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Wang S, Lyu Y, Ji S, Liu N, Wu B, Zhao F, Li Z, Qu Y, Zhu Y, Xie L, Li Y, Zhang Z, Song H, Hu X, Qiu Y, Zheng X, Zhang W, Yang Y, Li F, Cai J, Zhu Y, Cao Z, Tan F, Shi X. Heavy metals and metalloids exposure and liver function in Chinese adults - A nationally representative cross-sectional study. ENVIRONMENTAL RESEARCH 2024; 252:118653. [PMID: 38518907 DOI: 10.1016/j.envres.2024.118653] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/23/2023] [Revised: 02/16/2024] [Accepted: 03/05/2024] [Indexed: 03/24/2024]
Abstract
BACKGROUND In China, the effects of heavy metals and metalloids (HMMs) on liver health are not consistently documented, despite their prevalent environmental presence. OBJECTIVE Our research assessed the association between HMMs and liver function biomarkers in a comprehensive sample of Chinese adults. METHODS We analyzed data from 9445 participants in the China National Human Biomonitoring survey. Blood and urine were evaluated for HMM concentrations, and liver health was gauged using serum albumin (ALB), alanine aminotransferase (ALT), and aspartate aminotransferase (AST) metrics. Various statistical methods were employed to understand the relationship between 11 HMMs and liver function, adjusting for multiple factors. We also explored interactions with alcohol intake, gender, and age. RESULTS Among HMMs, selenium in blood [weighted geometric mean (GM) = 95.56 μg/L] and molybdenum in urine (GM = 46.44 μg/L) showed the highest concentrations, while lead in blood (GM = 21.92 μg/L) and arsenic in urine (GM = 19.80 μg/L) had the highest levels among risk HMMs. Manganese and thallium consistently indicated potential risk factor to liver in both sample types, while selenium displayed potential liver protection. Blood HMM mixtures were negatively associated with ALB (β = -0.614, 95% CI: -0.809, -0.418) and positively with AST (β = 0.701, 95% CI: 0.290, 1.111). No significant associations were found in urine HMM mixtures. Manganese, tin, nickel, and selenium were notable in blood mixture associations, with selenium and cobalt being significant in urine. The relationship of certain HMMs varied based on alcohol consumption. CONCLUSION This research highlights the complex relationship between HMM exposure and liver health in Chinese adults, particularly emphasizing metals like manganese, thallium, and selenium. The results suggest a need for public health attention to low dose HMM exposure and underscore the potential benefits of selenium for liver health. Further studies are essential to establish causality.
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Affiliation(s)
- Shiyu Wang
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuebin Lyu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Saisai Ji
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Nankun Liu
- Chinese Center for Disease Control and Prevention, Beijing, China
| | - Bing Wu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Zhao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zheng Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yingli Qu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yuanduo Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Linna Xie
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yawei Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zheng Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Haocan Song
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaojian Hu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yidan Qiu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Institute of Environmental Health, School of Public Health, and Bioelectromagnetics Laboratory, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xulin Zheng
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Wenli Zhang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yanwei Yang
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fangyu Li
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jiayi Cai
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ying Zhu
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhaojin Cao
- China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Feng Tan
- Chinese Center for Disease Control and Prevention, Beijing, China.
| | - Xiaoming Shi
- Chinese Center for Disease Control and Prevention, Beijing, China; China CDC Key Laboratory of Environment and Population Health, National Institute of Environmental Health, Chinese Center for Disease Control and Prevention, Beijing, China; Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu, China.
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Lane JM, Curtin P, Chelonis JJ, Pantic I, Martinez-Medina S, Téllez-Rojo MM, Wright RO. Prenatal manganese biomarkers and operant test battery performance in Mexican children: Effect modification by child sex. ENVIRONMENTAL RESEARCH 2023; 236:116880. [PMID: 37574101 PMCID: PMC10919280 DOI: 10.1016/j.envres.2023.116880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2023] [Revised: 08/10/2023] [Accepted: 08/11/2023] [Indexed: 08/15/2023]
Abstract
BACKGROUND Manganese (Mn) is essential to healthy neurodevelopment, but both Mn deficiency and over-exposure have been linked to prefrontal cortex (PFC) impairments, the brain region that regulates cognitive and neurobehavioral processes responsible for spatial memory, learning, motivation, and time perception. These processes facilitated by attention, inhibitory control, working memory, and cognitive flexibility are often sexually dimorphic and complex, driven by multiple interconnected neurologic and cognitive domains. OBJECTIVE We investigated the role of child sex as an effect modifier of the association between prenatal Mn exposure and performance in an operant testing battery (OTB) that assessed multiple cognitive and behavioral functional domains. METHODS Children (N = 575) aged 6-8 years completed five OTB tasks. Blood and urinary Mn measurements were collected from mothers in the 2nd and 3rd trimesters. Multiple regression models estimated the association between Mn biomarkers at each trimester with OTB performance while adjusting for socio-demographic covariates. Covariate-adjusted weighted quantile sum (WQS) regression models were used to estimate the association of a Mn multi-media biomarker (MMB) mixture with OTB performance. Interaction terms were used to estimate modification effect by child sex. RESULTS Higher blood Mn exposure was associated with better response rates (more motivation) on the progressive ratio task and higher overall accuracy on the delayed matching-to-sample task. In the WQS models, the MMB mixture was associated with better response rates (more motivation) on the progressive ratio task. Additionally, for the linear and WQS models, we observed a modification effect by child sex in the progressive ratio and delayed matching-to-sample tasks. Higher prenatal Mn biomarker levels were associated with improved task performance for girls and reduced performance in boys. CONCLUSION Higher prenatal blood Mn concentrations and the MMB mixture predicted improved performance on two of five operant tasks. Higher prenatal Mn concentrations regulated executive functions in children in a sexually dimorphic manner. Higher prenatal Mn exposure is associated with improved performance on spatial memory and motivation tasks in girls, suggesting that Mn's nutritional role is sexually dimorphic, and should be considered when making dietary and/or environmental intervention recommendations.
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Affiliation(s)
- Jamil M Lane
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Paul Curtin
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - John J Chelonis
- Division of Neurotoxicology, National Center for Toxicological Research, FDA, Jefferson, AR, USA
| | - Ivan Pantic
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Sandra Martinez-Medina
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, National Institute of Public Health, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, USA
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3
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Levin-Schwartz Y, Cowell W, Leon Hsu HH, Enlow MB, Amarasiriwardena C, Andra SS, Wright RJ, Wright RO. Metal mixtures are associated with increased anxiety during pregnancy. ENVIRONMENTAL RESEARCH 2022; 204:112276. [PMID: 34717944 PMCID: PMC8671328 DOI: 10.1016/j.envres.2021.112276] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Revised: 09/29/2021] [Accepted: 10/22/2021] [Indexed: 06/13/2023]
Abstract
BACKGROUND Exposure to low-dose toxic metals in the environment is ubiquitous. Several murine studies have shown metals induce anxiety-like behaviors, and mechanistic research supports that metals disrupt neurotransmitter signaling systems implicated in the pathophysiology of anxiety. In this study, we extend prior research by examining joint exposure to six metals in relation to maternal anxiety symptoms during pregnancy. METHODS The sample includes 380 participants enrolled in the PRogramming of Intergenerational Stress Mechanisms (PRISM) pregnancy cohort. Spot urine was collected during pregnancy (mean ± standard deviation: 31.1 ± 6.1 weeks), and concentrations of six metals (barium [Ba], cadmium [Cd], chromium [Cr], cesium [Cs], lead [Pb], antimony [Sb]) were measured by Inductively Coupled Plasma - Mass Spectrometry. Trait anxiety symptoms were measured during pregnancy using a short version of the Spielberger State Trait Anxiety Inventory (STAI-T) and information on covariates was collected by questionnaire. We used weighted quantile sum (WQS) regression as the primary modeling approach to examine metals, treated as a mixture, in relation to higher (≥20) vs. lower anxiety symptoms while adjusting for urinary creatinine and key sociodemographic variables. RESULTS The sample is socioeconomically and racially/ethnically diverse. Urinary metal concentrations were log-normally distributed and 25% of the sample had an STAI-T score ≥20. Joint exposure to metals was associated with elevated anxiety symptoms (ORWQS = 1.56, 95% CI: 1.24, 1.96); Cd (61.8%), Cr (14.7%), and Cs (12.7%) contributed the greatest weight to the mixture effect. CONCLUSION Exposure to metals in the environment may be associated with anxiety symptoms during pregnancy. This is a public health concern, as anxiety disorders are highly prevalent and associated with significant co-morbidities, especially during pregnancy when both the mother and developing fetus are susceptible to adverse health outcomes.
