Çalışma Yaşamında Manganez Maruz Kalımının Sağlık Etkileri ve Parkinsonizm

Öz

Yaygın olarak kullanılan, bir ağır metal olan manganez (Mn), biyolojik fonksiyonları yürüten birçok enzimatik işlem için gerekli olan bir eser elementtir. Bununla birlikte, Mn’e aşırı maruz kalım, toksisiteye yol açmaktadır. Bu toksisitenin santral sinir sistemine etkileri özel önem taşımaktadır. Mn aşırı maruz kalımı tipik olarak parkinsonizm olarak ortaya çıkmakta ve daha yaygın görülen idiyopatik Parkinson hastalığından ayırt edilmesi zor olabilmektedir. Mesleki ve çevresel maruz kalıma ek olarak, sistemik hastalıklar, total parenteral beslenme ve bazı ilaçlar Mn toksisitesinin diğer potansiyel etiyolojileri arasında sayılabilir. Bu derlemede; Mn mesleki ve çevresel maruz kalımı, patofizyolojisi ve klinik özellikleri ele alınmıştır. Ayrıca, Mn'in iş yerindeki etkisi ve bir toksisitenin nörodejeneratif bir hastalık olarak tanılanmaması için ayrıntılı bir mesleki ve çevresel öykünün gerekliliği vurgulanmıştır. Kapsamlı bir tedavinin yokluğunda, erken tanı ve önleyici tedbirlerin zamanında başlatılması, Mn toksik etkilerinin yönetilmesinin anahtarıdır.

Anahtar Kelimeler

• İş sağlığı ve güvenliği
• manganez
• parkinsonizm
• toksikoloji

Health Effects of Manganese Exposure at Workplace and Parkinsonism

Öz

Manganese (Mn), a heavy metal commonly used in industry, is a trace element required for many enzymatic processes that drive biological functions. However, excess exposure to Mn leads to toxicity. Its toxic effects on the central nervous system are important. The typical manifestation of Mn over exposure is parkinsonism, which may be challenging to differentiate it from more common idiopathic Parkinson's disease. In addition to occupational and environmental exposure to Mn, other potential etiologies causing Mn toxicity include systemic diseases, total parenteral nutrition and some drugs. In this review, we evaluated occupational and environmental exposure of Mn, its pathophysiology and clinical characteristics. We have highlighted the impact of Mn exposure at the workplace and emphasize the necessity of a detailed occupational and environmental history to ensure that a toxicity is not misdiagnosed as a neurodegenerative disease. In the absence of a comprehensive treatment, early diagnosis and timely initiation of preventive measures are the keys to managing Mn toxic effects.

Anahtar Kelimeler

• Manganese
• Occupational Health and Safety
• Parkinsonism
• Toxicology

Kaynakça

1. ATSDR 2012. Toxicological Profile for Manganese, Agency for Toxic Substances and Disease Registry. US Public Health Service.
2. Kazeem B, Salako Mahbub MU. (2014). Manganese. Ladou J, Harrison RJ. (Ed.). Occupational&Envorimental Medicine (s.918-920). New York:Mc Graw Hill Education
3. T.C. Çalışma ve Sosyal Güvenlik Bakanlığı. (2012). Meslek Hastalıkları ve İş ile İlgili Hastalıklar Tanı Rehberi. Ankara: T.C. Çalışma ve Sosyal Güvenlik Bakanlığı.
4. WHO. Manganese and Its Compounds: Environmental Aspects. Geneva, 2004: 6-7.
5. Singaraju M, Singaraju S, Parwani R., 2012. Cytogenetic biomonitoring in petrol station attendants: A micronucleus study. Journal of Cytology/Indian Academy of Cytologists, 29:1–5.
6. Williams M, Todd GD, Roney N, Crawford J, Coles C, McClure PR, et al. Toxicological Profile for Manganese. Atlanta (GA): Agency for Toxic Substances and Disease Registry (US); 2012 Sep.
7. Azcona-Cruz MI, Rothenberg SJ, Schnaas L, Zamaro-Munoz JS, Romeroplaceres M. Lead-Glazed Ceramic Ware and Blood Lead Levels of Children in the City of Oaxaca, Mexico. Archives of Environmental Health. 2000:55(3):217-222.
8. Carrington CD, Bolger PM. Toxic Metals; Lead. Encylopadia of Food Safety. 2014 (2):349.

