Manganese
Classification:
Manganese is a chemical element (atomic weight 54.938, melting point 1244±3° C), which is found predominantly in pyrolusite, psilomelane (MnO2), rhodochrosite, rhodonite, and other minerals.
Cas:
7439-96-5
Synonyms/Trade Names:
Braunstein, Brownstone, Magnacat, Tronamang; Manganismus, Man ganese Psychosis.
Chemistry/Composition:
Mn .
Structure:
Cubic.
Crystallographic Constants:
7.00 7.00 7.00 90.000 90.000 90.000.
Crystal Group:
Cubic.
Color:
Grayish-white.
Optical Properties:
Opaque.
Pleochroism:
None.
Powder Diagram:
4.03 2.47 2.02 4.03 (21-5479).
Natural Sources:
Mined in Brazil, Gabon, Ghana, India, the RSA, and Russia.
Medical Importance:
Key Hazards:
Intoxication, probably fibrotic.
Involved Organs:
Lung, central nervous system.
Exposure/Epidemiology:
Rare disease. Exposure may occur during mining, in metallurgy, in glass, ceramics, paint, and battery industries. It is used as a catalyst, in chemical industries, as enamel, in fungicides, in animal fodder, in pharmaceuticals, in magnets (so called “ferrite”), and in bricks. World production of manganese was 26.7×106 tons in 1980. Mn-induced disease are rare, and only two cases of acute intoxication have been reported. The number of patients with Mn-pneumonia is decreasing. Mn-pneumonias are often seen, but the other diseases are uncommon.
Thresholds: |
TWA |
|
mg/m3 |
| Denmark | 2.5 |
| Finland | 2.5 |
| Germany | 5 |
| Netherlands | 1 |
| Sweden | 2.5 |
| Switzerland | 5 |
| USA | 5 |
Etiology/Pathophysiology:
The normal daily uptake amounts to 3 mg. Intoxication is normally found in persons who are exposed to dusts containing a high concentration of Mn and oxidized Mn. Normally exposure time is >2 years. Mn2+ is twice as toxic as Mn3+. Mn is absorbed from the gastrointestinal tract (3% of the ingested mass). The absorbed portion of Mn can increase to 7-8% in case of Fe defiency. Inhaled Mn can also be absorbed; however, details are not known. An enterohepatic circulation has been reported. In the blood, Mn is bonded to transferrin and deposited in the brain, kidneys, pituitary glands, pancreas, and liver (depending on the concentration within the mitochondria). About 43% of the total body burden is transported into the bones. Excretion occurs via the gall-bladder and faeces (90%), and only a small portion is excreted in the urine. Two phases of excretion can be distinguished: an acute phase (4 days) and a chronic phase (39 days). The largest amount of the absorbed Mn is excreted in the chronic phase. The highest Mn concentrations are found in smokers and 51-60 year old men. Mn may crosses the placenta and has been detected in breast milk.
Lung Diseases:
Manganese may induce an acute or chronic pneumonia and an increased rate of non-specific respiratory symptoms and infectious diseases; CNS symptoms (Parkinson‘s disease), intoxication and pneumoconiosis. Mn defiency has been described in a patient who received artificial food supply. Mn could was found to be mutagenic in tissue culture tests.
Clinical Presentation:
Patients suffering from Mn-associated pneumonias present with no difference from other pneumonias, those with acute intoxication with thoracic and gastric pain, vomiting, tachycardia, fever, and edema (glottis), those with chronic intoxication with encephalitis (manganese madness, paralysis agitans), and prolonged sleep some weeks after the exposure. Madness, paralysis, muscular dystrophy, paresthesia, micrographia, impotence, fever, and hyperglobulinemia are additional symptoms. In Mn-defiency, the reported findings are hypocholesterolemia and nausea. The Mn concentration in the serum is reduced in dialysis patients.
Radiology:
Chest radiographs show diffuse interstitial densities or may be normal.
Lung Function:
Lung Function tests normally show alterations of the diffusion capacity.
