Journal of Occupational Medicine and Toxicology最新文献

{"title":"Single versus double lung transplantation in patients with pneumoconiosis: a retrospective cohort study.","authors":"Chaojian Chen, Yifeng Huang, Zijie Li, Junhan Wu, Weifeng Zhong, Leyan Chen, Feng Liu, Guibin Qiao","doi":"10.1186/s12995-026-00524-6","DOIUrl":"10.1186/s12995-026-00524-6","url":null,"abstract":"<p><strong>Background: </strong>Lung transplantation (LT) is emerging as a critical final treatment for end-stage lung diseases including pneumoconiosis. Outcomes of single lung transplantation (SLT) and double lung transplantation (DLT) in pneumoconiosis remain understudied. This study evaluates clinical differences between the two procedures in pneumoconiosis patients to guide therapeutic decision-making for this occupational population.</p><p><strong>Methods: </strong>This retrospective cohort study included 119 pneumoconiosis patients undergoing LT at The Affiliated Wuxi People's Hospital of Nanjing Medical University between Jan 2018 and Dec 2022. The choice of SLT versus DLT was primarily driven by clinical judgment of high surgical risk, primarily due to severe pleural adhesions or calcification deemed too risky for bilateral pneumonectomy. Data on demographics, intraoperative and postoperative characteristics and patient survival were collected to compare SLT and DLT outcomes using Mann-Whitney U test and Pearson's chi-square test. The primary outcome was 1-year posttransplant survival. Posttransplant survival was assessed by Kaplan-Meier analysis and Cox proportional hazards models.</p><p><strong>Results: </strong>Of all the transplant recipients, 61 (51.3%) underwent SLT and 58 (48.7%) underwent DLT. DLT recipients were younger (44 [33-51] vs. 49 [43-53], p = 0.012), had higher mean pulmonary pressure (25.0 [20.0-25.0] vs. 20.0 [15.0-25.0] mmHg, p = 0.005) and experienced longer ischemic time (16.1 [13.4-18.0] vs. 7.2 [6.2-8.5] hours, p < 0.001). The durations of intraoperative and postoperative extracorporeal membrane oxygenation (ECMO) were significantly longer in DLT recipients (p < 0.001; p = 0.003). The perioperative mortality of recipients who underwent SLT was more than three times higher than that of those undergoing DLT (18.0% vs. 5.2%, p = 0.059). Those who received DLT had significantly improved survival compared to SLT, with a hazard ratio of 0.24 (95% CI: 0.07-0.81, p = 0.022).</p><p><strong>Conclusion: </strong>Our preliminary data suggested that DLT might be associated with better survival in patients with pneumoconiosis compared to SLT. A randomized controlled trial or large-scale multicenter registry study is needed to confirm this survival benefit and refine patient selection criteria.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13531740/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866146","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heart rate variability as a strain parameter in maritime settings: a scoping review of methodological approaches to data collection and analysis in field studies on the high seas.","authors":"Daniel Vasylenko, Lorenz Scheit, Chiara Reck, Dorothee Dengler, Volker Harth, Marcus Oldenburg","doi":"10.1186/s12995-026-00526-4","DOIUrl":"10.1186/s12995-026-00526-4","url":null,"abstract":"<p><strong>Background: </strong>Seafarers are exposed to unique occupational stressors that place sustained demands on the autonomic nervous system. Heart rate variability (HRV) represents a promising non-invasive tool for assessing mental and physical strain in maritime settings. However, its methodological application in real field conditions remains poorly characterized, and existing HRV guidelines do not specifically address the methodological challenges of maritime field studies.</p><p><strong>Methods: </strong>A scoping review was conducted following PRISMA guidelines. Eleven maritime field studies measuring HRV in operational or semi-operational settings were included and assessed for device selection, measurement quality, analysis methods, HRV metrics, and covariates.</p><p><strong>Results: </strong>Chest strap systems were the most frequently used (n = 8) and showed sufficient validity for field use. Methodological heterogeneity in reporting of recording duration, analysis software, artifact handling and HRV parameters was high across studies. Operational factors including sailing schedule and work-rest organization were the most commonly examined covariates and were most frequently associated with significant HRV findings. Recurring findings were small and predominantly male populations, shared participant cohorts across multiple studies, and incomplete methodological reporting.</p><p><strong>Conclusion: </strong>Overall, the studies utilized HRV appropriately for their respective aims. HRV measurement in maritime field settings is feasible but methodologically demanding, and it remains an underexplored domain, which limits the conclusions that can be drawn. More detailed and standardized reporting is necessary. Based on the recurring methodological reporting gaps, this review proposes a maritime-specific reporting checklist and an overview of recommended methodological options for future studies. Larger study populations are needed to account for confounding factors on board ships.