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Exposure to Environmental Air Manganese and Medication Use
Citation:
Bowler, R., S. Adams, C. Wright, Y. Kim, A. Booty, M. Colledge, V. Gocheva, R. Garcia, I. Gomez, AND D. Lobdell. Exposure to Environmental Air Manganese and Medication Use. Society for Epidemiologic Research, Denver, CO, June 16 - 19, 2015.
Impact/Purpose:
This study addresses research questions under Sustainable and Healthy Communities (2.2.1.6 lessons learned, best practices and stakeholder feedback from community and tribal participative case studies). The present study reports findings of a study investigating medication use among adults living in three Ohio towns, two towns exposed to elevated air manganese (air-Mn) and one control town. The study was conducted through the Regional Applied Research Effort which is a joint effort between Region 5 and ORD Scientists. The study population is based on two towns exposed to elevated levels of air manganese and a control town not exposed. The findings for this first environmental study of air-Mn exposed U.S. adults indicates a higher prevalence of medication use for hypothyroidism and pain health problems among the air-Mn exposed group. Other studies examining health outcomes, other than neurologic outcomes, were from highly exposed occupational studies.
Description:
Manganese (Mn) is an essential element with natural low levels found in water, food, and air, but due to industrialized processes, both workplace and the environmental exposures to Mn have increased. Recently, environmental studies have reported physical and mental health problems associated with air-Mn exposure, but medical record reviews for exposed residents are rare in the literature. When medical records and clinical testing are unavailable, examination of residents’ prescribed medication use may be used as a surrogate of health effects associated with Mn. We examined medication use among adult Ohio residents in two towns with elevated air-Mn (n=185) and one unexposed control town (n=90). Study participants recorded medication use in a health questionnaire and brought their currently prescribed medication, over-the-counter and supplement lists to their interview. Two physicians (family and psychiatric medicine) reviewed the provided medication list and developed medical categories associated with the medications used. The exposed (E) and control (C) groups were compared on the established 12 medication and 1 supplement categories using chi-square tests. The significant medication categories were further analyzed using hierarchical binomial logistic regression adjusting for education, personal income, and years of residency. The two groups were primarily white (E:94.6%; C:96.7%) but differed on education (E:13.8; C:15.2 years), residence length in their respective towns (E:41.1; C:33.6 years) and hours sleep (E:6.6;C:7.0 hours). The exposed group was more likely to take medication than the controls (82.2% vs. 67.8%). Examining medication categories (OR [95%CI]), the exposed group was more likely to take medications for pain (2.40[1.28,6.25]) and hypothyroidism (7.03[1.58,31.23]). To our knowledge, this is the first reported air-Mn study of increased medication use in adult-exposed residents in the U.S. This abstract does not necessarily reflect EPA policy.