This cohort study measured manganese in repeated blood and hair samples from 449 pregnant women living near banana plantations sprayed from the air with the manganese-containing fungicide mancozeb, and in drinking water for a subset of homes. Hair manganese rose with living within 50 m of a plantation and with drinking water manganese. Blood manganese was linked mainly to gestational age, household size and housing materials.
Key numbers
- Blood manganese: mean 24.4 µg/L (SD 6.6), geometric mean 23.5 µg/L, median 24.0 µg/L, range 8.9 to 56.3 µg/L (664 samples from 418 women) (Table 2, p. 3471).
- Hair manganese: geometric mean 1.8 µg/g (GSD 3.2), median 1.6 µg/g, range 0.05 to 53.3 µg/g (800 samples from 449 women) (Table 2).
- Drinking water manganese: median 417.0 µg/L in homes supplied by wells (n = 27) versus 3.5 µg/L in homes on the local aqueduct (n = 102) (Results, p. 3471).
- Living within 50 m of a plantation: 42.1% higher hair manganese (95% CI 14.2 to 76.9); each µg/L of drinking water manganese: 17.5% change in hair manganese (95% CI 12.2 to 22.8) (Abstract).
- Limits of detection: 0.003 µg/L in blood (no samples below), 0.1 µg/g in hair (3 samples below), about 0.05 µg/L in water (Methods).
Methods (brief)
Women were enrolled between March 2010 and June 2011. Blood was analyzed by ICP-MS. Hair was washed, digested in nitric acid and analyzed by electrothermal atomic absorption spectroscopy with Zeeman background correction, with an IAEA hair reference material. Drinking water was analyzed by ICP-MS. Tap or stored drinking water was sampled in a convenience subset of homes. Mixed-effects models related blood and hair manganese to residential, occupational and lifestyle factors across repeated visits.
Evidence fitness
The paper supports reporting of manganese levels in pregnant women in an agricultural area and the contrast between well water and aqueduct water. It suggests environmental exposure from fungicide use and well water but cannot attribute exposure to a specific pathway, and it reports no health outcomes.
Limitations
Hair can be externally contaminated, including by washing with high-manganese water, as the authors note. Mancozeb exposure was not measured directly. Drinking water was sampled in only part of the cohort.
Related evidence
- Manganese
- Water
- ICP-MS — Inductively coupled plasma mass spectrometry
- Atomic absorption spectrometry (AAS)
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