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13528020/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148866131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Occupational health risks and provision gaps among live-in caregivers: findings from a qualitative interview study of Polish live-ins in Germany.","authors":"Lea Scheuvens, Maria Girbig, Melanie Schubert, Charlyn Görres, Amelie Schirmer, Agnieszka Sykut, Stephanie Drössler, Verena Weihofen, Liv Hübner, Daniel Kämpf, Charlotte Pietzsch, Katja Schladitz, Franziska Welzel, Nadja-Raphaela Baer, Steffi Riedel-Heller, Liane Schenk, Margrit Löbner, Andreas Seidler","doi":"10.1186/s12995-026-00522-8","DOIUrl":"10.1186/s12995-026-00522-8","url":null,"abstract":"<p><strong>Background: </strong>Migrant live-in caregivers play an important role in home-based long-term care, yet their working and living conditions remain largely underregulated. Despite increasing evidence of precarious employment and health risks among live-in caregivers internationally, little is known about their occupational health risks and access to occupational health care.</p><p><strong>Methods: </strong>This qualitative interview study is part of the project Live-In Health and reports findings from 16 semi-structured interviews with Polish live-in caregivers (15 females and one male) working in German private households. Interviews were conducted in Polish, transcribed, translated into German, and analyzed using qualitative content analysis following an inductive-deductive approach. Identified work-related strains and risks were structured in four main domains according to established occupational risk assessment frameworks from the German care sector.</p><p><strong>Results: </strong>Participants reported extensive occupational health risks across the four main domains: physical strain (e.g., musculoskeletal strain from patient transfers), psychological strain (e.g., social isolation, conflicts with agencies, emotional burden), occupational safety and health including working hours (e.g., long working hours, insufficient recovery time, lack of preparation and insurance coverage), and exposure to biological and hazardous substances (e.g., wound care, unhygienic living conditions). Access to occupational and general health care in Germany was largely absent. Preventive services, occupational medical examinations, and accident insurance coverage were inconsistently available or missing altogether. Live-ins described substantial barriers related to legal ambiguity, agency practices, lack of information, and unclear responsibilities. At the same time, informal support from families, ambulatory care services, and peer networks emerged as partial coping resources.</p><p><strong>Conclusions: </strong>Polish live-in caregivers in Germany are exposed to considerable occupational health risks while remaining largely excluded from occupational health care structures. The findings highlight substantial gaps in the implementation of existing occupational safety and health regulations for caregivers in private households. Strengthening occupational health protection for live-in caregivers requires enforceable working time regulations, reliable insurance coverage, accessible occupational health services, and clearer oversight of intermediary agencies. Tailored, low-threshold occupational health approaches are urgently needed to address the structural vulnerabilities of this workforce and to ensure healthy and sustainable care provision for the growing demand in home-based care for older people in Germany.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-08-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455274/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148708187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correction: Vapors, gases, dusts and fumes at work and chronic obstructive pulmonary disease/bronchitis: a systematic review and meta-analyses.","authors":"Victoria H Arrandale, Yizhi Zhang, Wendy Lou, Andrea C Tricco, Ambrose Lau, Ani Orchanian-Cheff, Paul K Henneberger, Susan M Tarlo","doi":"10.1186/s12995-026-00519-3","DOIUrl":"10.1186/s12995-026-00519-3","url":null,"abstract":"","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411690/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148609119","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perceived employment vulnerability in Latin America in the context of a potential new pandemic: a multicountry cross-sectional study.","authors":"Christian R Mejía, Víctor Serna-Alarcón, Jamil Cedillo-Balcázar, Leonel Vega-Useche, Dalia Useche-Villamizar, Camilo Vega-Useche","doi":"10.1186/s12995-026-00521-9","DOIUrl":"https://doi.org/10.1186/s12995-026-00521-9","url":null,"abstract":"<p><strong>Introduction: </strong>Emerging infectious disease threats may reactivate concerns about employment instability and economic disruption, particularly in regions marked by labor informality, social inequality, and limited social protection. Although the effects of COVID-19 on employment have been widely documented, less is known about how workers perceive the potential labor consequences of future health emergencies. This study aimed to assess perceived labor-related repercussions of a potential new pandemic among workers in Latin America.