Occupational exposure to manganese and fine motor skills in elderly men: Results from the Heinz Nixdorf Recall Study

Beate Pesch, Swaantje Casjens, Tobias Weiss, Benjamin Kendzia, Marina Arendt, Lewin Eisele, Thomas Behrens, Nadin Ulrich, Noreen Pundt, Anja Marr, Sibylle Robens, Christoph Van Thriel, Rainer Van Gelder, Michael Aschner, Susanne Moebus, Nico Dragano, Thomas Brüning, Karl Heinz Jöckel

Research output: Contribution to journalArticlepeer-review

9 Scopus citations


Objectives: Exposure to manganese (Mn) may cause movement disorders, but less is known whether the effects persist after the termination of exposure. This study investigated the association between former exposure to Mn and fine motor deficits in elderly men from an industrial area with steel production. Methods: Data on the occupational history and fine motor tests were obtained from the second follow-up of the prospective Heinz Nixdorf Recall Study (2011-2014). The study population included 1232 men (median age 68 years). Mn in blood (MnB) was determined in archived samples (2000-2003). The association between Mn exposure (working as welder or in other at-risk occupations, cumulative exposure to inhalable Mn, MnB) with various motor functions (errors in line tracing, steadiness, or aiming and tapping hits) was investigated with Poisson and logistic regression, adjusted for iron status and other covariates. Odds ratios (ORs) with 95% confidence intervals (CIs) were estimated for substantially impaired dexterity (errors >90th percentile, tapping hits <10th percentile). Results: The median of cumulative exposure to inhalable Mn was 58 μg m-3 years in 322 men who ever worked in at-risk occupations. Although we observed a partly better motor performance of exposed workers at group level, we found fewer tapping hits in men with cumulative Mn exposure >184.8 μg m-3 years (OR 2.15, 95% CI 1.17-3.94). MnB ≥ 15 μg l-1, serum ferritin ≥ 400 μg l-1, and gamma-glutamyl transferase ≥74 U l-1 were associated with a greater number of errors in line tracing. Conclusions: We found evidence that exposure to inhalable Mn may carry a risk for dexterity deficits. Whether these deficits can be exclusively attributed to Mn remains to be elucidated, as airborne Mn is strongly correlated with iron in metal fumes, and high ferritin was also associated with errors in line tracing. Furthermore, hand training effects must be taken into account when testing for fine motor skills.

Original languageEnglish (US)
Pages (from-to)1118-1131
Number of pages14
JournalAnnals of Work Exposures and Health
Issue number9
StatePublished - Nov 1 2017


  • Community-based cohort
  • Ferritin
  • Fine motor skills
  • Manganese
  • Welding

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health


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