Tremor, olfactory and motor changes in Italian adolescents exposed to historical ferro-manganese emission.
OBJECTIVE
Increased prevalence of Parkinsonism was observed in Valcamonica, Italy, a region impacted by ferroalloy plants emissions containing manganese and other metals for a century until 2001. The aim of this study was to assess neurobehavioral functions in adolescents from the impacted region and the reference area of Garda Lake.


METHODS
Adolescents age 11-14 years were recruited through the school system for neuro-behavioral testing. Metals including manganese, lead, iron, zinc, copper were measured in airborne particulate matter collected with 24-h personal samplers, and in soil, tap water, blood, urine and hair. Independent variables included parental education and socio-economic status, children's body mass index, number of siblings, parity order, smoking and drinking habits.


RESULTS
A total of 311 subjects (49.2% females), residing in either the exposed (n=154) or the reference (n=157) area participated. Average airborne and soil manganese were respectively 49.5 ng/m(3) (median 31.4, range 1.24-517) and 958 ppm (median 897, range 465-1729) in the impacted area, and 27.4 ng/m(3) (median 24.7, range 5.3-85.9) ng/m(3) and 427 ppm (median 409 range 160-734) in the reference area. Regression models showed significant impairment of motor coordination (Luria-Nebraska test, p=0.0005), hand dexterity (Aiming Pursuit test, p=0.0115) and odor identification (Sniffin' task, p=0.003) associated with soil manganese. Tremor intensity was positively associated with blood (p=0.005) and hair (p=0.01) manganese.


CONCLUSIONS
Historical environmental exposure to manganese from ferroalloy emission reflected by the concentration in soil and the biomarkers was associated with sub-clinical deficits in olfactory and motor function among adolescents.
Occupational Health, University of Brescia, Italy. lucchini@med.unibs.it
Roberto G
RG
Lucchini
Stefano
S
Guazzetti
Silvia
S
Zoni
Filippo
F
Donna
Stephanie
S
Peter
Annalisa
A
Zacco
Marco
M
Salmistraro
Elza
E
Bontempi
Neil J
NJ
Zimmerman
Donald R
DR
Smith
D000293:Adolescent; D041923:Adolescent Development / Q000187:drug effects*; D000367:Age Factors; D000393:Air Pollutants / Q000009:adverse effects*; D015415:Biomarkers / Q000032:analysis; D002648:Child; D003430:Cross-Sectional Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D007501:Iron / Q000009:adverse effects*; D007558:Italy; D016014:Linear Models; D016015:Logistic Models; D008297:Male; D008345:Manganese / Q000009:adverse effects*; D020149:Manganese Poisoning / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D009043:Motor Activity / Q000187:drug effects*; D015999:Multivariate Analysis; D009420:Nervous System / Q000187:drug effects* / Q000254:growth & development / Q000503:physiopathology; D009483:Neuropsychological Tests; D000857:Olfaction Disorders / Q000139:chemically induced* / Q000503:physiopathology; D012111:Residence Characteristics; D018570:Risk Assessment; D012307:Risk Factors; D012903:Smell / Q000187:drug effects*; D014202:Tremor / Q000139:chemically induced* / Q000175:diagnosis
D000393:Air Pollutants; D015415:Biomarkers; C083456:ferro-manganese alloy; D008345:Manganese; D007501:Iron