9. Agency for Toxic Substances and Disease Registry Toxicological Profile for Manganese. (2012). ATSDR. Erişim: 6 Mayıs 2021 http://www.atsdr. cdc.gov/toxprofiles/tp151.pdf.
10. Zeidler-Erdely PC, Erdely A, Antonini JM. Immunotoxicology of arc welding fume: Worker and experimental animal studies. Journal of Immunotoxicology. 2012;9(4):411-25.
11. Erdely A, Antonini JM, Young S-H, Kashon ML, Gu JK, Hulderman T, et al. Oxidative stress and reduced responsiveness of challenged circulating leukocytes following pulmonary instillation of metal-rich particulate matter in rats. Particle and Fibre Toxicology. 2014;11(1):34.
12. Shoeb M, Kodali V, Farris B, LM, Meighan T, Salmen R, et al. Evaluation of the molecular mechanisms associated with cytotoxicity and inflammation after pulmonary exposure to different metal-rich welding particles. Nanotoxicology. 2017;11(6):725-36.
13. Taube F. Manganese in occupational arc welding fumes: Aspects on physiochemical properties, with focus on solubility. Annals of Occupational Hygiene. 2012;57(1):6-25.
14. Antonini JM, Roberts JR, Chapman RS, Soukup JM, Ghio AJ, Sriram K. Pulmonary toxicity and extrapulmonary tissue distribution of metals after repeated exposure to different welding fumes. Inhalation Toxicology. 2010;22(10):805-16.
15. Chia SE, Foo SC, Gan SL, Jeyaratnam J, Tian CS. Neurobehavioral functions among workers exposed to manganese ore. Scand J Work Environ Health 1993;19:264-270.
16. Lucchini R, Selis L, Folli D, Apostoli P, Mutti A, Vanoni O, et al. Neurobehavioral effects of manganese in workers from a ferroalloy plant after temporary cessation of exposure. Scand J Work Environ Health 1995;21:143- 149.
17. Myers JE, Thompson ML, Ramushu S, Young T, Jeebhay MF, London L, et al. The nervous system effects of occupational exposure on workers in a South African manganese smelter. Neurotoxicology 2003;24:885-894.
18. Lee EY, Flynn MR, Lewis MM, Mailman RB, Huang X. Welding-related brain and functional changes in welders with chronic and low-level exposure. Neurotoxicology 2018;64:50-59.
19. O’Neal SL, Zheng W. Manganese toxicity upon over exposure: A decade in review. Curr Environ Health Rep 2015;2:315-328.
20. Zayed J. Use of MMT in Canadian gasoline: health and environment issues. American Journal of Industrial Medicine 2001; 39(4), 426-433.
21. Pouchieu C, Piel C, Carles C, Gruber A, Helmer C, Tual S, et al. Pesticide use in agriculture and Parkinson’s disease in the AGRICAN cohort study. Int J Epidemiol 2018;47:299-310.
22. Mergler D, Baldwin M, Bélanger S, Larribe F, Beuter A, Bowler R, et al. Manganese neurotoxicity, a continuum of dysfunction: Results from a community based study. Neurotoxicology 1999;20:327-342.
23. Lucchini RG, Albini E, Benedetti L, Borghesi S, Coccaglio R, Malara EC, et al. High prevalence of parkinsonian disorders associated to manganese exposure in the vicinities of ferroalloy industries. American Journal of Industrial Medicine 2007;50: 788-800.
24. Standridge JS, Bhattacharya A, Succop P, Cox C, Haynes E. Effect of chronic low level manganese exposure on postural balance: A pilot study of residents in Southern Ohio. J Occup Environ Med 2008;50:1421-1429.
25. Winder BS. Manganese in the air: Are children at greater risk than adults? J Toxicol Environ Health A 2010;73:156-158.
