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Manganese exposure, parkinsonian signs, and quality of life in South African mine workers
Author(s) -
Dlamini Wendy W.,
Nelson Gill,
Nielsen Susan Searles,
Racette Brad A.
Publication year - 2020
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.23060
Subject(s) - medicine , parkinsonism , quality of life (healthcare) , cohort , cumulative dose , cross sectional study , parkinson's disease , cohort study , disease , pathology , nursing
Background Manganese (Mn) neurotoxicity is associated with parkinsonism; the associated motor deficits can affect individuals’ quality of life (QoL). We investigated associations between Mn exposure, parkinsonian signs, and QoL in Mn mine workers. Methods We assessed parkinsonian signs and QoL in 187 black South African Mn mine workers, using the Unified Parkinson Disease Rating Scale motor subsection 3 (UPDRS3) and the Parkinson Disease Questionnaire (PDQ‐39), respectively. We estimated cumulative Mn exposure in mg Mn/m 3 ‐years using complete occupational histories and a job‐exposure matrix. We investigated the cross‐sectional association between cumulative Mn exposure and UPDRS3 score, and the UPDRS3 score and PDQ‐39, adjusting for age, using linear regression. Results Participants’ mean age was 41.8 years (range, 21‐67 years); 97.3% were male. Estimated mean cumulative Mn exposure at the time of examination was 5.4 mg Mn/m 3 ‐years, with a mean of 14.0 years working in a Mn mine. The mean UPDRS3 score was 10.1 and 25.7% of the workers had a UPDRS3 score greater than or equal to 15. There was a U‐shaped dose‐response relation between cumulative Mn exposure and UPDRS3 score, with a positive association up to 15 mg Mn/m 3 ‐years of exposure and an inverse association thereafter. Greater UPDRS3 scores were associated with poorer self‐reported QoL. Conclusion In this cohort of employed Mn mine workers, parkinsonian signs were common and were associated with both estimated cumulative Mn exposure and poorer QoL.