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Background: Studies have reported associations between manganese (Mn) exposures and Mn levels in blood and urine, though the suitability of these biological measures as biomarkers of exposure is not well known., Methods: We evaluated whether whole blood, plasma, and urine Mn levels reflect exposures in occupationally exposed humans., Results: In active ferroalloy workers, blood Mn was associated with total air Mn levels in subjects currently exposed to low (median = 0.42 microg/m(3), P = 0.009) and moderate (median = 4.2 microg/m(3), P = 0.007) air Mn levels, but not in workers exposed to the highest Mn levels (median = 292 microg/m(3), P = 0.31). In bridge welders blood Mn (P < 0.01), but not plasma or urine Mn was significantly associated with their cumulative respiratory exposure index. In welders, approximately 6% (range approximately 3-9%) of whole blood Mn was contained in the plasma fraction, though there was no association between whole blood and plasma Mn levels (Pearson's R = 0.258, P = 0.12). In contrast, in fresh whole blood samples spiked with Mn ex vivo approximately 80% or more of added Mn partitioned in the plasma, while only approximately 20% or less partitioned in the cellular fraction., Conclusions: These data suggest a complex and limited relationship between exposure and blood Mn levels that may depend upon exposure attributes and the latency of blood sampling relative to exposure; plasma and urine Mn appear to be of little utility as exposure biomarkers. This underscores the need to fully characterize and validate these or other biomarkers for use in constructing appropriate exposure metrics and determining exposure-effect relationships., ((c) 2007 Wiley-Liss, Inc.)

An acute oral protein load causes a transient hyperfiltration that might reveal a loss of glomerular permselectivity properties. The effect of an oral protein load on the urinary excretion rate of albumin (UAE), beta-2-microglobulin (UB2MGE), and retinol-binding protein (URBPE) was thus examined in cadmium- and lead-exposed workers. The results show a transient increase in UB2MGE and URBPE without relevant changes in UAE. These changes were also observed in control groups and are due to competitive inhibition of tubular protein reabsorption by absorbed cationic amino acids. These results do not support the hypothesis that the acute protein load test is of great utility in revealing a silent glomerular filtration disturbance in lead- or cadmium-exposed workers. However, it might disclose imminent renal tubular dysfunction in cadmium workers not yet showing increased microproteinuria under baseline conditions.

In a plant producing manganese (Mn) oxides and salts, 11 different workplaces were identified. The current exposure to airborne Mn (total dust, personal sampling, n = 80) varied from 0.07 to 8.61 mg/m3. The geometric mean and median values amounted approximately to 1 mg/m3 and the 95th percentile was 3.30 mg/m3. The concentration of Mn in blood (Mn-B) in a group of 141 Mn-exposed male workers ranged from 0.10-3.59 micrograms/100 ml compared to 0.04-1.31 micrograms/100 ml in a group of 104 control subjects. The ranges of the concentrations of Mn in urine (Mn-U) were 0.06-140.6 and 0.01-5.04 micrograms/g creatinine for the exposed and control groups, respectively. The average level of Mn-B in the Mn group was more than twice as high as in the control group (arithmetic mean, 1.36 vs 0.57 microgram/100 ml) and that of Mn-U was ten times higher in the Mn group (geometric mean, 1.56 vs 0.15 microgram/g creatinine). The Mn-B level did not change significantly after 8 h of Mn exposure, whereas the Mn-U level dropped rapidly when exposure ceased (half-life less than 30 h). On an individual basis, neither Mn-B nor Mn-U correlated with the current levels of Mn-air or duration of Mn exposure. There was also no relationship between Mn-B and Mn-U. On a group basis, there was no correlation between the mean Mn-B levels and the current levels of Mn-air at each workplace.(ABSTRACT TRUNCATED AT 250 WORDS)

The fertility of male workers exposed to mercury vapor or to manganese dust was assessed with the use of the questionnaire developed by Levine et al [1980]. In the mercury group (concentration of mercury in urine ranging from 5.1 to 272.1 micrograms/g creatinine), no statistically significant difference was found between the observed number of children and that expected on the basis of the reproductive experience of a well-matched control group. On the contrary, by comparison with their corresponding controls, the manganese-exposed workers exhibited a statistically significant deficit in the number of children during their period of exposure to the metal. The airborne concentration of manganese dusts at the different workplaces ranged from 0.07 to 8.61 mg/m3 with a geometric mean of 0.94 mg/m3.

A cross-sectional epidemiological study was carried out among subjects exposed to mercury (Hg) vapour, ie, a group of 131 male workers (mean age: 30.9 yr; average duration of exposure, 4.8 yr) and a group of 54 female workers (mean age, 29.9 yr; average duration of exposure 7 yr). The results were compared with those obtained in well-matched control groups comprising 114 and 48 male and female workers, respectively. The intensity of current Hg vapour exposure was rather moderate as reflected by the levels of mercury in urine (HgU) (mean and 95th percentile: males 52 and 147 micrograms/g creatinine; females 37 and 63 micrograms/g creatinine) and of mercury in blood (mean and 95th percentile: males 1.4 and 3.7 micrograms/dl; females 0.9 and 1.4 microgram/dl). Several symptoms mainly related to the central nervous system (memory disturbances, depressive feelings, fatigue, irritability) were more prevalent in the Hg-exposed subjects. They were, however, not related to exposure parameters. In both male and female Hg-exposed workers no significant disturbances were found in short-term memory (audioverbal), simple reaction time (visual), critical flicker fusion, and colour discrimination ability. Only slight renal tubular effects were detected in Hg-exposed males and females, ie, an increased urinary beta-galactosidase activity and an increased urinary excretion of retinol-binding protein. The prevalence of these preclinical renal effects was more related to the current exposure intensity (HgU) than to the duration of exposure and was detected mainly when HgU exceeds 50 micrograms/g creatinine. Changes in hand tremor spectrum recorded with an accelerometer were found in the Hg-exposed males only. The prevalence of abnormal values for some hand tremor parameters (total velocity and total displacement in the 2-50-Hz band) was mainly increased in male workers exposed for more than 10 yr. Unlike the renal tubular effects, the preclinical signs of tremor were more related to the integrated exposure than to the current exposure. Since the female workers, who have been exposed to Hg vapour levels usually insufficient to increase their HgU levels above 50 micrograms/g creatinine, did not exhibit any change in hand tremor pattern, the results of the present study tend to validate our previously proposed biological threshold limit value of a HgU of 50 micrograms/g creatinine for workers chronically exposed to mercury vapour.