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Affiliation(s)
- Yuri Levin-Schwartz
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Whitney Cowell
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Hsiao-Hsien Leon Hsu
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Michelle Bosquet Enlow
- Department of Psychiatry, Boston Children's Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Syam S Andra
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Rosalind J Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Kravis Children's Hospital, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Robert O Wright
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Institute for Exposomic Research, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Baj J, Teresiński G, Forma A, Flieger M, Proch J, Niedzielski P, Grochowski C, Blicharska E, Buszewicz G, Bogucki J, Majerek D, Karakuła K, Czeczelewski M, Flieger J. Chronic Alcohol Abuse Alters Hepatic Trace Element Concentrations-Metallomic Study of Hepatic Elemental Composition by Means of ICP-OES. Nutrients 2022; 14:nu14030546. [PMID: 35276905 PMCID: PMC8838438 DOI: 10.3390/nu14030546] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 01/25/2022] [Accepted: 01/25/2022] [Indexed: 02/06/2023] Open
Abstract
Trace element accumulation varies in different human tissues. Distribution of several elements was found to be disrupted in the case of excessive alcohol consumption, causing negative effects and exacerbation of pathological processes in the liver. In this study, we analyzed the levels and interactions between seven trace elements including calcium (Ca), cobalt (Co), chromium (Cr), copper (Cu), iron (Fe), potassium (K), and magnesium (Mg), manganese (Mn), sodium (Na), zinc (Zn), and selenium (Se) in individuals with alcohol-use disorder (AUD) and patients without AUD (control group). The liver samples were collected during autopsy from 39 individuals with AUD and 45 control subjects. Elemental composition inductively coupled plasma optical emission spectrometry (ICP-OES) after wet mineralization by nitric acid was applied for the evaluation of the samples. Positive correlations dominated in the AUD group, mainly in relation to Mg, which strongly positively correlated with Ca, Mn, Fe; K correlated with Mn and Zn, and Cu positively correlated with K and Zn. The strongest positive correlation in the AUD group was observed for the Mg-Mn pair (r = 0.87). Significant statistical differences (p < 0.05) between the groups concerned the average concentration of Co, Cu, Mn, and Mg, which were lower in the AUD group, and Fe, the level of which was significantly higher in the AUD group compared to the control group. Evaluation of the chronic alcohol consumption effect on the accumulation of trace elements in the liver allows a better understanding of the pathological processes taking place in this organ.
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Affiliation(s)
- Jacek Baj
- Department of Anatomy, Medical University of Lublin, Jaczewskiego 4 (Collegium Anatomicum), 20-090 Lublin, Poland;
- Correspondence:
| | - Grzegorz Teresiński
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b (Collegium Pathologicum), 20-090 Lublin, Poland; (G.T.); (A.F.); (G.B.); (M.C.)
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b (Collegium Pathologicum), 20-090 Lublin, Poland; (G.T.); (A.F.); (G.B.); (M.C.)
| | - Michał Flieger
- Department of Anatomy, Medical University of Lublin, Jaczewskiego 4 (Collegium Anatomicum), 20-090 Lublin, Poland;
| | - Jędrzej Proch
- Department of Analytical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, 89B Umultowska Street, 61-614 Poznan, Poland; (J.P.); (P.N.)
| | - Przemysław Niedzielski
- Department of Analytical Chemistry, Faculty of Chemistry, Adam Mickiewicz University, 89B Umultowska Street, 61-614 Poznan, Poland; (J.P.); (P.N.)
| | - Cezary Grochowski
- Laboratory of Virtual Man, Medical University of Lublin, Jaczewskiego 4 (Collegium Anatomicum), 20-439 Lublin, Poland;
| | - Eliza Blicharska
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland; (E.B.); (J.F.)
| | - Grzegorz Buszewicz
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b (Collegium Pathologicum), 20-090 Lublin, Poland; (G.T.); (A.F.); (G.B.); (M.C.)
| | - Jacek Bogucki
- Department of Organic Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland;
| | - Dariusz Majerek
- Department of Applied Mathematics, University of Technology, Nadbystrzycka 38D, 20-618 Lublin, Poland;
| | - Kaja Karakuła
- Department of Psychiatry, Psychotherapy and Early Intervention, Medical University of Lublin, Głuska 1 (SPSK Nr 1), 20-439 Lublin, Poland;
| | - Marcin Czeczelewski
- Department of Forensic Medicine, Medical University of Lublin, Jaczewskiego 8b (Collegium Pathologicum), 20-090 Lublin, Poland; (G.T.); (A.F.); (G.B.); (M.C.)
| | - Jolanta Flieger
- Department of Analytical Chemistry, Medical University of Lublin, Chodźki 4A, 20-093 Lublin, Poland; (E.B.); (J.F.)
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Racette BA, Nelson G, Dlamini WW, Hershey T, Prathibha P, Turner JR, Checkoway H, Sheppard L, Searles Nielsen S. Depression and anxiety in a manganese-exposed community. Neurotoxicology 2021; 85:222-233. [PMID: 34087333 DOI: 10.1016/j.neuro.2021.05.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2021] [Revised: 05/24/2021] [Accepted: 05/31/2021] [Indexed: 11/24/2022]
Abstract
OBJECTIVE To characterize the association between residential environmental manganese (Mn) exposure and depression and anxiety, given prior associations among occupationally-exposed workers. METHODS We administered the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) to 697 study participants in their preferred languages. These participants represented a population-based sample of residents aged ≥40 from two predominantly Black African communities in Gauteng province, South Africa: 605 in Meyerton, adjacent to a large Mn smelter, and 92 in Ethembalethu, a comparable non-exposed community. We investigated the associations between community (Meyerton vs. Ethembalethu) and severity of depression and anxiety, using linear regression, adjusting for age and sex. To document community-level differences in Mn exposure, we measured airborne PM2.5-Mn. RESULTS Meyerton residents had BDI scores 5.63 points (95 % CI 3.07, 8.20) higher than Ethembalethu residents, with all questions contributing to this significant difference. STAI-state scores were marginally higher in Meyerton than Ethembalethu residents [2.12 (95 % CI -0.17, 4.41)], whereas STAI-trait scores were more similar between the communities [1.26 (95 % CI -0.82, 3.35)]. Mean PM2.5-Mn concentration was 203 ng/m3 at a long-term fixed site in Meyerton and 10 ng/m3 in Ethembalethu. CONCLUSION Residence near Mn emission sources may be associated with greater depression symptomatology, and possibly current, but not lifetime, anxiety.
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Affiliation(s)
- Brad A Racette
- Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA; School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, South Africa.
| | - Gill Nelson
- School of Public Health, Faculty of Health Sciences, University of the Witwatersrand, 7 York Road, Parktown, 2193, South Africa.
| | - Wendy W Dlamini
- Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA.
| | - Tamara Hershey
- Departments of Psychiatry and Radiology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8225, St. Louis, MO, 63110, USA.
| | - Pradeep Prathibha
- Department of Energy, Environmental, and Chemical Engineering, Washington University, Campus Box 1180, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Jay R Turner
- Department of Energy, Environmental, and Chemical Engineering, Washington University, Campus Box 1180, One Brookings Drive, St. Louis, MO, 63130, USA.
| | - Harvey Checkoway
- Herbert Wertheim School of Public Health, University of California, San Diego, 9500 Gilman Drive, #0725, La Jolla, CA, 92093, USA.
| | - Lianne Sheppard
- Departments of Biostatistics and Environmental and Occupational Health Sciences, Box 357232, University of Washington, Seattle, WA, 98195, USA.
| | - Susan Searles Nielsen
- Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO, 63110, USA.
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Dickerson AS, Wu AC, Liew Z, Weisskopf M. A Scoping Review of Non-Occupational Exposures to Environmental Pollutants and Adult Depression, Anxiety, and Suicide. Curr Environ Health Rep 2020; 7:256-271. [PMID: 32533365 PMCID: PMC7483936 DOI: 10.1007/s40572-020-00280-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
PURPOSE OF REVIEW Despite a call for better understanding of the role of environmental pollutant influences on mental health and the tremendous public health burden of mental health, this issue receives far less attention than many other effects of pollutants. Here we summarize the body of literature on non-occupational environmental pollutant exposures and adult depression, anxiety, and suicide-in PubMed, Embase, Web of Science, and PsychINFO through the end of year 2018. RECENT FINDINGS One hundred twelve articles met our criteria for further review. Of these, we found 88 articles on depression, 33 on anxiety, and 22 on suicide (31 articles covered multiple outcomes). The earliest article was published in 1976, and the most frequent exposure of interest was air pollution (n = 33), followed by secondhand smoke (n = 20), metals (n = 18), noise (n = 17), and pesticides (n = 10). Other exposures studied less frequently included radiation, magnetic fields, persistent organic pollutants (POPs), volatile organic compounds, solvents, and reactive sulfur compounds. The current literature, although limited, clearly suggests many kinds of environmental exposures may be risk factors for depression, anxiety, and suicide. For several pollutants, important limitations exist with many of the studies. Gaps in the body of research include a need for more longitudinal, life-course studies, studies that can measure cumulative exposures as well as shorter-term exposures, studies that reduce the possibility of reverse causation, and mechanistic studies focused on neurotoxic exposures.
