Correlation study of blood cell manganese and hemoglobin levels among workers occupationally exposed to manganese
Objective To explore the correlation and dose-response relationship between blood cell manganese(Mn)and hemoglobin(Hb)levels among workers occupationally exposed to manganese,providing the scientific basis for preventing health damage caused by occupational manganese exposure.Methods A total of 826 manganese-exposed workers from a ferromanganese alloy smelting plant in Guangxi were studied.Data from the epidemiologic questionnaires survey and on-site occupational health investigation were conducted during follow-up in 2017.The mass concentration of manganese in blood cells was measured using inductively coupled plasma mass spectrometry(ICP-MS),and hemoglobin levels were measured using an automatic blood cell analyzer.Generalized linear models(GLMs)and restricted cubic spline analyses were used to investigate the correlation and dose-response relationship between blood cell manganese and hemoglobin levels.Results Finally,this study included 823 study subjects due to data missed.The manganese concentration in the air ranged from 0.004 to 0.061 mg/m3 for the workers in the control group(n=141),while 0.004 to 1.557 mg/m3 for the workers in the low-exposure group(n=141),and 0.060 to 2.461 mg/m3 for workers in the high-exposure group(n=141).The median manganese mass concentrations in blood cells of the three study groups were 25.68 μg/L,30.87 μg/L,and 32.11 μg/L,respectively,with significant differences(P＜0.001);the mean hemoglobin levels were(150.1±17.4)μg/L,(143.9±17.5)μg/L,and(149.2±15.8)μg/L,respectively,also showing significant differences(P＜0.001).Higher blood cell manganese concentrations were observed in the females,non-smokers,non-drinkers,and individuals with a BMI ≥ 28.0 kg/m2(all P＜0.05).GLM analysis showed that compared to the Q1 group(blood cell manganese mass concentration＜24.17 μg/L),hemoglobin levels increased by 4.771 μg/L,7.747 μg/L,and 2.995 μg/L in the Q2(24.17-30.62 μg/L),Q3(＞30.62-39.11 μg/L),and Q4(＞39.11 μg/L)groups,respectively(all P＜0.05).Compared to the males,the females had 20.824 μg/L lower hemoglobin levels(P＜0.05).Restricted cubic spline analysis indicated an inverted U-shaped dose-response relationship between blood cell manganese concentration and hemoglobin levels(F=53.9,P＜0.05).Conclusions The level of manganese in blood cells of manganese-exposed workers was higher than that of the general population.Lower levels of blood cell manganese may promote hemoglobin synthesis,while higher concentrations may inhibit hemoglobin synthesis.
metal exposuremanganesehemoglobinrestricted cubic spline analysisdose-response relationship
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