Bronchoalveolar Lavage:
The lavage fluid can contain an increased number of macrophages and mononuclear inflammatory infiltrates.
Pathology:
Gross:
The lungs are wet and heavy or may display an increased consistency.
Histology:
The alveoli and terminal bronchioles are filled with numerous dust-laden macrophages and mononuclear inflammatory infiltrates. A marked hyperplasia and dysplasia of the cells of the alveolar lining may be noted.
Prognosis:
Persons with mild intoxication usually present with complete recovery. Neurological symptoms are normally progressive and may mimic those seen in amyotrophic lateral sclerosis. Severe Mn-pneumonia may be fatal.
Additional Diseases:
Central Nervous System:
The associated findings include madness, paralysis agitans, muscular dystrophy, and pain.
Remarks:
In the oceans, large rocks containing high concentrations of Mn are found.
References:
search Pubmed for Manganese
Baader EW: Manganvergiftung. In: EW Baader (Ed): Handbuch der gesamten Arbeitsmedizin. Urban & Schwarzenbeck, München (1961)
Braknova IT: Studies in soviet science: environmental hazards of metals. Consultants Bureau, New York (1975)
Campbell MJ, Campbell AM, Chanez P, Michel FB, Bousquet J: Low levels of manganese in bronchial biopsies from asthmatic patients. J Allergy Clin Immunol (1992) 332
Eriksson H, Gillberg PG, Aquilonius SM, Hedstöm KG, Heilbronn E: Receptor alterations in manganese intoxicated monkeys. Arch Toxicol 66 (1992) 359-364
Fraser RG, Paré JAP: Diagnosis of diseases of the chest. WB Saunders, London, Toronto (1979)
Huang CC, Chu NS, Lu CH, Wang JD, Tsai JL: Chronic manganese intoxication. Arch Neurol 46 (1989) 1104-1106
Järvisalo J, Olkinuora M, Kilunen M, Kivisto H, Ristola P, Tossuvainen A, Aitio A: Urinary and blood manganese in occupationally non exposed populations and in manual metal arc welders of mild steel. Int Arch Occup Environ Health 63 (1992) 495-501
Kayser K: Analytical Lung Pathology. Springer, Heidelberg, New York (1992)
Kraus T, Raithel HJ, Schaller KH: Quantifizierung des Manganund Vanadium-Gehaltes von “normalen” und beruflich exponierten Personen. Zentralbl Hyg Umweltmed 188 (1989) 108-126
Lewis RJ: Carcinogenically active chemicals. Van Nostrand Reinhold, New York (1991)
Roels HA, Ghyselen P, Buchet JP, Ceulemans E, Lauwerys RR: Assessment of the permissible exposure level to manganese in workers exposed to manganese dioxide dust. Br J Ind Med 49 (1992) 1-9
Rom WN (Ed): Occupation and environmental medicine. Little, Brown and Comp, Boston (1983)
Saric M: Manganese. In: L Friberg, GF Nordberg, VB Vouk (Eds): Handbook on the toxicology of metals. Elsevier, Amsterdam, New York (1990)
Schunk W: Die chronische berufliche Manganvergiftung. Arbeitsmed Sozialmed Präventivmed 23 (1988) 198-203
Valentin H, Lehnert G, Petry H, Weber G, Wittgens H, Woitowitz HJ: Arbeitsmedizin. Thieme, Stuttgart, New York (1985)
Valentin H, Schile R: Manganese. In: Commission of the European Communities (Eds): Human biological monitoring of industrial chemicals series, Brussels (1983)
Wang JD, Huang CC, Hwang YH, Chinag JR, Lin JM, Chen JS: Manganese induced parkinsonism: an outbreak due to an unrepaired ventilation control system in a ferromanganese smelter. Br J Ind Med 46 (1989) 856-859
Wennberg A, Iregren A, Struwe G, Cizinsky G, Hagman M, Johanson L: Manganese exposure in steel smelters a health hazard to the nervous system. Scand J Work Environ Health 17 (1991) 255-262
Wirth W, Gloxhuber C: Toxikologie. Thieme, Stuttgart (1985)