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Affiliation(s)
- Aisha S Dickerson
- Departments of Epidemiology and Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Alexander C Wu
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, 02115, USA
| | - Zeyan Liew
- Department of Environmental Health Sciences, Center for Perinatal Pediatric, and Environmental Epidemiology, Yale School of Public Health, New Haven, CT, 06510, USA
| | - Marc Weisskopf
- Departments of Epidemiology and Environmental Health, Harvard T.H. Chan School of Public Health, 665 Huntington Avenue, Building 1, Suite 1402, Boston, MA, 02115, USA.
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McRae N, Bello G, Svensson K, Solano-González M, Wright RJ, Niedzwiecki MM, Calapiz MT, Amarasiriwardena C, Schnaas L, Tamayo-Ortiz M, Téllez-Rojo MM, Wright RO. Blood manganese levels during pregnancy and postpartum depression: A cohort study among women in Mexico. Neurotoxicology 2020; 76:183-190. [PMID: 31730893 PMCID: PMC6980678 DOI: 10.1016/j.neuro.2019.11.005] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/16/2019] [Accepted: 11/11/2019] [Indexed: 01/09/2023]
Abstract
BACKGROUND Occupational studies have shown an association between elevated Mn exposure and depressive symptoms. Blood Mn (BMn) naturally rises during pregnancy due to mobilization from tissues, suggesting it could contribute to pregnancy and postpartum depressive symptoms. OBJECTIVES To assess the association between BMn levels during pregnancy and postpartum depression (PPD), creating opportunities for possible future interventions. METHODS We studied 561 women from the reproductive longitudinal Programming Research in Obesity, Growth, Environment, and Social Stressors (PROGRESS) cohort in Mexico City. BMn was measured at the 2nd and 3rd trimesters, as well as delivery. The Edinburgh Postnatal Depression Scale (EPDS) was used to assess PPD symptoms at 12-months postpartum. We used a generalized linear model assuming a Poisson distribution to assess the association between BMn levels and PPD, with adjustments for age, stress and depressive symptoms during pregnancy, education, socioeconomic status, and contemporaneous blood lead levels. RESULTS The mean ± standard deviation (SD) EPDS score at 12-months postpartum was 6.51 ± 5.65, and 17.11% of women met the criteria for possible PPD (score ≥ 13). In adjusted models, BMn during the 3rd trimester (β: 0.13, 95% CI: 0.04-0.21) and BMn levels averaged at the 2nd and 3rd trimester (β: 0.14, 95% CI: 0.02-0.26) had a positive association with EPDS scores at 12 months postpartum. BMn at the 2nd trimester (β: 0.07, 95% CI: -0.09-0.22) and delivery (β: 0.03, 95% CI: -0.04-0.10) had a non-significant positive association with EPDS scores at 12-months postpartum. Stress and depressive symptoms during pregnancy was associated with higher EPDS scores at 12-months postpartum in all of the adjusted models but were only significant when either BMn during 3rd trimester or BMn averaged across 2nd and 3rd trimester was assessed as the exposure. DISCUSSION Our results demonstrate that elevated BMn levels during pregnancy predict PPD symptoms and could be a potential pathway for intervention and prevention of PPD.
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Affiliation(s)
- Nia McRae
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Ghalib Bello
- London Institute of Medical Sciences, Imperial College, London, UK
| | | | - Maritsa Solano-González
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Rosalind J Wright
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Megan M Niedzwiecki
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mariana Torres Calapiz
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Chitra Amarasiriwardena
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lourdes Schnaas
- Division of Community Interventions Research, National Institute of Perinatology, Mexico City, Mexico
| | - Marcela Tamayo-Ortiz
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico; Consejo Nacional de Ciencia y Tecnología, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Martha M Téllez-Rojo
- Center for Nutrition and Health Research, Instituto Nacional de Salud Pública, Cuernavaca, Morelos, Mexico
| | - Robert O Wright
- Department of Environmental Medicine & Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Grochowski C, Blicharska E, Baj J, Mierzwińska A, Brzozowska K, Forma A, Maciejewski R. Serum iron, Magnesium, Copper, and Manganese Levels in Alcoholism: A Systematic Review. Molecules 2019; 24:E1361. [PMID: 30959950 PMCID: PMC6480471 DOI: 10.3390/molecules24071361] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2019] [Revised: 04/03/2019] [Accepted: 04/06/2019] [Indexed: 01/03/2023] Open
Abstract
The aim of this paper was to review recent literature (from 2000 onwards) and summarize the newest findings on fluctuations in the concentration of some essential macro- and microelements in those patients with a history of chronic alcohol abuse. The focus was mainly on four elements which the authors found of particular interest: Iron, magnesium, copper, and manganese. After independently reviewing over 50 articles, the results were consistent with regard to iron and magnesium. On the other hand, data were limited, and in some cases contradictory, as far as copper and manganese were concerned. Iron overload and magnesium deficiency are two common results of an excessive and prolonged consumption of alcohol. An increase in the levels of iron can be seen both in the serum and within the cells, hepatocytes in particular. This is due to a number of factors: Increased ferritin levels, lower hepcidin levels, as well as some fluctuations in the concentration of the TfR receptor for transferrin, among others. Hypomagnesemia is universally observed among those suffering from alcoholism. Again, the causes for this are numerous and include malnutrition, drug abuse, respiratory alkalosis, and gastrointestinal problems, apart from the direct influence of excessive alcohol intake. Unfortunately, studies regarding the levels of both copper and manganese in the case of (alcoholic) liver disease are scarce and often contradictory. Still, the authors have attempted to summarize and give a thorough insight into the literature available, bearing in mind the difficulties involved in the studies. Frequent comorbidities and mutual relationships between the elements in question are just some of the complications in the study of this topic.
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Affiliation(s)
- Cezary Grochowski
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (J.B.); (R.M.)
- Department of Neurosurgery and Pediatric Neurosurgery, Medical University of Lublin, 20-090 Lublin, Poland
| | - Eliza Blicharska
- Department of Analitical Chemistry, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Jacek Baj
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (J.B.); (R.M.)
| | - Aleksandra Mierzwińska
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (A.M.); (K.B.); aforma@o2pl (A.F.)
| | - Karolina Brzozowska
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (A.M.); (K.B.); aforma@o2pl (A.F.)
| | - Alicja Forma
- Department of Forensic Medicine, Medical University of Lublin, 20-090 Lublin, Poland; (A.M.); (K.B.); aforma@o2pl (A.F.)
| | - Ryszard Maciejewski
- Chair and Department of Anatomy, Medical University of Lublin, 20-090 Lublin, Poland; (J.B.); (R.M.)
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Liu Y, Rolle-McFarland D, Mostafaei F, Zhou Y, Li Y, Zheng W, Wells E, Nie LH. In vivo neutron activation analysis of bone manganese in workers. Physiol Meas 2018; 39:035003. [PMID: 29328060 DOI: 10.1088/1361-6579/aaa749] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
OBJECTIVE Manganese (Mn) is a neurotoxin. However, the impact of elevated, chronic Mn exposure is not well understood, partially due to the lack of a cumulative exposure biomarker. To address this gap, our group developed a compact in vivo neutron activation analysis (IVNAA) system to quantify Mn concentration in bone (MnBn). APPROACH In this study, we used this system and determined MnBn among male Chinese workers and compared results to their blood Mn (MnB), a measure of recent exposure, and the years of employment, a measure of cumulative exposure. A cross-sectional study was conducted with 30 ferroalloy smelters (exposed) and 30 general manufacturing workers (controls). MnBn was assessed using IVNAA, MnB was measured with inductively coupled plasma mass spectrometry, and occupational history and demographics were obtained via questionnaire. Mn-doped phantoms were used to generate a calibration curve; spectra from these phantoms were consistent with in vivo spectra. MAIN RESULTS The median (interquartile range (IQR)) values for Mn biomarkers were 2.7 µg g-1 (7.2) for MnBn and 14.1 µg l-1 (4.0) for MnB. In regression models adjusted for age and education, the natural log transformed MnBn (ln(MnBn)) was significantly associated with the exposed/control status (β = 0.44, p = 0.047) and years of employment (β = 0.05, p = 0.002), but not with natural log transformed MnB (ln(MnB)) (β = 0.54, p = 0.188). SIGNIFICANCE Our results support the use of IVNAA to quantify MnBn and the use of MnBn as a biomarker of cumulative Mn exposure.
