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Manganese (Mn) is an essential nutrient; however, overexposure can be neurotoxic. Recent evidence suggests that exposure to Mn from drinking water could be neurotoxic; however, research is hampered by the lack of consensus on a reliable biomarker of Mn exposure. Naturally high concentrations of Mn can occur in groundwater, particularly for private, unregulated water systems. This study aimed to investigate the association between exposure to Mn from drinking water with a relatively low Mn content (median of 2.9 μg/L; range, undetectable-8,340 μg/L) and Mn in toenails from women collected at two time points: during and after pregnancy. Mn concentrations in the paired toenail samples gathered during the second to third trimester of pregnancy and 2 weeks postpartum were correlated (r = 0.47, p < 0.001, n = 596). Among women consuming drinking water Mn in the highest tertile (i.e., > 9.8 μg/L) significant positive correlations were found between water Mn and toenails Mn (r = 0.31 and r = 0.38, for toenail samples collected during pregnancy and postpartum, respectively), whereas little to no correlation was observed at lower water concentrations. Overall, our data suggest that maternal toenail samples are a reliable environmental Mn exposure biomarker and reflect exposure from drinking water.

Background: Manganese is an essential element, but excessive manganese exposure has neurotoxic effects., Objective: To examine blood manganese levels in the general population with respect to sex, age, race/ethnicity, pregnancy and menauposal status, as well as levels of trace elements in blood., Methods: We used data from the National Health and Nutrition Examination Survey, a national survey of U.S. residents (n = 7720 participants, ages 1 to 80 years). General linear models and generalized additive models were used to examine the association between blood manganese concentration and participants' characterisics, accounting for the complex survey design., Results: Blood manganese levels ranged from 1.6 to 62.5 μg/L, with arithmetic means of 10.6 and 9.2 μg/L for women and men, respectively. The following characteristics were significantly associated with higher blood manganese levels: female sex, younger age, Asian origin, and being pregnant. In addition, there were non-linear relationships between blood manganese levels and cadmium, iron, lead, and mercury levels., Conclusion: The higher blood manganese levels observed among females suggest sex-related metabolic differences in the regulation of manganese, and elevated levels among pregnant women suggest an important role of manganese in reproduction. The present study supports the need to take into consideration age- and sex-related differences in blood manganese levels, as well as pregnancy status when examining manganese essentiality or toxicity.

Background: Polychlorinated biphenyls (PCBs) are ubiquitously present in humans because of their resistance to degradation and accumulation in fatty tissues. Data on neurotoxic effects in older adults are limited., Objective: We examined the cross-sectional association between serum PCB concentrations and cognitive function in older adults from the general U.S. population., Methods: We analyzed data from 708 respondents, 60-84 years of age, participating in the National Health and Nutrition Examination Survey (1999-2002). We used the summed concentrations of 12 lipid-standardized PCB congeners as the measure of exposure and assessed cognitive function with the Digit-Symbol Coding test. We adjusted analyses for age, education, race/ethnicity, and poverty/income ratio., Results: The median concentration of lipid-standardized PCBs in serum was 271 ng/g (interquartile range, 193-399 ng/g). We found a significant interaction between dioxin-like PCB concentration and age in association with cognitive score (p=0.04). Among older individuals (70-84 years of age), a 100-ng/g increase in serum concentrations of dioxin-like PCBs was associated with a significantly lower cognitive score (-2.7 points; 95% CI: -5.1, -0.2; p=0.04); however, in younger individuals (60-69 years of age), there was a nonsignificant positive association (2.9 points; 95% CI: -1.8, 7.7; p=0.32). Among the older participants, the negative association was more pronounced in women than in men., Conclusion: Our findings support the hypothesis that PCB exposure has adverse cognitive effects even at levels generally considered to pose low or no risk, perhaps affecting mainly those of advanced age.

Objective: The goal was to examine the association between urinary concentrations of dialkyl phosphate metabolites of organophosphates and attention-deficit/hyperactivity disorder (ADHD) in children 8 to 15 years of age., Methods: Cross-sectional data from the National Health and Nutrition Examination Survey (2000-2004) were available for 1139 children, who were representative of the general US population. A structured interview with a parent was used to ascertain ADHD diagnostic status, on the basis of slightly modified criteria from the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition., Results: One hundred nineteen children met the diagnostic criteria for ADHD. Children with higher urinary dialkyl phosphate concentrations, especially dimethyl alkylphosphate (DMAP) concentrations, were more likely to be diagnosed as having ADHD. A 10-fold increase in DMAP concentration was associated with an odds ratio of 1.55 (95% confidence interval: 1.14-2.10), with adjustment for gender, age, race/ethnicity, poverty/income ratio, fasting duration, and urinary creatinine concentration. For the most-commonly detected DMAP metabolite, dimethyl thiophosphate, children with levels higher than the median of detectable concentrations had twice the odds of ADHD (adjusted odds ratio: 1.93 [95% confidence interval: 1.23-3.02]), compared with children with undetectable levels., Conclusions: These findings support the hypothesis that organophosphate exposure, at levels common among US children, may contribute to ADHD prevalence. Prospective studies are needed to establish whether this association is causal.

Context: Lead is a ubiquitous neurotoxicant, and adverse cognitive and behavioral effects are well-documented in children and occupationally exposed adults but not in adults with low environmental exposure., Objective: To investigate the association of current blood lead levels with 3 common psychiatric disorders-major depression, panic, and generalized anxiety-in young adults., Design: Cross-sectional epidemiologic survey., Setting: Nationally representative sample of US adults., Participants: A total of 1987 adults aged 20 to 39 years who responded to the National Health and Nutrition Examination Survey (1999-2004)., Main Outcome Measures: Twelve-month DSM-IV criteria-based diagnoses of major depressive disorder, panic disorder, and generalized anxiety disorder assessed using the Composite International Diagnostic Interview., Results: The mean (SD) blood lead level was 1.61 (1.72) microg/dL (range, 0.3-37.3 microg/dL) (to convert to micromoles per liter, multiply by 0.0483). Increasing blood lead levels were associated with higher odds of major depression (P = .05 for trend) and panic disorder (P = .02 for trend) but not generalized anxiety disorder (P = .78 for trend) after adjustment for sex, age, race/ethnicity, education status, and poverty to income ratio. Persons with blood lead levels in the highest quintile had 2.3 times the odds of major depressive disorder (95% confidence interval [CI], 1.13-4.75) and 4.9 times the odds of panic disorder (1.32-18.48) as those in the lowest quintile. Cigarette smoking was associated with higher blood lead levels and outcome, but models that excluded current smokers also resulted in significantly increased odds of major depression (P = .03 for trend) and panic disorder (P = .01 for trend) with higher blood lead quintiles., Conclusions: In these young adults with low levels of lead exposure, higher blood lead levels were associated with increased odds of major depression and panic disorders. Exposure to lead at levels generally considered safe could result in adverse mental health outcomes.