{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,21]],"date-time":"2026-10-21T04:10:10Z","timestamp":1792555810848,"version":"4.5.0"},"reference-count":35,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2020,2,29]],"date-time":"2020-02-29T00:00:00Z","timestamp":1582934400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["81860573"],"award-info":[{"award-number":["81860573"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J Industrial Med"],"published-print":{"date-parts":[[2020,5]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Elevated exposure to manganese (Mn) could induce cardiovascular dysfunction. However, limited research is available on the effects of occupational Mn exposure on myocardial enzymes. We aimed to evaluate the relationships between Mn exposure and myocardial enzyme elevation among Mn\u2010exposed workers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Data were from a follow\u2010up investigation of a Mn\u2010exposed workers healthy cohort in 2017. A total of 744 workers were divided into low\u2010exposure and high\u2010exposure groups according to Mn time\u2010weighted average (Mn\u2010TWA) of less than or equal to 0.15\u2009mg\/m<jats:sup>3<\/jats:sup> or greater than 0.15\u2009mg\/m<jats:sup>3<\/jats:sup>, respectively. Serum levels of myocardial enzymes, including creatine kinase (CK) and creatine kinase\u2010MB (CK\u2010MB), lactic dehydrogenase, \u03b1\u2010hydroxybutyrate dehydrogenase, and aspartate transaminase, were assessed, as well as airborne Mn exposure levels.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>After adjustment for sex, body mass index, seniority, education, current smoking status, current drinking status, and hypertension, Mn\u2010TWA levels were positively associated with the risk of CK elevation (odds ratio [OR]\u2009=\u20091.47 (95% confidence interval [CI]: 1.18\u20101.83) per interquartile range [IQR] increase), and risk of CK\u2010MB elevation [OR\u2009=\u20091.57 (95% CI: 1.03\u20102.38) per IQR increase]. In a stratified analysis, Mn\u2010TWA levels were positively correlated with CK elevation in workers of seniority greater than 19 years, male workers, current smokers, and drinkers.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Our results suggest that occupational exposure to Mn is associated with increased risk of CK and CK\u2010MB elevation. The potential mechanisms of the associations between airborne exposure to Mn and increased risk of these myocardial enzyme elevations warrant further investigation.<\/jats:p><\/jats:sec>","DOI":"10.1002\/ajim.23097","type":"journal-article","created":{"date-parts":[[2020,2,29]],"date-time":"2020-02-29T08:33:16Z","timestamp":1582965196000},"page":"394-401","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":12,"title":["Occupational exposure to manganese and risk of creatine kinase and creatine kinase\u2010MB elevation among ferromanganese refinery workers"],"prefix":"10.1002","volume":"63","author":[{"given":"Sifang","family":"Huang","sequence":"first","affiliation":[{"name":"Department of Occupational Health and Environmental Health, School of Public Health Guangxi Medical University Nanning Guangxi 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