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Affiliation(s)
- Yingzi Liu
- School of Health Sciences, Purdue University, West Lafayette, IN 47906, United States of America. Willis-Knighton Cancer Center, Shreveport, LA 71105, United States of America
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Mandal M, Basu S. Development of a new radioanalytical technique for the determination of manganese(II) using potassium periodate. RADIOCHEMISTRY 2017. [DOI: 10.1134/s1066362217020102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Menon AV, Chang J, Kim J. Mechanisms of divalent metal toxicity in affective disorders. Toxicology 2015; 339:58-72. [PMID: 26551072 DOI: 10.1016/j.tox.2015.11.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Revised: 10/19/2015] [Accepted: 11/03/2015] [Indexed: 01/01/2023]
Abstract
Metals are required for proper brain development and play an important role in a number of neurobiological functions. The divalent metal transporter 1 (DMT1) is a major metal transporter involved in the absorption and metabolism of several essential metals like iron and manganese. However, non-essential divalent metals are also transported through this transporter. Therefore, altered expression of DMT1 can modify the absorption of toxic metals and metal-induced toxicity. An accumulating body of evidence has suggested that increased metal stores in the brain are associated with elevated oxidative stress promoted by the ability of metals to catalyze redox reactions, resulting in abnormal neurobehavioral function and the progression of neurodegenerative diseases. Metal overload has also been implicated in impaired emotional behavior, although the underlying mechanisms are not well understood with limited information. The current review focuses on psychiatric dysfunction associated with imbalanced metabolism of metals that are transported by DMT1. The investigations with respect to the toxic effects of metal overload on behavior and their underlying mechanisms of toxicity could provide several new therapeutic targets to treat metal-associated affective disorders.
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Affiliation(s)
| | - JuOae Chang
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA
| | - Jonghan Kim
- Department of Pharmaceutical Sciences, Northeastern University, Boston, MA 02115, USA.
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12
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Ellingsen DG, Kusraeva Z, Bast-Pettersen R, Zibarev E, Chashchin M, Thomassen Y, Chashchin V. The interaction between manganese exposure and alcohol on neurobehavioral outcomes in welders. Neurotoxicol Teratol 2014; 41:8-15. [DOI: 10.1016/j.ntt.2013.11.004] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2013] [Revised: 10/31/2013] [Accepted: 11/12/2013] [Indexed: 12/18/2022]
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13
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Liu Y, Koltick D, Byrne P, Wang H, Zheng W, Nie LH. Development of a transportable neutron activation analysis system to quantify manganese in bone in vivo: feasibility and methodology. Physiol Meas 2013; 34:1593-609. [PMID: 24165395 PMCID: PMC4154064 DOI: 10.1088/0967-3334/34/12/1593] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
This study was conducted to investigate the methodology and feasibility of developing a transportable neutron activation analysis (NAA) system to quantify manganese (Mn) in bone using a portable deuterium-deuterium (DD) neutron generator as the neutron source. Since a DD neutron generator was not available in our laboratory, a deuterium-tritium (DT) neutron generator was used to obtain experimental data and validate the results from Monte Carlo (MC) simulations. After validation, MC simulations using a DD generator as the neutron source were then conducted. Different types of moderators and reflectors were simulated, and the optimal thicknesses for the moderator and reflector were determined. To estimate the detection limit (DL) of the system, and to observe the interference of the magnesium (Mg) γ line at 844 keV to the Mn γ line at 847 keV, three hand phantoms with Mn concentrations of 30 parts per million (ppm), 150 ppm, and 500 ppm were made and irradiated by the DT generator system. The Mn signals in these phantoms were then measured using a 50% high-efficiency high-purity germanium (HPGe) detector. The DL was calculated to be about 4.4 ppm for the chosen irradiation, decay, and measurement time. This was calculated to be equivalent to a DL of about 3.3 ppm for the DD generator system. To achieve this DL with one 50% high-efficiency HPGe detector, the dose to the hand was simulated to be about 37 mSv, with the total body equivalent dose being about 23µSv. In conclusion, it is feasible to develop a transportable NAA system to quantify Mn in bone in vivo with an acceptable radiation exposure to the subject.
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Affiliation(s)
- Yingzi Liu
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - David Koltick
- Physics Department, Purdue University, West Lafayette, IN, USA
| | - Patrick Byrne
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
- Medical Physics Consultants, Inc. Indianapolis, IN, USA
| | - Haoyu Wang
- Physics Department, Purdue University, West Lafayette, IN, USA
| | - Wei Zheng
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
| | - Linda H Nie
- School of Health Sciences, Purdue University, West Lafayette, IN, USA
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Guilarte TR. Manganese neurotoxicity: new perspectives from behavioral, neuroimaging, and neuropathological studies in humans and non-human primates. Front Aging Neurosci 2013; 5:23. [PMID: 23805100 PMCID: PMC3690350 DOI: 10.3389/fnagi.2013.00023] [Citation(s) in RCA: 130] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Accepted: 06/05/2013] [Indexed: 01/10/2023] Open
Abstract
Manganese (Mn) is an essential metal and has important physiological functions for human health. However, exposure to excess levels of Mn in occupational settings or from environmental sources has been associated with a neurological syndrome comprising cognitive deficits, neuropsychological abnormalities and parkinsonism. Historically, studies on the effects of Mn in humans and experimental animals have been concerned with effects on the basal ganglia and the dopaminergic system as it relates to movement abnormalities. However, emerging studies are beginning to provide significant evidence of Mn effects on cortical structures and cognitive function at lower levels than previously recognized. This review advances new knowledge of putative mechanisms by which exposure to excess levels of Mn alters neurobiological systems and produces neurological deficits not only in the basal ganglia but also in the cerebral cortex. The emerging evidence suggests that working memory is significantly affected by chronic Mn exposure and this may be mediated by alterations in brain structures associated with the working memory network including the caudate nucleus in the striatum, frontal cortex and parietal cortex. Dysregulation of the dopaminergic system may play an important role in both the movement abnormalities as well as the neuropsychiatric and cognitive function deficits that have been described in humans and non-human primates exposed to Mn.
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Affiliation(s)
- Tomás R Guilarte
- Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University New York, NY, USA
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Deng Q, Liu J, Li Q, Chen K, Liu Z, Shen Y, Niu P, Yang Y, Zou Y, Yang X. Interaction of occupational manganese exposure and alcohol drinking aggravates the increase of liver enzyme concentrations from a cross-sectional study in China. Environ Health 2013; 12:30. [PMID: 23587294 PMCID: PMC3639182 DOI: 10.1186/1476-069x-12-30] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2012] [Accepted: 04/10/2013] [Indexed: 05/30/2023]
Abstract
BACKGROUND Over exposure to manganese (Mn) can damage the human central nervous system and potentially cause liver toxicity. Alcohol drinking is also one of the well-known harmful factors to hepatic organism. The interaction between Mn exposure and alcohol consumption to liver function was investigated in this study. METHODS A total of 1112 on-the-spot workers were included in the cross-sectional survey from a large scale of manganese exposed workers healthy cohort (MEWHC) in a ferro-manganese refinery company. A questionnaire was used to collect the demographic information, occupational history, and alcohol drinking habits. Occupational health examination was carried out for each worker. The five key serum indices, including total bilirubin (TBILI), direct bilirubin (DBILI), indirect bilirubin (IBILI), alanine transaminase (ALT), and aspartate transaminase (AST), were determined to evaluate the liver function of each subject. RESULTS Workers exposed to high levels of Mn had significantly elevated serum concentrations of liver enzymes (DBILI: 3.84±1.20 μmol/L, ALT: 27.04±19.12 IU/L, and AST: 29.96±16.68 IU/L), when compared to those in the low-exposure group (DBIL: 3.54±0.85 μmol/L, ALT: 20.38±10.97 IU/L, and AST: 26.39±8.07 IU/L), all P<0.01. These serum indices had a significantly increasing trend with the elevation of Mn exposure level (Ptrend <0.01). In addition, the workers with alcohol drinking also showed higher concentrations of liver enzymes than those non-drinkers, especially, and there was significant interaction between Mn exposure and alcohol consumption in terms of these three indices (P<0.001). CONCLUSIONS Occupational exposure to Mn can lead to a dose-dependent increase of liver enzyme concentrations, and interact with alcohol drinking to potentially aggravate the liver damage. It will be important for Mn exposed workers to control drinking and also assess liver function in the occupational health examination.