Six volunteers (two office and four cadmium (Cd)-exposed workers, all nonsmokers) from an electric condenser factory participated in a study involving the measurement of cadmium in air and in dust, the evaluation of hand and mouth contamination by cadmium, and the determination of fecal cadmium. The mean levels of total airborne cadmium measured with static and personal samplers were for the exposed workers 9.5 and 16.7 microgram/m3, respectively, and for the office workers 0.3 and 0.5 microgram/m3, respectively. In the office workers, hand contamination by Cd hardly changes over the workday (less than 10 microgram/hand), whereas in the exposed workers important hand contamination by Cd was observed (up to 1,200 microgram/hand during the workday and up to 300 microgram/hand before lunch or before leaving the factory). Mouth contamination by Cd is rather similar in both groups on Monday morning, but increases 20- to 50-fold on Friday afternoon in the Cd workers against a slight increase for the office workers. The concentration of Cd in the feces was not much different between Sunday and Friday in the office workers, whereas in the exposed workers it was higher on Friday than on Sunday. There is suggestive evidence from a comparative study of fecal cadmium in two Cd-exposed volunteers who carried out their jobs with and without gloves that direct cadmium intake from hand contamination may contribute to the overall Cd absorption. A limited study in a glassware factory (As2O3 exposure) involving the measurement of total airborne arsenic, the determination of urinary arsenic, and the evaluation of hand and mouth contamination by arsenic before and after the workshift suggests that the high urinary arsenic levels (300 microgram/g creatinine) are likely to be more related to an increased oral intake from contaminated hands than to an increased absorption from the lungs.

A cross-sectional epidemiological study was carried out among 141 male subjects exposed to inorganic manganese (Mn) in a Mn oxide and salt producing plant (mean age 34.3 years; duration of exposure, mean 7.1 years, range 1-19 years). The results were compared with those of a matched control group of 104 subjects. The intensity of Mn exposure was moderate as reflected by the airborne Mn levels and the concentrations of Mn in blood (Mn-B) and in urine (Mn-U). A significantly higher prevalence of cough in cold season, dyspnea during exercise, and recent episodes of acute bronchitis was found in the Mn group. Lung ventilatory parameters (forced vital capacity, FVC; forced expiratory volume in one second, FEV1; peak expiratory flow rate, PEFR) were only mildly altered in the Mn group (smokers) and the intensity and the prevalence of these changes were not related to Mn-B, Mn-U, or duration of exposure. There was no synergistic effect between Mn exposure and smoking on the spirometric parameters. Except for a few nonspecific symptoms (fatigue, tinnitus, trembling of fingers, increased irritability), the prevalence of the other subjective complaints did not differ significantly between the control and Mn groups. Psychomotor tests were more sensitive than the standardized neurological examination for the early detection of adverse effects of Mn on the central nervous system (CNS). Significant alterations were found in simple reaction time (visual), audioverbal short-term memory capacity, and hand tremor (eye-hand coordination, hand steadiness). A slight increase in the number of circulating neutrophils and in the values of several serum parameters (ie, calcium, ceruloplasmin, copper, and ferritin) was also found in the Mn group. There were no clear-cut dose-response relationships between Mn-U or duration of Mn exposure and the prevalence of abnormal CNS or biological findings. The prevalences of disturbances in hand tremor and that of increased levels of serum calcium were related to Mn-B. The response to the eye-hand coordination test suggests the existence of a Mn-B threshold at about 1 microgram Mn/100 ml of whole blood. This study demonstrates that a time-weighted average exposure to airborne Mn dust (total dust) of about 1 mg/m3 for less than 20 years may present preclinical signs of intoxication.

The hemangioendothelioma is a benign neoplasm, rarely observed in the mouth. In the literature, reports on the treatment and on the therapeutic results are lacking. This type of gingival neoplasm was observed in a young adult male. It was located in the attached gingiva in the upper and in the lower jaw, covering almost the entire coronal part of the anterior teeth. An exhaustive internal and neurological examination revealed no associated general disease. The gingival biopsies displayed the typical characteristics of a hemangioendothelioma: proliferation of the blood vessels, with a reduced lumen surrounded by swollen endothelial cells. The treatment consisted of a meticulous mechanical plaque control, chlorhexidine rinses, gingivectomy procedures and a monthly professional prophylaxis. 3 years after the periodontal treatment, the gingival structures remained clinically healthy. In the biopsies, only a small amount of inflammatory cells could be detected. This report shows a case of benign gingival neoplasms of unknown etiology in which meticulous plaque control, combined with extensive gingivectomies and repeated professional prophylaxis may have prevented or, at least, retarded the recurrence of the lesion.