</p><p><strong>Methods: </strong>An analytical cross-sectional study was conducted using secondary data from an online survey administered to workers from more than ten Latin American countries between June and July 2022, during the early phase of the 2022 mpox outbreak. Participants were asked about the expected impact of a potential new pandemic on their employment, salary, and overall work situation. Associations between perceived labor-related repercussions and sociodemographic and occupational factors were evaluated using Poisson generalized linear models with a log link and robust variance, adjusted for country of residence.</p><p><strong>Results: </strong>Among 850 surveyed workers, 64.2% perceived that a potential new pandemic would have a considerable or very strong impact on their work. In the adjusted analysis, men reported a lower perceived impact than women (aPR: 0.87; 95% CI: 0.78-0.97; p = 0.009). Lower perceived impact was also observed among those engaged in virtual work (aPR: 0.64; 95% CI: 0.44-0.93; p = 0.018) and hybrid work (aPR: 0.84; 95% CI: 0.73-0.97; p = 0.017), compared with in-person workers. No occupational sector showed a statistically significant difference compared with healthcare workers in the revised adjusted model, although the food sector had a higher, non-significant point estimate.</p><p><strong>Conclusions: </strong>Perceived labor-related vulnerability in the context of a potential new pandemic was substantial among workers in Latin America. Perceptions differed mainly according to sex and work modality, while occupational-sector estimates should be interpreted cautiously because of subgroup heterogeneity and limited precision.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148457315","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations of weekly working hours with biological aging and all-cause and cardiovascular mortality: the role of lifestyle.","authors":"Tiina Föhr, Anna Kankaanpää, Aino Heikkinen, Mikaela Hukkanen, Christer Hublin, Jaakko Kaprio, Miina Ollikainen, Elina Sillanpää","doi":"10.1186/s12995-026-00518-4","DOIUrl":"https://doi.org/10.1186/s12995-026-00518-4","url":null,"abstract":"<p><strong>Background: </strong>This explorative study investigated the associations between working hours, biological aging, and all-cause and cardiovascular disease (CVD) mortality, and assessed the potential mediating role of lifestyle factors.</p><p><strong>Methods: </strong>We utilized data from the Older Finnish Twin Cohort, which comprised 9246 participants who had reported their weekly working hours in 1990. Biological aging was assessed using blood-based epigenetic aging measures in a subsample (n = 740). We used a counterfactual mediation approach. Lifestyle-related factors, including leisure-time physical activity (LTPA), alcohol consumption, body mass index (BMI), smoking, and sleep, were considered potential mediators. Between-within twin models were used to evaluate the extent to which shared familial factors confounded the observed associations.</p><p><strong>Results: </strong>During the mean 28-year follow-up period, 20.5% of the participants died. Long hours were directly associated with decreased risk of all-cause mortality, but only at the between-pair level; there were no associations with biological aging. However, long hours were indirectly associated with an increased risk of all-cause and CVD mortality through a higher BMI and smoking, and with an increased risk of CVD mortality through lower LTPA levels. Long hours were also indirectly associated with accelerated biological aging through smoking. Part-time work was indirectly associated with a lower risk of all-cause and CVD mortality through a lower BMI.</p><p><strong>Conclusions: </strong>The findings of this explorative study suggest that direct associations between long working hours, biological aging, and mortality are shaped by lifestyle-mediated pathways and shared familial factors.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363202","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Vapors, gases, dusts and fumes at work and chronic obstructive pulmonary disease/bronchitis: a systematic review and meta-analyses.","authors":"Victoria H Arrandale, Yizhi Zhang, Wendy Lou, Andrea C Tricco, Ambrose Lau, Ani Orchanian-Cheff, Paul K Henneberger, Susan M Tarlo","doi":"10.1186/s12995-026-00515-7","DOIUrl":"10.1186/s12995-026-00515-7","url":null,"abstract":"<p><strong>Background: </strong>Chronic obstructive pulmonary disease (COPD) is the third leading cause of death after cardiovascular disease and stroke. A 2019 American Thoracic Society (ATS) statement estimated that 13-15% of all COPD is attributable to occupational exposures.</p><p><strong>Research question: </strong>This study reports on a systematic review with meta-analysis (PROSPERO 2022 CRD42022302451) that was undertaken to characterize jobs and work exposures associated with an increased risk of developing COPD.