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Affiliation(s)
- Qi Deng
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
| | - Jing Liu
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
| | - Qing Li
- School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
| | - Kangcheng Chen
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
| | - Zhenfang Liu
- Department of Hematology, The First Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China
| | - Yuefei Shen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Guangxi, Nanning, China
| | - Piye Niu
- Department of Occupational health and environmental health, School of Public Health and Family Medicine, Capital Medical University, Beijing, China
| | - Yiping Yang
- School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
| | - Yunfeng Zou
- School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
| | - Xiaobo Yang
- Department of occupational health and environmental health, School of Public Health, Guangxi Medical University, Guangxi, Nanning, China
- Center for Genomic and Personalized Medicine, Guangxi Medical University,, Guangxi, Nanning, China
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16
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Wołowiec P, Michalak I, Chojnacka K, Mikulewicz M. Hair analysis in health assessment. Clin Chim Acta 2013; 419:139-71. [PMID: 23415695 DOI: 10.1016/j.cca.2013.02.001] [Citation(s) in RCA: 71] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2012] [Revised: 01/30/2013] [Accepted: 02/03/2013] [Indexed: 01/30/2023]
Abstract
BACKGROUND Hair analysis is used for estimation of the nutritional status of individuals. In the present work, a systematic review on the relation between the mineral composition of hair and the physical or mental disorders is discussed. Detailed information of examined populations, methods of sample preparations and analytical techniques are presented. METHODS A systematic literature search in four electronic databases Scopus, PubMed, Web of Science and Medline (from 1997 to 2012/01/31) for English language articles was performed. In addition, a reference list and manual search was undertaken. RESULTS The following number of studies was included: 66. Most of the authors reported that there exists a correlation between deficiency or excess of some elements in hair and occurrence of some diseases, such as: autism, cancer, hypertension, myocardial infarction, kidney disease and diabetes mellitus. However, not all results were consistent. CONCLUSIONS Most of the authors concluded that the profile of hair mineral imbalance might be useful as a diagnostic tool for the early diagnosis of many diseases. However, it seems that there is a need to standardize sample preparation procedures, in particular washing and mineralization methods.
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Affiliation(s)
- Paulina Wołowiec
- Institute of Inorganic Technology and Mineral Fertilizers, Wrocław University of Technology, Wrocław, Poland.
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17
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Bowler RM, Harris M, Gocheva V, Wilson K, Kim Y, Davis SI, Bollweg G, Lobdell DT, Ngo L, Roels HA. Anxiety affecting parkinsonian outcome and motor efficiency in adults of an Ohio community with environmental airborne manganese exposure. Int J Hyg Environ Health 2012; 215:393-405. [DOI: 10.1016/j.ijheh.2011.10.005] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2011] [Revised: 09/12/2011] [Accepted: 10/08/2011] [Indexed: 11/26/2022]
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Perazzo JC, Tallis S, Delfante A, Souto PA, Lemberg A, Eizayaga FX, Romay S. Hepatic encephalopathy: An approach to its multiple pathophysiological features. World J Hepatol 2012; 4:50-65. [PMID: 22489256 PMCID: PMC3321490 DOI: 10.4254/wjh.v4.i3.50] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2011] [Revised: 11/19/2011] [Accepted: 02/24/2012] [Indexed: 02/06/2023] Open
Abstract
Hepatic encephalopathy (HE) is a neuropsychiatric complex syndrome, ranging from subtle behavioral abnormalities to deep coma and death. Hepatic encephalopathy emerges as the major complication of acute or chronic liver failure. Multiplicity of factors are involved in its pathophysiology, such as central and neuromuscular neurotransmission disorder, alterations in sleep patterns and cognition, changes in energy metabolism leading to cell injury, an oxidative/nitrosative state and a neuroinflammatory condition. Moreover, in acute HE, a condition of imminent threat of death is present due to a deleterious astrocyte swelling. In chronic HE, changes in calcium signaling, mitochondrial membrane potential and long term potential expression, N-methyl-D-aspartate-cGMP and peripheral benzodiazepine receptors alterations, and changes in the mRNA and protein expression and redistribution in the cerebral blood flow can be observed. The main molecule indicated as responsible for all these changes in HE is ammonia. There is no doubt that ammonia, a neurotoxic molecule, triggers or at least facilitates most of these changes. Ammonia plasma levels are increased two- to three-fold in patients with mild to moderate cirrhotic HE and up to ten-fold in patients with acute liver failure. Hepatic and inter-organ trafficking of ammonia and its metabolite, glutamine (GLN), lead to hyperammonemic conditions. Removal of hepatic ammonia is a differentiated work that includes the hepatocyte, through the urea cycle, converting ammonia into GLN via glutamine synthetase. Under pathological conditions, such as liver damage or liver blood by-pass, the ammonia plasma level starts to rise and the risk of HE developing is high. Knowledge of the pathophysiology of HE is rapidly expanding and identification of focally localized triggers has led the development of new possibilities for HE to be considered. This editorial will focus on issues where, to the best of our knowledge, more research is needed in order to clarify, at least partially, controversial topics.
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Affiliation(s)
- Juan Carlos Perazzo
- Juan Carlos Perazzo, Silvina Tallis, Amalia Delfante, Pablo Andrés Souto, Abraham Lemberg, Francisco Xavier Eizayaga, Salvador Romay, Laboratory of Portal Hypertension and Hepatic Encephalopathy, Pathophysiology, School of Pharmacy and Biochemistry, University of Buenos Aires, Junin 950, CP 1113, Buenos Aires, Argentina
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Carrera N, Arrojo M, Sanjuán J, Ramos-Ríos R, Paz E, Suárez-Rama JJ, Páramo M, Agra S, Brenlla J, Martínez S, Rivero O, Collier DA, Palotie A, Cichon S, Nöthen MM, Rietschel M, Rujescu D, Stefansson H, Steinberg S, Sigurdsson E, St Clair D, Tosato S, Werge T, Stefansson K, González JC, Valero J, Gutiérrez-Zotes A, Labad A, Martorell L, Vilella E, Carracedo Á, Costas J. Association study of nonsynonymous single nucleotide polymorphisms in schizophrenia. Biol Psychiatry 2012; 71:169-77. [PMID: 22078303 DOI: 10.1016/j.biopsych.2011.09.032] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2010] [Revised: 08/19/2011] [Accepted: 09/06/2011] [Indexed: 01/07/2023]
Abstract
BACKGROUND Genome-wide association studies using several hundred thousand anonymous markers present limited statistical power. Alternatively, association studies restricted to common nonsynonymous single nucleotide polymorphisms (nsSNPs) have the advantage of strongly reducing the multiple testing problem, while increasing the probability of testing functional single nucleotide polymorphisms (SNPs). METHODS We performed a case-control association study of common nsSNPs in Galician (northwest Spain) samples using the Affymetrix GeneChip Human 20k cSNP Kit, followed by a replication study of the more promising results. After quality control procedures, the discovery sample consisted of 5100 nsSNPs at minor allele frequency >5% analyzed in 476 schizophrenia patients and 447 control subjects. The replication sample consisted of 4069 cases and 15,128 control subjects of European origin. We also performed multilocus analysis, using aggregated scores of nsSNPs at liberal significance thresholds and cross-validation procedures. RESULTS The 5 independent nsSNPs with false discovery rate q ≤ .25, as well as 13 additional nsSNPs at p < .01 and located in functional candidate genes, were genotyped in the replication samples. One SNP, rs13107325, located at the metal ions transporter gene SLC39A8, reached significance in the combined sample after Bonferroni correction (trend test, p = 2.7 × 10(-6), allelic odds ratio = 1.32). This SNP presents minor allele frequency of 5% to 10% in many European populations but is rare outside Europe. We also confirmed the polygenic component of susceptibility. CONCLUSIONS Taking into account that another metal ions transporter gene, SLC39A3, is associated to bipolar disorder, our findings reveal a role for brain metal homeostasis in psychosis.
