title: Impact of open manganese mines on the health of children dwelling in the surrounding area.
abstract: BACKGROUND
  Chronic manganese (Mn) exposure is a health hazard associated with the mining and processing of Mn ores. Children living in an area with increased environmental exposure to Mn may have symptoms of chronic toxicity that are different from adults who experience occupational exposure. The aim of the study was to compare health outcomes in a pediatric population living near open Mn mines with a group of children from a reference area and then to develop and implement preventive/rehabilitation measures to protect the children in the mining region.
  
  
  METHODS
  After environmental assessment, a group of 683 children living in a Mn-rich region of Ukraine were screened by clinical evaluation, detection of sIgA (37 children), micronucleus analysis (56 children), and hair Mn content (166 children).
  
  
  RESULTS
  Impaired growth and rickets-like skeletal deformities were observed in 33% of the children. This was a significantly higher percentage than in children in the reference region (15%). The children from the Mn-mining region also had increased salivary levels of immunoglobulin A (104.4±14.2 mcg/ml vs. 49.7±6.1 mcg/ml) among the controls (p<0.05), increased serum alpha 1 proteinase inhibitor levels (4.93±0.21 g/l compared with 2.91±0.22 g/l for controls; p<0.001) and greater numbers of micronuclei in the mucous cells of the oral cavity (0.070±0.008 vs. 0.012±0.009, p<0.001).
  
  
  CONCLUSIONS
  These findings indicate the deleterious health consequences of living in a Mn-mining area. Medical rehabilitation programs were conducted and produced positive results, but further validation of their effectiveness is required. The study provided background information to formulate evidence-based decisions about public health in a region of high Mn exposure.
authors.affiliation: Department of Propedeutics of Children Diseases, Dnipropetrovsk State Medical Academy, Dnipropetrovsk, Ukraine.
authors.forename: Ykateryna D
authors.initials: YD
authors.lastname: Duka
authors.forename: Svetlana I
authors.initials: SI
authors.lastname: Ilchenko
authors.forename: Mykola M
authors.initials: MM
authors.lastname: Kharytonov
authors.forename: Tetyana L
authors.initials: TL
authors.lastname: Vasylyeva
keywords: children; chronic manganese toxicity; manganese; manganese exposure; manganese mining