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2014 ; 45
(ä): 201-7
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Manganism in the 21st century: the Hanninen lecture
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Racette BA
Neurotoxicology
2014[Dec]; 45
(ä): 201-7
PMID24148923
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Since the original description of the health effects of inhaled occupational
manganese (Mn) by Couper in 1837, an extensive literature details the clinical
syndrome and pathophysiology of what was thought to be a rare condition. In the
last decade, conventional wisdom regarding the clinicopathological effects of Mn
has been challenged. Past exposures to Mn were an order of magnitude higher than
modern exposures in developed countries; therefore, the clinical syndrome seen in
the time of Couper is no longer typical of modern Mn exposed workers.
Parkinsonism (rigidity, bradykinesia, rest tremor, and postural instability) is
present in 15% of Mn-exposed workers in welding industries, and these
parkinsonian signs are associated with reduced health status and quality of life.
These parkinsonian signs also overlap considerably with the clinical findings
seen in early stages of Parkinson's disease (PD); although, molecular imaging
suggests that Mn-exposed workers have dopaminergic dysfunction in a pattern
unique from PD. Furthermore, geographic information system studies demonstrate
that regions of the US with high industrial Mn emissions have an increased
incidence of PD and increased PD associated mortality. This review will contrast
historical, descriptive human studies in Mn-exposed subjects with more recent
data and will suggest a research agenda for the 21st century.