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Affiliation(s)
- Noa Carrera
- Fundación Pública Galega de Medicina Xenómica-SERGAS, Hospital Clínico Universitario, Santiago de Compostela, Spain
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Bocca B, Madeddu R, Asara Y, Tolu P, Marchal JA, Forte G. Assessment of reference ranges for blood Cu, Mn, Se and Zn in a selected Italian population. J Trace Elem Med Biol 2011; 25:19-26. [PMID: 21242073 DOI: 10.1016/j.jtemb.2010.12.004] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/17/2010] [Revised: 11/17/2010] [Accepted: 12/09/2010] [Indexed: 11/19/2022]
Abstract
The reference ranges for blood Cu, Mn, Se and Zn of 215 adult subjects non-occupationally exposed and living in the Nuoro province (Sardinia, insular Italy) were assessed. Metals were determined by sector field inductively coupled plasma mass spectrometry after microwave-assisted acid digestion of blood. The blood reference ranges estimated as P5-P95 percentiles (geometric mean, GM) were 776-1495μg/L (1036μg/L) for Cu; 4.73-17.0μg/L (8.91μg/L) for Mn; 106-185μg/L (140μg/L) for Se and 4686-8585μg/L (6418μg/L) for Zn. These results were then stratified for sex, age, alcohol consumption, smoking habit and living area. The GM value of Cu was significantly higher in females (1127μg/L) than in males (957μg/L). Age, alcohol intake, smoking habit and residential area did not influence blood Cu. The GM of Mn was significantly higher in females (9.98μg/L) respect to males (8.01μg/L) and in drinkers (9.67μg/L) compared to non-drinkers (8.38μg/L). The other variables did not change the Mn data. Selenium concentrations did not differ significantly as a function of individuals factors. With reference to Zn, males had GM of 6804μg/L and females of 6031μg/L, and more blood Zn was found in subjects consuming alcohol (6618μg/L) respect to abstainers (6155μg/L). In addition, blood Zn was not affected by age, smoking habit and place of living.
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Affiliation(s)
- Beatrice Bocca
- Istituto Superiore di Sanità, Dipartimento di Ambiente e Connessa Prevenzione Primaria, Viale Regina Elena 299, 00161 Rome, Italy
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Márquez-Aguirre A, Canales-Aguirre A, Gómez-Pinedo U, Gálvez-Gastélum F. Aspectos moleculares de la encefalopatía hepática. Neurologia 2010. [DOI: 10.1016/j.nrl.2009.12.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Márquez-Aguirre A, Canales-Aguirre A, Gómez-Pinedo U, Gálvez-Gastélum F. Molecular aspects of hepatic encephalopathy. NEUROLOGÍA (ENGLISH EDITION) 2010. [DOI: 10.1016/s2173-5808(10)70048-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
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Park EJ, Park K. Induction of oxidative stress and inflammatory cytokines by manganese chloride in cultured T98G cells, human brain glioblastoma cell line. Toxicol In Vitro 2009; 24:472-9. [PMID: 19815061 DOI: 10.1016/j.tiv.2009.09.022] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2009] [Revised: 09/19/2009] [Accepted: 09/30/2009] [Indexed: 12/16/2022]
Abstract
Manganese, an essential trace nutrient in human beings, has been widely used in the steel industry to improve hardness, stiffness, and strength. With the increased applications of manganese compounds, discharge into the environment has rapidly increased and may exert adverse effects on human health. In this study, manganese toxicity was investigated using cultured T98G cells, which are derived from human glioblasts with the ability to differentiate into several different types of neuroglia. Cytotoxicity was shown in manganese-treated groups (100, 200, 400, and 800microM of MnCl(2)), and cell viability was decreased to 58.8% of the control group at 2days after treatment with 800microM of MnCl(2). When cells were treated with manganese for 24h, ROS dose-dependently increased while antioxidant intracellular GSH decreased. With the generation of ROS, the increased activity of caspase-3 was shown, and was followed by chromatin condensation and breakage, which is an indication of the cellular apoptotic process. ROS also triggered pro-inflammatory responses in cultured T98G cells, which were demonstrated by the increased gene expression and protein levels of IL-6 and IL-8.
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Affiliation(s)
- Eun-Jung Park
- College of Pharmacy, Dongduk Women's University, 23-1, Wolgok-dong, Seongbuk-gu, Seoul 136-714, Republic of Korea
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Abstract
Metals are ubiquitous and play a critical role in neurobiology. Transition metals are important because they alter the redox state of the physical environment. Biologically, transition metals catalyze redox reactions that are critical to cellular respiration, chemical detoxification, metabolism, and even neurotransmitter synthesis. Many metals are both nutrients and neurotoxicants, such as iron, zinc, copper, and manganese. Other metals, such as lead and cadmium, are metabolized similarly to these metals, particularly iron. Iron metabolism and genes that regulate iron metabolism may be the key to understanding metal toxicity. Finally, recent evidence demonstrates that early life exposures may program later life and adult disease phenotypes via processes of epigenetics. Parallel work in metals demonstrates that epigenetics may be a critical pathway by which metals produce health effects.
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Affiliation(s)
- Robert O Wright
- Department of Pediatrics, Children's Hospital, Boston Department of Environmental Health, Harvard School of Public Health, Boston, MA 02115, USA.
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Zoni S, Albini E, Lucchini R. Neuropsychological testing for the assessment of manganese neurotoxicity: a review and a proposal. Am J Ind Med 2007; 50:812-30. [PMID: 17918193 DOI: 10.1002/ajim.20518] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
BACKGROUND Manganese exposure can cause neurobehavioral and neurological signs and symptoms. A review of the literature was carried out in order to identify the most sensitive and effective methods to assess these outcomes. METHODS Studies on manganese exposure performed with neuropsychological tests were reviewed using Medline. Test methods, obtained outcomes, and dose-response relationships were considered. Based on the review and additional considerations, a testing battery for adult and children was identified. RESULTS A total number of 31 studies were reviewed and divided in 18 occupational, 7 environmental, and 6 on children. A large variety of tests exploring motor and cognitive functions and mood were applied. Neurobehavioral effects were dose-dependent in several studies and determined by much lower exposure levels compared to 1 mg Mn/m(3) in total dust which is considered to be the minimum concentration able to induce the classical clinical features of "manganism." Although through a wide variety of tests, the observed outcomes support the knowledge that manganese exposure can cause neurobehavioral effects. Motor functions are mainly affected in adults, and cognitive functions and behavior are more affected in children. CONCLUSIONS Literature on manganese neurobehavioral effect is quite consistent, however, further improvement may be achieved by using better structured and more comparable evaluation methods. Based on the analysis of the existing experiences a test battery including tests of motor functions, response speed, cognitive functions, intellectual abilities, mood, and symptom questionnaires is suggested. We recommend that the tests indicated should always be included in future studies as a core battery.
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Affiliation(s)
- Silvia Zoni
- Department of Experimental and Applied Medicine, Section of Occupational Health, University of Brescia, Piazzale Spedali Civili 1, Brescia, Italy.
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Guilarte TR, Chen MK. Manganese inhibits NMDA receptor channel function: implications to psychiatric and cognitive effects. Neurotoxicology 2007; 28:1147-52. [PMID: 17662456 PMCID: PMC2100416 DOI: 10.1016/j.neuro.2007.06.005] [Citation(s) in RCA: 61] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2007] [Revised: 05/31/2007] [Accepted: 06/20/2007] [Indexed: 10/23/2022]
Abstract
Humans exposed to excess levels of manganese (Mn(2+)) express psychiatric problems and deficits in attention and learning and memory. However, there is a paucity of knowledge on molecular mechanisms by which Mn(2+) produces such effects. We now report that Mn(2+) is a potent inhibitor of [(3)H]-MK-801 binding to the NMDA receptor channel in rat neuronal membrane preparations. The inhibition of [(3)H]-MK-801 to the NMDA receptor channel by Mn(2+) was activity-dependent since Mn(2+) was a more potent inhibitor in the presence of the NMDA receptor co-agonists glutamate and glycine (K(i)=35.9+/-3.1 microM) than in their absence (K(i)=157.1+/-6.5 microM). We also show that Mn(2+) is a NMDA receptor channel blocker since its inhibition of [(3)H]-MK-801 binding to the NMDA receptor channel is competitive in nature. That is, Mn(2+) significantly increased the affinity constant (K(d)) with no significant effect on the maximal number of [(3)H]-MK-801 binding sites (B(max)). Under stimulating conditions, Mn(2+) was equipotent in inhibiting [(3)H]-MK-801 binding to NMDA receptors expressed in neuronal membrane preparations from different brain regions. However, under basal, non-stimulated conditions, Mn(2+) was more potent in inhibiting NMDA receptors in the cerebellum than other brain regions. We have previously shown that chronic Mn(2+) exposure in non-human primates increases Cu(2+), but not zinc or iron concentrations in the basal ganglia [Guilarte TR, Chen M-K, McGlothan JL, Verina T, Wong DF, Zhou Y, Alexander M, Rohde CA, Syversen T, Decamp E, Koser AJ, Fritz S, Gonczi H, Anderson DW, Schneider JS. Nigrostriatal dopamine system dysfunction and subtle motor deficits in manganese-exposed non-human primates. Exp Neurol 2006a;202:381-90]. Therefore, we also tested the inhibitory effects of Cu(2+) on [(3)H]-MK-801 binding to the NMDA receptor channel. The data shows that Cu(2+) in the presence of glutamate and glycine is a more potent inhibitor of the NMDA receptor than Mn(2+). Our findings suggest that the inhibitory effect of Mn(2+) and/or Cu(2+) on the NMDA receptor may produce a deficit in glutamatergic transmission in the brain of individuals exposed to excess levels of Mn(2+) and produce neurological dysfunction.
