Health, Saint Paul, Minnesota, USA.
Environ Health Perspect. 2021 Apr;129(4):47011. doi: 10.1289/EHP7901. Epub 2021 Apr 13.
High oral exposure and biological vulnerabilities may put formula-fed infants at risk for manganese-induced neurotoxicity.
We sought to characterize manganese concentrations in public drinking water and prepared infant formulas commonly purchased in the United States, integrate information from these sources into a health risk assessment specific to formula-fed infants, and examine whether households that receive water with elevated manganese concentrations avoid or treat the water, which has implications for formula preparation.
Manganese was measured in 27 infant formulas and nearly all Minnesota community public water systems (CPWS). The risk assessment produced central tendency and upper-end exposure estimates that were compared to a neonatal animal-based health reference dose (RfD) and considered possible differences in bioavailability. A survey study assessed esthetic concerns, treatment, and use of water in a Twin Cities community with various levels of manganese in drinking water.
Ten percent of CPWSs were estimated to exceed the EPA health advisory level of . Manganese concentrations in formula ranged from 69.8 to , with amino formula concentrations. Central tendency estimates of soy and amino acid formula reconstituted with water at the CPWS 95th percentile manganese concentration exceeded the neonatal-based RfD. Upper-end estimates of manganese intake from formula alone, independent of any water contribution, equaled or exceeded the neonatal-based RfD. In the survey study, we observed increased awareness of esthetic issues and water avoidance at higher manganese concentrations, but these concentrations were not a reliable consumption deterrent, as the majority of households with inside tap drinking water results above reported drinking the water.
Excessive exposure to manganese early in life can have long-lasting neurological impacts. This assessment underscores the potential for manganese overexposure in formula-fed infants. U.S. agencies that regulate formula and drinking water must work collaboratively to assess and mitigate potential risks. https://doi.org/10.1289/EHP7901.
高口服暴露量和生物脆弱性可能使配方奶喂养的婴儿面临锰诱导的神经毒性风险。
我们旨在描述美国常见的公共饮用水和婴儿配方食品中的锰浓度，将这些来源的信息整合到针对配方奶喂养婴儿的特定健康风险评估中，并研究是否存在摄入高浓度锰水的家庭会选择避免或处理这些水，这对配方奶的制备有影响。
我们测量了 27 种婴儿配方食品和明尼苏达州几乎所有社区公共供水系统（CPWS）中的锰浓度。风险评估产生了中心趋势和上限暴露估计值，将其与基于新生动物的健康参考剂量（RfD）进行了比较，并考虑了生物利用度的可能差异。一项调查研究评估了明尼阿波利斯市一个社区的美学问题、水的处理和使用情况，该社区的饮用水中锰含量存在差异。
估计有 10%的 CPWS 超过了 EPA 的健康咨询水平。配方食品中的锰浓度范围为 69.8 至 ，其中氨基酸配方的浓度最高。以 CPWS 第 95 百分位数锰浓度配制的大豆和氨基酸配方的中心趋势估计值超过了基于新生动物的 RfD。仅从配方中摄入锰的上限估计值，无论水的贡献如何，都等于或超过了基于新生动物的 RfD。在调查研究中，我们观察到在更高的锰浓度下，对美学问题和水的回避意识增加，但这些浓度并不是可靠的消费抑制因素，因为大多数家庭的内部水龙头饮用水结果高于报告的饮用水。
生命早期过度接触锰可能会对神经系统造成持久影响。这项评估强调了配方奶喂养婴儿中锰暴露过量的潜在风险。监管配方奶和饮用水的美国机构必须共同合作，评估和减轻潜在风险。https://doi.org/10.1289/EHP7901.