26. Kullar SS, Shao K, Surette C, Foucher D, Mergler D, Cormier P, et al. A benchmark concentration analysis for manganese in drinking water and IQ deficits in children. Environ Int 2019;130:104889.
27. Neal AP, Guilarte TR. Mechanisms of lead and manganese neurotoxicity. 700. Toxicol Res (Camb) 2013;2:99-114.
28. Abdalian R, Saqui O, Fernandes G, Allard JP. Effects of manganese froma commercial multi-trace element supplement in a population sample of Canadian patients on long-term parenteral nutrition. JPEN J Parenteral Nutr 2013;37:538-543.
29. Koksal A, Baybas S, Sozmen V, Koksal NS, Altunkaynak Y, Dirican A, et al. Chronic manganese toxicity due to substance abuse in Turkish patients. Neurol India 2012;60:224-227.
30. Smith D., Woodall GM., Jarabek AM, & Boyes WK. Manganese testing under a clean air act test rule and the application of resultant data in risk assessments. Neurotoxicology 2018; 64, 177-184.
31. Hasan H. Understanding the Element of the Periodic Table: Manganese. New York, Rosen Central, 2008:4-12.
32. Çelik A, Abalı Y, Edgünlü G, Uzunoğlu S, & Tirtom VN. İnsan saçında bulunan (Manisa ilinin üç farklı yerleşim bölgesinde) bazı ağır metallerin ICP-OES yöntemi ile tayini. Ekoloji 2009; 19(73), 71-75.
33. Goldhaber SB. Trace element risk assessment: essentiality vs. toxicity.Regul Toxicol Pharmacol 2003; 38(2):232-42.
34. Cikrt M. VEGJ. Manganese. Environmental Health Criteria: Genevra; 1981. Report No.: 17.
35. Lucchini R, Placidi D, Cagna G, Fedrighi C, Oppini M, Peli M, et al. Manganese and Developmental Neurotoxicity. Neurotoxicity of Metals: U.S.A., Springer; 2017.13-34.
36. Nordberg G., Fowler BA, Nordberg M, Friberg LT. Handbook on The Toxicology of Metals, U.S.A.: Academic Press; 2014.
37. OSHA Occupational Safety&Health Administration Manganese Fume, Manganese Compounds.[Internet]. [Erişim tarihi: 01.05.2021] Erişim adresi: https://www.osha.gov/dts/chemical
38. Raval G, Straughen JE, McMillin GA, Bornhorst JA.Unex- plained hemolytic anemia with multiorgan failure. Clin Chem 2011; 57(1485).
39. Roels H, Djubgang J, Buchet JP, Bernard A, & Lauwerys R. Evolution of cadmium-induced renal dysfunction in workers removed from exposures. Scandinavian Journal of Work, Environment & Health 1982; 191-200.
40. Agency for Toxic Substances and Disease Registry, Division of Toxicology, 2012. Toxicolgical Profile for manganese. Update Draft for Public Comments. ATSDR, Atlanta GA.
41. Pfeifer GD, Roper, J.M., Dorman, D., Lynam, D.R., 2004. Health and environmental testing of manganese exhaust products from use of methylcyclopentadienyl manganese tricarbonyl in gasoline. Sci Total Environ., 334- 335:397-408.
42. Goyer RA. and Clarkson TW. Toxic Effects of Metals. Casarett and Doullis Toxicology. New York: McGraw-Hill; 2001.
43. Nogawa K, Kobayashi E, Okubo Y, Suwazono Y. Environmental cadmium exposure, adverse effects and preventive measures in Japan. Biometals 2004;17(581).
44. Kulshreshtha D., Ganguly J, & Jog M. Manganese and Movement Disorders: A Review. Journal of Movement Disorders 2021;14(2), 93.
45. Aschner M, Erikson KM, Hernández EH, & Tjalkens R. Manganese and its role in Parkinson’s disease: From transport to neuropathology. Neuromolecular Medicine 2009;11(4), 252-266.
46. Chen P, Chakraborty S, Mukhopadhyay S, Lee E, Paoliello MM, BowmanAB, et al. Manganese homeostasis in the nervous system. J Neurochem 2015;134:601-610.
