A child with chronic manganese exposure from drinking water.

Abstract

The patient's family bought a home in a suburb, but the proximity of the house to wetlands and its distance from the town water main prohibited connecting the house to town water. The family had a well drilled and they drank the well water for 5 years, despite the fact that the water was turbid, had a metallic taste, and left an orange-brown residue on clothes, dishes, and appliances. When the water was tested after 5 years of residential use, the manganese concentration was elevated (1.21 ppm; U.S. Environmental Protection Agency reference, < 0.05 ppm). The family's 10-year-old son had elevated manganese concentrations in whole blood, urine, and hair. The blood manganese level of his brother was normal, but his hair manganese level was elevated. The patient, the 10-year-old, was in the fifth grade and had no history of learning problems; however, teachers had noticed his inattentiveness and lack of focus in the classroom. Our results of cognitive testing were normal, but tests of memory revealed a markedly below-average performance: the patient's general memory index was at the 13th percentile, his verbal memory at the 19th percentile, his visual memory at the 14th percentile, and his learning index at the 19th percentile. The patient's free recall and cued recall tests were all 0.5-1.5 standard deviations (1 SD = 16th percentile) below normal. Psychometric testing scores showed normal IQ but unexpectedly poor verbal and visual memory. These findings are consistent with the known toxic effects of manganese, although a causal relationship cannot necessarily be inferred. Key words: ADHD, attention deficit hyperactivity disorder, manganese, manganese exposure, water, water pollution.

Assessment of Trace Metals Contamination of Surface Water and Sediment: A Case Study of Mvudi River, South Africa

“…Mn concentrations in the range of 0.24-0.35 mg/L can lead to memory lapses in children. Similar findings have also reported decreased concentration and attentiveness in classes by children who drink water with a high Mn concentration [41,42]. Neurotoxicity has been implicated for adults over 50 years who drink Mn-rich water [43].…”

The Challenge Posed to Children's Health by Mixtures of Toxic Waste: The Tar Creek Superfund Site as a Case-Study

“…In Chinese children, exposure to elevated manganese concentrations in drinking water was associated with lower scores on tests of short-term memory, manual dexterity, and visualperceptual speed (65). We recently reported a child with manganism (blood Mn 3.8 μg/dL) from a private well water source with normal full scale IQ but deficits in verbal, visual and general memory indices (66). Using the McCarthy General Cognitive Index test at age 5 years, Takser et al (67) reported deficits in memory, attention and psychomotor indices associated with elevated umbilical cord Mn levels.…”

Manganese inhibits NMDA receptor channel function: Implications to psychiatric and cognitive effects

“…Effects of Mn 2+ on working memory points to deficits in frontal cortex function, a brain region known to be involved in psychiatric illnesses such as schizophrenia (Abi-Dargham et al, 2002;Goldman-Rakic, 1999). Other reports also indicate effects of Mn 2+ exposure on the intellectual performance of children (Wasserman et al, 2006;Woolf et al, 2002).…”