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Affiliation(s)
- Tomás R Guilarte
- Neurotoxicology & Molecular Imaging Laboratory, Department of Environmental Health Sciences, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, Maryland 21205, United States.
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Williamson A. Using self-report measures in neurobehavioural toxicology: Can they be trusted? Neurotoxicology 2007; 28:227-34. [PMID: 16620990 DOI: 10.1016/j.neuro.2006.03.009] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2005] [Accepted: 03/10/2006] [Indexed: 11/22/2022]
Abstract
Questionnaires are one of the most common methodologies used in research on neurobehavioural effects in occupational and environmental health, most commonly for gathering information on demographic characteristics, psychological or neurological symptoms, mood state, or exposure to hazards. Questionnaires are self-report measures, so by definition are subjective, although their degree of subjectivity depends on the phenomenon they are measuring. For some phenomena questionnaires are used because they are convenient but the information can be obtained from other sources. For other phenomena questionnaire or self-report is the only way of obtaining the information, for example, feelings and experiences, mood or emotions. Questionnaires are essential tools in psychological and neurobehavioural research as they can tap into aspects of nervous system function that cannot be readily measured in other ways. Despite the obvious need for self-report measures, there are a number of serious issues that threaten their validity as effective indicators of neurobehavioural function. This paper considers the implications of some of the major problems with self-report measures, focusing particularly on current approaches to measurement of symptoms and mood. It includes issues relating to validity of measures such as demand characteristics, malingering and under or over reporting, individual differences and problems of language and question style. It also includes issues relating to the interpretation of self-report measures, the relationship between self-report and performance measures, whether they reflect primary or secondary effects and whether they can be used as diagnostic criteria for neurobehavioural functional effects of occupational or environmental exposure. The paper looks at some of the current approaches to overcoming these problems including using interviews and observational methods and improving psychometric qualities of these measures. Self-report measures are important tools in our arsenal of measures of the neurobehavioural effects of occupational and environmental exposure, but they need to be used with care.
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Affiliation(s)
- Ann Williamson
- NSW Injury Risk Management Research Centre, University of New South Wales, Building G2, Western Campus, UNSW Sydney 2052, Australia.
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Hu H, Shine J, Wright RO. The challenge posed to children's health by mixtures of toxic waste: the Tar Creek superfund site as a case-study. Pediatr Clin North Am 2007; 54:155-75, x. [PMID: 17306689 PMCID: PMC1862721 DOI: 10.1016/j.pcl.2006.11.009] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In the United States, many of the millions of tons of hazardous wastes that have been produced since World War II have accumulated in sites throughout the nation. Citizen concern about the extent of this problem led Congress to establish the Superfund Program in 1980 to locate, investigate, and clean up the worst sites nationwide. Most such waste exists as a complex mixture of many substances. This article discusses the issue of toxic mixtures and children's health by focusing on the specific example of mining waste at the Tar Creek Superfund Site in Northeast Oklahoma.
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Affiliation(s)
- Howard Hu
- Department of Environmental Health Sciences, University of Michigan School of Public Health, Room 1518, Vaughan Building (SPH-I), 109 S. Observatory St., Ann Arbor, MI 48109-2029, USA.
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Abstract
Manganese and its inorganic compounds are widely used in many industries and have been accepted as occupational neurotoxins that have caused a distinct and disabling clinical entity, manganism, in several types of work, notably where exposure is by way of dust. There is inconclusive and inconsistent evidence that, in these occupations, subclinical neurological effects, detectable only by neurobehavioural studies, may be caused by low doses. This has prompted a re-evaluation of occupational exposure limits. Some countries, including the UK, already demand much higher levels of protection against exposure than 5 years ago. Welding is the most common source of occupational exposure as manganese is an essential component of steel and so its compounds are inevitable components of fume emitted from steel welding processes. There it is found in respirable particles, often as complex oxides (spinels), sometimes within a core protected by a silicon oxide shell - as distinct from the much simpler form of particle formed by disintegration in processes such as mining and ore milling where manganism has been diagnosed convincingly. Millions of workers are at risk of exposure to manganese-containing compounds in fumes from electric arc welding of steel. In recent years it has been asserted that neurological and neurobehavioural disorders may develop consequent to exposure to steel welding fumes and that employment as a welder is associated with the unusually early onset of Parkinson's disease. Causal relationships have been postulated. Welders have been recorded as having been exposed to high levels of manganese-containing fume, especially where they have worked in confined, unventilated spaces, although this appears from limited data to be the exception rather than the rule. Even then the dose received is generally less than in mining or ore crushing. When care is taken to exclude exposures from hardfacing and burning and cutting arc processes, where manganese may form a high percentage of the fume, manganese compounds usually form a relatively low percentage of the composition of welding fume particles, <2.0%, much outweighed by iron. Although these manganese-compound-containing welding fume particles are insoluble in water, the manganese compounds in particles that are retained in the alveoli may be absorbed, at least in part. Manganese concentrations in biological material samples in some exposed groups reflect this relative to unexposed workers. Some of the transfer systems for absorption and transport, including across the blood-brain barrier, are used in competition with iron which is present in abundance in welding fume. This may reduce absorption of manganese in welders and thus reduce the opportunity for sufficient doses to cause neurotoxicological consequences. Scrutiny of the literature covering the last 40 years has revealed only five cases that meet sufficient criteria for manganism to just cross the diagnostic threshold, and even then they carry a degree of doubt with them. This low incidence alone gives notice that welders have not been and are not at high risk of clinically apparent damage from exposure to manganese. If this needs to be further emphasised, there is the fact that the literature contains no confirmed cases of manganism in welders. Assertions of abnormal results in neurobehavioural studies of welders have raised the possibility of there being a subclinical form of manganism with loss of fine motor control as one of its features. While observations of such changes in workers in other industries have caused regulators in some countries to apply more stringent controls of exposure, as yet the results lack convincing consistency and there is no indication of any dose-effect relationship. If welding fume can have these motor effects it would be a heavy and perhaps career-ending blow to those affected. It would not be prudent to dismiss the warnings sounded by the results of studies of welders, no matter how flawed these investigations are, but wiser and better to act with vigour to reduce exposure and monitor the effectiveness of this additional protection whilst conducting high quality research to allow sound conclusions to be drawn as to whether there actually is a subclinical disorder. Idiopathic Parkinson's disease is a common disorder affecting 1-2% of those in the general population aged >65 years. It has been suggested, on flawed and contested evidence, not that welding causes the disease but rather that employment as a welder carries with it the risk of developing this disease at a younger age than if that trade had not been followed. Manganese in welding fume has been nominated as the neurotoxin. This may be biologically feasible if manganese destroys insufficient receptor cells to produce clinical manganism but sufficient to enhance the effects of a reduced supply of dopamine to give the manifestations of already developing idiopathic Parkinson's disease earlier in the course of destruction of the substantia nigra than if all receptors were intact.
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Bouchard M, Mergler D, Baldwin M, Panisset M, Roels HA. Neuropsychiatric symptoms and past manganese exposure in a ferro-alloy plant. Neurotoxicology 2006; 28:290-7. [PMID: 16962176 DOI: 10.1016/j.neuro.2006.08.002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2006] [Revised: 08/01/2006] [Accepted: 08/04/2006] [Indexed: 10/24/2022]
Abstract
INTRODUCTION Psychiatric manifestations have been reported in cases of manganism, and mood disorders are often observed in manganese (Mn) exposed workers. We examined neuropsychiatric symptoms among formerly Mn-exposed workers 14 years after cessation of exposure. MATERIALS AND METHODS A study was conducted in 1990 among workers from a ferro- and silico-Mn plant and unexposed working men referents from the same region in South-West Quebec. At follow-up in 2004, 77 former Mn-workers and 81 referents agreed to participate and responded to a neuropsychiatric symptom checklist, the Brief Symptom Inventory (BSI); scores were transformed into T-scores based on a normative population. Cumulated exposure indices (CEI) were computed for each former Mn-worker. Linear and logistic regression analyses were used. RESULTS Mean T-scores were significantly higher among former Mn-workers than referents on scales of Depression and Anxiety. Mean T-scores of psychological distress increased with the CEI tertiles, with significant associations for the scales Somatization, Depression, Anxiety and Hostility. Former Mn-workers in the two highest tertiles of CEI showed a higher risk for T-scores >or=63 for Hostility (OR, 7.5; 95% CI, 1.5-38.9), Depression (OR, 2.6; 95% CI, 1.1-8.4) and Anxiety (OR, 3.0; 95% CI, 1.1-8.4). CONCLUSION These results suggest that past exposure to Mn may have lasting consequences on neuropsychiatric symptoms.