</p><p><strong>Methods: </strong>Five databases were searched (MEDLINE, Embase, CINAHL, Cochrane Systematic reviews, Register of Controlled Trials) from inception until February 26, 2025. Studies published in English or Chinese that studied workers (or workplace exposures) in relation to COPD, chronic bronchitis (CB) or emphysema and reported on a minimum of 15 exposed cases, with a comparison group, were included. The National Heart, Blood, and Lung Institute (NHLBI) Study Quality Assessment Tool was used. All reported estimates (e.g., RR, OR, HR) were extracted. Random effects models were used to estimate meta effect estimates (mEE) with 95% confidence intervals. Stratified models were constructed by study design, smoking, and sex, where possible.</p><p><strong>Results: </strong>After de-duplication, 9115 citations were screened. Following full-text review 257 studies met the inclusion criteria. Most were cross-sectional (71%) and conducted in Europe or North America (68%). Most were fair quality (72%) with only 5.8% assessed as good quality. Results showed a consistent relationship between workplace exposure to vapours, gases, dusts or fumes (VGDF) for spirometry-defined COPD (mEE 1.51; 95% CI 1.31-1.73; n = 20 studies), self-reported COPD (mEE 1.48; 95% CI 1.23-1.77; n = 14) and chronic bronchitis (mEE 1.83; 95% CI 1.51-2.21; n = 29). This relationship was slightly stronger in non-smokers and was weaker among women.</p><p><strong>Interpretation: </strong>There was a consistent relationship of workplace exposures with both CB and COPD. The effect of occupational exposures on COPD outcomes appears to be at least additive with smoking.</p><p><strong>Clinical trial registration: </strong>The project was registered with PROSPERO, the International Prospective Register of Systematic Reviews (PROSPERO 2022 CRD42022302451). Date of registration: 5th April 2022.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":"21 1","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13292429/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148320150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Why do occupational hygienists and physicians fail to communicate and collaborate when faced with chemicals in the workplace? A qualitative study from the Netherlands.","authors":"Julia M van Beekum, Dorine van Geuns, Floor Stuit, Gilbert W M Wijntjens, Jolanda Willems, Wendy Tijssen-Caan, Karin I Proper, Frederieke G Schaafsma","doi":"10.1186/s12995-026-00517-5","DOIUrl":"10.1186/s12995-026-00517-5","url":null,"abstract":"<p><strong>Background: </strong>Workers who handle hazardous substances are at risk of health impairments, occupational diseases and even premature death. Occupational diseases are preventable, but early detection, diagnosis and intervention remain inadequate. Therefore, we aim to gain insight into the determinants of timely identification of health effects caused by exposure to hazardous substances in the workplace as perceived by occupational health professionals.</p><p><strong>Methods: </strong>We conducted seventeen online semi-structured interviews among Dutch occupational hygienists and occupational physicians on their perspectives and experiences in identifying chemical-related health effects in the workplace. The interviews were transcribed verbatim and the data were analysed using the Capability, Opportunity, Motivation-Behaviour (COM-B) model.</p><p><strong>Results: </strong>Occupational hygienists and occupational physicians experience limited knowledge, skills, and self-efficacy for timely identification of chemical-related health effects. These modifiable determinants hinder effective collaboration between these occupational health professionals in translating exposure to hazardous substances into health effects and vice versa. Moreover, different system-level determinants in the Netherlands further impede this collaboration. Existing tools for occupational health professionals reinforce this gap by supporting either exposure assessment or health effect evaluation, rarely bridging the two. As a result, current tools are often tailored to a single professional group.</p><p><strong>Conclusions: </strong>The results from our study suggest that gaps in knowledge, skills and self-efficacy hinder timely identification of chemical-related health effects in the Netherlands. The findings of this study can inform the development of multidisciplinary interventions and multifaceted strategies aimed at improving prevention of chemical-related occupational disease and timely implementation of appropriate (workplace) measures.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148303653","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Voice characteristics of iron and steel workers: an acoustic and self-reported cross-sectional study.","authors":"Gamze Yesilli-Puzella, İlknur Coşkun-Karaveli","doi":"10.1186/s12995-026-00516-6","DOIUrl":"10.1186/s12995-026-00516-6","url":null,"abstract":"<p><strong>Background: </strong>Occupational environments with dust, noise, and high vocal demands can adversely impact voice production. Iron and steel workers encounter several environmental risk factors that may impair vocal function, nevertheless, objective acoustic and self-reported voice outcomes in this population have not been thoroughly investigated. This study aimed to evaluate the acoustic and self-reported voice characteristics of iron and steel manufacturing workers and compare these findings with those of a normophonic control group.