47. Huang C. Parkinsonism induced by chronic manganese intoxication-an experience in Taiwan. Chang Gung Medical Journal 2007;30(5), 385.
48. Harischandra DS, Ghaisas S, Zenitsky G, Jin H, Kanthasamy A, Anantharam V, & Kanthasamy AG. Manganese-induced neurotoxicity: New insights into the triad of protein misfolding, mitochondrial impairment, and neuroinflammation. Frontiers in Neuroscience, 2019;13, 654.
49. Gavin CE, Gunter KK, Gunter TE. Manganese and calcium efflux kinetics in brain mitochondria. Relevance to manganese toxicity. Biochem J 1990; 266:329-334.
50. Kowaltowski AJ, Castilho RF, & Vercesi AE. Ca (2+)-induced mitochondrial membrane permeabilization: role of coenzyme Q redox state. American Journal of Physiology-Cell Physiology 1995;269(1), 141-147.
51. Gonzalez-Cuyar LF, Nelson G, Criswell SR, Ho P, Lonzanida JA, Checko- way H, et al. Quantitative neuropathology associated with chronic manganese exposure in South African mine workers. Neurotoxicology 2014; 45:260-266.
52. Harischandra DS, Rokad D, Neal ML., Ghaisas S., Manne S, Sarkar S, & Kanthasamy AG. Manganese promotes the aggregation and prion-like cell-to-cell exosomal transmission of α-synuclein. Science Signaling, 2019;12(572).
53. Calne DB, Chu NS, Huang CC, Lu CS, Olanow W. Manganism and idiopathic parkinsonism: Similarities and differences. Neurology 1994;44;1583- 1586.
54. Ikeda K, Ebina J, Kawabe K, Iwasaki Y. Dopamine transporter imaging in Parkinson disease: Progressive changes and therapeutic modification after anti-parkinsonian medications. Intern Med 2019;58:1665-1672.
55. Andruska KM, Racette BA. Neuromythology of manganism. Curr Epidemiol Rep 2015;2:143-148.
56. Josephs KA, Ahlskog JE, Klos KJ, Kumar N, Fealey RD, Trenerry MR, et al. Neurologic manifestations in welders with pallidal MRI T1 hyperintensity. Neurology 2005;64:2033-2039.
57. Huang CC, Chu NS, Lu CS, Chen RS, Calne DB. Long-term progression in chronic manganism: Ten years of follow-up. Neurology 1998;50:698-700.
58. Rocha E, Vale TC., Kok F, Pedroso JL., & Barsottini, OG. Teaching Video NeuroImages: Spinocerebellar ataxia type 3 presenting with a cock-walk gait phenotype. Neurology 2017;89:e192.
59. Fasano A, Bloem BR. Gait disorders. Continuum (MinneapMinn) 2013; 19:1344-1382.
60. Ghosh R, Dubey S, Chatterjee S, Ghosh M, Ray BK, Benito-León J. Hypermanganesemia induced chorea and cognitive decline in a tea seller. Tremor Other Hyperkinet Mov (N Y) 2020;10:45.
61. Ono K, Komai K, Yamada M. Myoclonic involuntary movement associated with chronic manganese poisoning. J Neurol Sci 2002;199:93-96.
62. Liu J, Jin L, Zhang L, Li Z, Wang L, Ye R, & Ren A. Placental concentrations of manganese and the risk of fetal neural tube defects. Journal of Trace Elements in Medicine and Biology 2013; 27(4), 322-325.
63. Avila DS, Puntel RL, Aschner M. Manganese in health and disease. MetIons Life Sci 2013;13:199-227.
64. Andersen O. Principles and recent developments in chelation treatment of metal intoxication. Chem Rev 1999;99:2683-2710.
65. Eastman RR, Jursa TP, Benedetti C, Lucchini RG, Smith DR. Hair as a biomarker of environmental manganese exposure. Environ. Sci. Technol 2013; 47(3),1629–1637.
66. Jarvisalo J, Olkinuora M, Kiilunen M, Kivisto H, Ristola P, Tossavainen A., et al. Urinary and blood manganese in occupationally nonexposed populations and in manual metal arc welders of mild steel. Int. Arch. Occup. Environ. Health 1992; 63(7), 495–501.