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Affiliation(s)
- Maryse Bouchard
- CINBIOSE, Université du Québec à Montréal, Institut des Sciences de l'environnement, CINBIOSE (SB-1983), C.P. 8888, Succ. Centre-Ville, Montréal, Québec H3C 3P8, Canada
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Ostiguy C, Asselin P, Malo S. The emergence of manganese-related health problems in Quebec: An integrated approach to evaluation, diagnosis, management and control. Neurotoxicology 2006; 27:350-6. [PMID: 16337003 DOI: 10.1016/j.neuro.2005.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2005] [Accepted: 11/02/2005] [Indexed: 01/02/2023]
Abstract
This paper describes the strategy developed in Quebec to deal with an emerging problem: manganism in welders. Only two cases of manganism had been reported to the Commission de la santé et de la sécurité du travail (CSST, Workers Compensation Board in Quebec) before 2000. In the fall of 2001, the CSST was informed of a possible cluster of manganism and received 20 compensation claims from one plant. Action was rapidly taken to understand and tackle this emerging problem. Under the leadership of the CSST, a coordinating working group implemented medical and environmental subcommittees involving representatives of the different partners of the prevention network. After a literature review to document the health risks associated with manganese and the lack of some important information, a panel of international experts was formed to try to reach agreement on the parameters to consider in the diagnosis and management of manganism. The CSST compensation management policies would be adjusted accordingly. Simultaneously, all the available industrial hygiene data were analyzed to estimate where and at what levels workers were exposed to manganese. To complete these data, the exposure of workers in more than 50 industrial plants was evaluated and existing control measures were documented. All these data have been presented for a revision of the Quebec permissible exposure limit (PEL). In this integrated approach, the next step targets the formation of neurologists and neuropsychologists for a standardized medical evaluation, to complete workplace evaluation in the high risk sectors, inform workers and employers and recommend control measures where required, based on a revised PEL. Many strategies will be used to inform the prevention network (about 1000 people), employers and employees of the risks of overexposure to manganese and of the measures to control exposure in all the plants where workers are susceptible to be exposed to manganese.
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Affiliation(s)
- Claude Ostiguy
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 De Maisonneuve Boulevard West, Montréal, Que., Canada H3A 3C2.
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Abstract
Manganese is an essential nutrient that also may be toxic at high concentrations. Subjects chronically exposed to manganese-laden dust in industrial settings develop neuropsychological changes that resemble Parkinson's disease. Manganese has been proposed as an additive to gasoline (as a replacement for the catalytic properties of lead), which has generated increased research interest in the possible deleterious effects of environmental exposure to manganese. Low-level exposure to manganese has been implicated in neurologic changes, decreased learning ability in school-aged children, and increased propensity for violence in adults. However, a thorough review of the literature shows very weak cause-and-effect relationships that do not justify concern about environmental exposure to manganese for most of the North American population.
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Affiliation(s)
- John W Finley
- United States Department of Agriculture, Agricultural Research Service, Grand Forks Human Nutrition Research Center, Grand Forks, ND 58202, USA
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Bouchard M, Mergler D, Baldwin M, Sassine MP, Bowler R, MacGibbon B. Blood manganese and alcohol consumption interact on mood states among manganese alloy production workers. Neurotoxicology 2003; 24:641-7. [PMID: 12900077 DOI: 10.1016/s0161-813x(03)00028-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Long-term exposure to manganese (Mn) can induce neurotoxic effects including neuromotor, neurocognitive and neuropsychiatric effects, but there is a great interpersonal variability in the occurrence of these effects. It has recently been suggested that blood Mn (MnB) may interact with alcohol use disorders, accentuating neuropsychiatric symptoms. The objective of the present study was to explore a possible interaction between alcohol consumption and MnB on mood states, using an existing data set on Mn exposed workers. Respirable Mn exposure in the plant averaged 0.23mg/m(3) and was correlated with MnB. All participants for whom all data on MnB concentration and mood (assessed with the Profile of Mood States (POMS)) were available and who reported currently drinking alcohol were included in the analyses (n=74). Workers were grouped according to their MnB concentration (<10 and > or =10 microg/l) and alcohol consumption (<400 and > or =400g per week). Two-way ANOVAs were performed on each POMS scale and Mann-Whitney tests were used to assess group differences. Workers in the higher alcohol consumption group had higher scores on three POMS scales: tension, anger and fatigue. There was no difference for POMS scale scores between MnB subgroups. Dividing the group with respect to alcohol consumption and MnB showed that the group with high alcohol consumption and high MnB displayed the highest scores. In the lower MnB category, those in the higher alcohol consumption group did not have higher scores than the others. The interaction term for alcohol consumption and MnB concentration was statistically significant (P<0.05) for the depression, anger, fatigue and confusion POMS scales. There was a tendency for tension (P<0.06), and it was not significant for vigor. This study shows the first evidence of an interaction between MnB and alcohol consumption on mood states among Mn exposed workers and supports the results from a previous population-based study.
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Affiliation(s)
- Maryse Bouchard
- CINBIOSE, University of Québec in Montréal, Montréal, Québec, Canada.
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Roth JA, Garrick MD. Iron interactions and other biological reactions mediating the physiological and toxic actions of manganese. Biochem Pharmacol 2003; 66:1-13. [PMID: 12818360 DOI: 10.1016/s0006-2952(03)00145-x] [Citation(s) in RCA: 158] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Chronic exposure to the divalent heavy metals, such as iron, lead, manganese (Mn), and chromium, has been linked to the development of severe, often irreversible neurological disorders and increased vulnerability to developing Parkinson's disease. Although the mechanisms by which these metals elicit or facilitate neuronal cell death are not well defined, neurotoxicity is limited by the extent to which they are transported across the blood-brain barrier and their subsequent uptake within targeted neurons. Once inside the neuron, these heavy metals provoke a series of biochemical and molecular events leading to cell death induced by either apoptosis and/or necrosis. The toxicological properties of Mn have been studied extensively in recent years because of the potential health risk created by increased atmospheric levels owing to the impending use of the gas additive methylcyclopentadienyl manganese tricarbonyl. Individuals exposed to high environmental levels of Mn, which include miners, welders, and those living near ferroalloy processing plants, display a syndrome known as manganism, best characterized by debilitating symptoms resembling those of Parkinson's disease. Mn disposition in vivo is influenced by dietary iron intake and stores within the body since the two metals compete for the same binding protein in serum (transferrin) and subsequent transport systems (divalent metal transporter, DMT1). There appear to be two distinct carrier-mediated transport systems for Mn and ferrous ion: a transferrin-dependent and a transferrin-independent pathway, both of which utilize DMT1 as the transport protein. Accordingly, this commentary focuses on the biochemical and molecular processes responsible for the cytotoxic actions of Mn and the role that cellular transport plays in mediating the physiological as well as the toxicological actions of this metal.
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Affiliation(s)
- Jerome A Roth
- Department of Pharmacology and Toxicology, 102 Farber Hall, University at Buffalo, Buffalo, NY 14214, USA.
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Levy BS, Nassetta WJ. Neurologic effects of manganese in humans: a review. INTERNATIONAL JOURNAL OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH 2003; 9:153-63. [PMID: 12848244 DOI: 10.1179/oeh.2003.9.2.153] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Abstract
Manganese, which enters the body primarily via inhalation, can damage the nervous system and respiratory tract, as well as have other adverse effects. Occupational exposures occur mainly in mining, alloy production, processing, ferro-manganese operations, welding, and work with agrochemicals. Among the neurologic effects is an irreversible parkinsonian-like syndrome. An estimated 500,000 to 1.5 million people in the United States have Parkinson's disease, and physicians need to consider manganese exposure in its differential diagnosis. Since 1837, there have been many reports of cases and case series describing manganese toxicity. More recently, there have been epidemiologic studies of its adverse effects on health. Occupational medicine physicians can play critical roles in preventing the adverse health effects of manganese.
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Affiliation(s)
- Barry S Levy
- P.O. Box 1230, Sherborn,, Massachusetts, 01770USA.
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