</p><p><strong>Methods: </strong>This cross-sectional comparative research comprised 128 male participants: 64 steel and iron factory workers and 64 normophonic controls. Voice evaluation consisted of F0, jitter, shimmer, noise-to-harmonics ratio, smoothed cepstral peak prominence, Acoustic Voice Quality Index, maximum phonation time, Voice Handicap Index-10 and Voice-Related Quality of Life. Mann-Whitney U tests or Welch's t-tests were used for between-group comparisons, as appropriate.</p><p><strong>Results: </strong>Iron and steel workers had significantly lower F0 and smoothed cepstral peak prominence values and higher jitter, shimmer, noise-to-harmonics ratio, and Acoustic Voice Quality Index scores than controls (all p < 0.01). The maximum phonation time was significantly shorter in workers (p < 0.001). The mean Voice Handicap Index-10 score among workers exceeded the Turkish threshold, and the Voice-Related Quality of Life scores were significantly lower than those of controls (p < 0.001).</p><p><strong>Conclusions: </strong>Iron and steel industry workers had lower acoustic and self-reported markers of voice quality than normophonic individuals. These findings indicate that exposure to industrial noise and airborne irritants may be associated with subclinical changes in voice characteristics. In occupational health, a comprehensive voice assessment can serve as a time-saving, non-invasive screening tool to support early diagnosis and prevention of work-related voice problems.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13411114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148260075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between blood manganese and cognitive function in a national representative survey.","authors":"Sahara Elfaks, Eric Amster","doi":"10.1186/s12995-026-00513-9","DOIUrl":"10.1186/s12995-026-00513-9","url":null,"abstract":"<p><strong>Background: </strong>Manganese (Mn) is an essential heavy metal, required for the normal development of many organ systems and is crucial to brain growth and development. At high exposure concentrations, Mn is a neurotoxicant. Mn exposure has been associated with motor, behavioral and cognitive impairment. Few studies have assessed the association between Mn exposure and cognitive function using NHANES data.</p><p><strong>Purpose: </strong>This study re-explored the association between blood manganese concentrations and cognitive function through a re-analysis of NHANES 2011-2014 data using a larger combined sample and composite cognitive z-score methodology.</p><p><strong>Methods: </strong>A representative survey of the US population (60-80 years of age) completed objective cognitive function assessments and metal biomonitoring (n = 2,439). We created a composite cognitive z-score by using the average of the standardized scores of the six cognitive tests (three trials of CERAD Word List Learning Test, CERAD delayed recall, Animal fluency test and DSST) and compared to adjusted blood Mn. Linear regression was performed by constructing three models (univariate model, a model with all covariates and a model with only significant covariates). Confounding by gender, age, race/ethnicity, education level, total number of people in the family, smoking history and income (family monthly poverty level category) are included in the models.</p><p><strong>Results: </strong>Median Mn was 8.71 µg/L with an IQR of 6.94-11.16. There was a statistically significant association between quartiles of blood Mn and composite z-score, only in the univariate model. However, in linear regression analyses, adjusting for potential confounders, blood Mn as a continuous variable was not statistically associated with the composite cognitive z-score (µg/L, β = 0.0038, 95% CI -0.004 to 0.012). The mean of composite z-score in the first quartile is the lowest compared to the mean of the second, third and fourth, with statistical significance. While the mean of the third quartile is the highest, followed by the fourth and then the second (0.022, 0.012 and 0.007, respectively).</p><p><strong>Conclusions: </strong>Our findings suggest that associations between blood manganese concentrations and cognitive performance at low environmental exposure levels are modest and attenuate after adjustment for demographic and socioeconomic confounders. Unlike some previous NHANES analyses that reported impaired cognition primarily among individuals with higher manganese exposure, we did not observe a consistent independent dose-response association across the broader population exposure range.</p>","PeriodicalId":48903,"journal":{"name":"Journal of Occupational Medicine and Toxicology","volume":" ","pages":""},"PeriodicalIF":3.2,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13455330/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148165097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}