Diseases Caused by Manganese or Its Compounds

1. Introduction and Definitions

Manganese is a naturally occurring element found in many types of rock and soil. It is essential for human health in small amounts, playing a role in bone formation, blood clotting, and immune function. However, excessive exposure to manganese, particularly in industrial settings, can lead to serious health issues. Manganism, a neurological condition resembling Parkinson's disease, is one of the most severe outcomes of chronic manganese exposure. This article aims to provide comprehensive information on diseases caused by manganese or its compounds, targeting occupational health nurses and doctors.

2. Agent Causes the Disease

Manganese exposure can occur through inhalation of dust or fumes, ingestion of contaminated water or food, and, less commonly, through dermal contact. Industrial activities such as mining, welding, and the production of steel, batteries, and fertilizers can release manganese into the environment. The most hazardous form of exposure is inhalation of manganese fumes or dust, which can occur in various occupational settings.

3. Workers at Risk of This Disease

Several occupations and tasks put workers at higher risk of manganese exposure, including:

  • Welders and Metal Workers: Exposure to manganese fumes during welding and metal cutting.
  • Miners: Particularly those involved in manganese ore extraction.
  • Steel Workers: Involved in the production and processing of steel.
  • Battery Manufacturing Workers: Handling manganese compounds in battery production.
  • Fertilizer Plant Workers: Exposure to manganese in fertilizers.
  • Ceramic and Glass Industry Workers: Using manganese in glazing and coloring processes.

4. Symptoms

Symptoms of manganese-related diseases can vary depending on the level and duration of exposure:

  • Neurological Symptoms: Early signs include headaches, fatigue, irritability, and memory loss. Chronic exposure can lead to manganism, characterized by tremors, muscle rigidity, slow movement, and psychological disturbances.
  • Respiratory Symptoms: Including cough, bronchitis, and reduced lung function due to inhalation of manganese dust or fumes.
  • Other Symptoms: Gastrointestinal issues, liver and kidney damage, and reproductive problems in severe cases.

5. Diagnosis

Diagnosing manganese-related diseases involves a combination of clinical evaluation, occupational exposure assessment, and specific tests:

  • Medical History and Physical Examination: Detailed assessment of the patient's work history and symptoms.
  • Neurological Evaluation: Including tests for motor function, cognitive abilities, and psychological state.
  • Blood and Urine Tests: Measuring manganese levels to assess exposure.
  • Imaging Tests: MRI scans can detect changes in the brain associated with manganism.
  • Pulmonary Function Tests: To evaluate respiratory impairment in cases of inhalation exposure.

6. Treatment

Treatment for manganese-related diseases focuses on managing symptoms and preventing further exposure:

  • Remove from Exposure: Immediate removal from the source of manganese exposure is crucial.
  • Symptomatic Treatment: Providing medications to manage neurological and respiratory symptoms. This may include medications used for Parkinson's disease, such as levodopa.
  • Chelation Therapy: In cases of severe manganese poisoning, chelating agents may be used to bind manganese and enhance its excretion.
  • Supportive Care: Including physical therapy for motor symptoms and psychological support.
  • Long-term Monitoring: Regular follow-up to monitor neurological and respiratory function.

7. Prevention

Preventing manganese-related diseases involves implementing strict control measures in the workplace:

  • Engineering Controls: Using local exhaust ventilation, enclosed processes, and proper maintenance of equipment to reduce airborne manganese.
  • Work Practices: Implementing safe work practices such as proper handling and disposal of manganese-containing materials, and avoiding eating, drinking, or smoking in areas where manganese is used.
  • Personal Protective Equipment (PPE): Providing and ensuring the use of appropriate respirators, protective clothing, and gloves.
  • Health Surveillance: Regular health screenings, including neurological and respiratory assessments for workers exposed to manganese.
  • Education and Training: Informing workers about the hazards of manganese and safe work practices to minimize exposure.

By understanding the risks associated with manganese exposure and implementing effective preventive measures, occupational health professionals can significantly reduce the incidence of manganese-related diseases and enhance the overall well-being of workers.

Workplace Exposure Limits: