title: Childhood exposure to manganese and postural instability in children living near a ferromanganese refinery in Southeastern Ohio.
abstract: Airborne manganese (Mn) exposure can result in neurotoxicity and postural instability in occupationally exposed workers, yet few studies have explored the association ambient exposure to Mn in children and postural stability. The goal of this study was to determine the association between Mn and lead (Pb) exposure, as measured by blood Pb, blood and hair Mn and time weighted distance (TWD) from a ferromanganese refinery, and postural stability in children. A subset of children ages 7-9 years enrolled in the Marietta Community Actively Researching Exposure Study (CARES) were invited to participate. Postural balance was conducted on 55 children residing in Marietta, Ohio and the surrounding area. Samples of blood were collected and analyzed for Mn and Pb, and samples of hair were analyzed for Mn. Neuromotor performance was assessed using postural balance testing with a computer force platform system. Pearson correlations were calculated to identify key covariates. Associations between postural balance testing conditions and Mn and Pb exposure were estimated with linear regression analyses adjusting for gender, age, parent IQ, and parent age. Mean blood Mn was 10 μg/L (SEM=0.36), mean blood Pb was 0.85 μg/dL (SEM=0.05), and mean hair Mn was 0.76 μg/g (SEM=0.16). Mean residential distance from the refinery was 11.5 km (SEM=0.46). All three measures of Mn exposure were significantly associated with poor postural balance. In addition, low-level blood Pb was also negatively associated with balance outcomes. We conclude that Mn exposure and low-level blood Pb are significantly associated with poor postural balance.
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: ruglesfe@mail.uc.edu.
authors.forename: Fedoria
authors.initials: F
authors.lastname: Rugless
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: bhattaat@ucmail.uc.edu.
authors.forename: Amit
authors.initials: A
authors.lastname: Bhattacharya
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: succoppa@ucmail.uc.edu.
authors.forename: Paul
authors.initials: P
authors.lastname: Succop
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: DIETRIKN@UCMAIL.UC.EDU.
authors.forename: Kim N
authors.initials: KN
authors.lastname: Dietrich
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: coxcl@ucmail.uc.edu.
authors.forename: Cyndy
authors.initials: C
authors.lastname: Cox
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: aldenjy@ucmail.uc.edu.
authors.forename: Jody
authors.initials: J
authors.lastname: Alden
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: kuhnelp@ucmail.uc.edu.
authors.forename: Pierce
authors.initials: P
authors.lastname: Kuhnell
authors.affiliation: Marietta College, 215 5th Street, Marietta, OH 45740, United States. Electronic address: barnasm@marietta.edu.
authors.forename: Mary
authors.initials: M
authors.lastname: Barnas
authors.affiliation: Harvard University, Channing Laboratory, 181 Longwood Ave., Boston, MA 02115, United States. Electronic address: ROWRIGHT@hsph.harvard.edu.
authors.forename: Robert
authors.initials: R
authors.lastname: Wright
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, PO Box 509, Albany, NY 12201-0509, United States; University at Albany, Department of Environmental Health Sciences, School of Public Health, Albany, NY, United States. Electronic address: pparsons@wadsworth.org.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Parsons
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, PO Box 509, Albany, NY 12201-0509, United States; University at Albany, Department of Environmental Health Sciences, School of Public Health, Albany, NY, United States. Electronic address: mpraamsma@albany.edu.
authors.forename: Meredith L
authors.initials: ML
authors.lastname: Praamsma
authors.affiliation: Laboratory of Inorganic and Nuclear Chemistry, Wadsworth Center, New York State Department of Health, PO Box 509, Albany, NY 12201-0509, United States; University at Albany, Department of Environmental Health Sciences, School of Public Health, Albany, NY, United States. Electronic address: palmer@wadsworth.org.
authors.forename: Christopher D
authors.initials: CD
authors.lastname: Palmer
authors.affiliation: Neighbors for Clean Air, Marietta, OH, United States. Electronic address: ccbeidler@gmail.com.
authors.forename: Caroline
authors.initials: C
authors.lastname: Beidler
authors.affiliation: Mid-Ohio Valley Health Department, 211 6th St., Parkersburg, WV 26101, United States. Electronic address: Richard.a.wittberg@wv.gov.
authors.forename: Richard
authors.initials: R
authors.lastname: Wittberg
authors.affiliation: University of Cincinnati College of Medicine, Department of Environmental Health, Division of Epidemiology and Biostatistics, 3223 Eden Ave., PO Box 670056, Cincinnati, OH 45267-0056, United States. Electronic address: Erin.Haynes@uc.edu.
authors.forename: Erin N
authors.initials: EN
authors.lastname: Haynes
mesh_terms: D000367:Age Factors; D002648:Child; D004777:Environment; D004781:Environmental Exposure; D005260:Female; D006801:Humans; D007360:Intelligence; D007501:Iron / Q000097:blood / Q000633:toxicity*; D008297:Male; D008345:Manganese / Q000097:blood / Q000633:toxicity*; D020149:Manganese Poisoning / Q000150:complications* / Q000209:etiology; D009820:Ohio; D004856:Postural Balance / Q000187:drug effects*; D012678:Sensation Disorders / Q000097:blood / Q000139:chemically induced*; D013054:Spectrophotometry, Atomic
chemical_list: C083456:ferro-manganese alloy; D008345:Manganese; D007501:Iron
keywords: Appalachian American; Children; Lead; Manganese; Postural balance