67. Michalke B, and Fernsebner K. New insights into manganese toxicity and speciation. J. Trace Elem. Med. Biol 2014;28(2), 106-116.
68. Özdek U, Alacabey İ, Alacabey NA.,Kömüroğlu AU, Kul AR, Atasoy N, Üçler R. Petrol İstasyonu Çalışanlarında Manganez (Mn) Düzeyinin Belirlenmesi. Yüzüncü Yıl Üniversitesi Fen Bilimleri Enstitüsü Dergisi 2017;22(2), 97-101.
69. Kendzia B, Van Gelder R, Schwank T, Hagemann C, Zschiesche W, Behrens T, & Pesch B. Occupational exposure to inhalable manganese at German workplaces. Annals of Work Exposures and Health 2017;61(9), 1108-1117.
70. Yang H, Wang J, Yang X, Wu F, Qi Z, Xu B., & Deng Y. Occupational manganese exposure, reproductive hormones, and semen quality in male workers: A cross-sectional study. Toxicology and Industrial Health 2019; 35(1), 53-62.
71. Palzes VA, Sagiv SK, Baker JM, Rojas-Valverde D, Gutiérrez-Vargas R, Winkler MS, & Mora AM. Manganese exposure and working memory-related brain activity in small holder farm workers in Costa Rica: Results from a pilot study. Environmental Research 2019; 173, 539-548.
72. Chen X, Liu Z, Ge X, Luo X, Huang S, Zhou Y, & Yang X. Associations between manganese exposure and multiple immunological parameters in manganese-exposed workers healthy cohort. Journal of Trace Elements in Medicine and Biology 2020; 59, 126454.
73. Dlamini WW, Nelson G, Nielsen SS, & Racette BA. Manganese exposure, parkinsonian signs, and quality of life in South African mine workers. American Journal of Industrial Medicine 2020; 63(1), 36-43.
74. Irizar A, Molinuevo A, Andiarena A, Jimeno-Romero A, San Román A, Broberg K, & Lertxundi A. Prenatal manganese serum levels and neurodevelopment at 4 years of age. Environmental Research 2021; 197, 111172.
75. Rahman MA, Hashem MA., Rana MS, & Islam MR. Manganese in potable water of nine districts, Bangladesh: human health risk. Environmental Science and Pollution Research 2021;1-13.
76. Herrero Hernandez E, Discalzi G, Valentini C, Venturi F, Chiò A, Carmellino C, et al. Follow-up of patients affected by manganese-induced parkinsonism after treatment with CaNa2EDTA. Neurotoxicology 2006; 27:333-339.
77. Yoon H, Kim DS, Lee GH, Kim JY, Kim DH, Kim KW, et al. Protective effects of sodium para-amino salicylate on manganese-induced neuronal death: The involvement of reactive oxygen species. J Pharm Pharmacol 2009; 61:1563-1569.
78. Jiang YM, Mo XA, Du FQ, Fu X, Zhu XY, Gao HY, et al. Effective treatment of manganese-induced occupational parkinsonism with p-aminosalicylic acid: A case of 17-year follow-up study. J Occup Environ Med 2006;48:644-649.
79. Racette BA, Searles Nielsen S, Criswell SR, Sheppard L, Seixas N, Warden MN, et al. Dose-dependent progression of parkinsonism in manganese-exposed welders. Neurology 2017;88:344-351.
80. Canadian Centre for Occupational Health and Safety (CCOHS). Welding-fumes and gases [Internet]. Hamilton: Canadian Centre for Occupational Health and Safety; 2016. Available at: https://www.ccohs.ca/oshan- swers/safety_haz/welding/fumes.html.
81. Government of Canada. Canada Occupational Health and Safety Regu- lations (SOR/86-304) [Internet]. Ottawa: Department of Justice of Canada; 2018. Available at: https://laws.justice.gc.ca/eng/regulations/sor-86- 304/index.html.