{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T12:12:32Z","timestamp":1788437552333,"version":"build-2803163510"},"reference-count":94,"publisher":"American Chemical Society (ACS)","issue":"34","license":[{"start":{"date-parts":[[2026,7,29]],"date-time":"2026-07-29T00:00:00Z","timestamp":1785283200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/na","name":"Research Project Supported by Shanxi Scholarship Council of China","doi-asserted-by":"publisher","award":["2024-146"],"award-info":[{"award-number":["2024-146"]}],"id":[{"id":"10.13039\/na","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/na","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82173492"],"award-info":[{"award-number":["82173492"]}],"id":[{"id":"10.13039\/na","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Workers in aluminum smelting and processing, besides aluminum, are also chronically exposed to other complex metal mixtures in their working settings, yet integrated evidence linking internal dose, blood neurodegeneration biomarkers, and mild cognitive impairment (MCI) remains limited for occupational surveillance. We measured plasma concentrations of 10 metals (Al, Zn, Li, Cr, Mn, Fe, Co, Cu, Se, Pb) and plasma neurodegeneration-related biomarkers (A\u03b242\/A\u03b240, GFAP, NfL, Total-tau, P-tau181, P-tau396) in 382 aluminum workers in Shanxi, China, and evaluated associations with MCI. Multivariable logistic regression with restricted cubic splines and Bayesian kernel machine regression were applied to characterize exposure\u2013response relationships and mixture effects, while structural equation modeling explored biomarker pathways. Higher Al and lower Zn were consistently associated with greater odds of MCI, and GFAP, NfL, and P-tau396 were positively associated with MCI. Pathway analyses suggested partial mediation of Al- and Zn-related associations through NfL and P-tau396. Integrating metals with biomarkers improved discrimination compared with single indicators (best AUC = 0.924). Model-averaged benchmark dose analysis (BMR = 10% extra risk) yielded an aluminum BMDL of \u223c31 \u03bcg\/L, within the observed exposure range, providing a candidate biomonitoring reference point to inform derivation of biological exposure limits.<\/jats:p>","DOI":"10.1021\/acs.est.6c01298","type":"journal-article","created":{"date-parts":[[2026,8,4]],"date-time":"2026-08-04T13:16:12Z","timestamp":1785849372000},"page":"23706-23721","source":"Crossref","is-referenced-by-count":0,"title":["Integrated\nAssessment of Internal Metal Mixtures and\nPlasma Neurodegeneration Biomarkers in Relation to Mild Cognitive\nImpairment among Aluminum Workers"],"prefix":"10.1021","volume":"60","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3925-4385","authenticated-orcid":true,"given":"Shanshan","family":"Wang","sequence":"first","affiliation":[{"name":"First Hospital of Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]},{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0314-2859","authenticated-orcid":true,"given":"Nan","family":"Shang","sequence":"additional","affiliation":[{"name":"First Hospital of Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-6464-6014","authenticated-orcid":true,"given":"Wanying","family":"Chen","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Jinzhong, Shanxi, China, 030600"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jingsi","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huaxing","family":"Meng","sequence":"additional","affiliation":[{"name":"First Hospital of Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Guo","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]},{"name":"Sixth Hospital of Shanxi Medical University (General Hospital of Tisco) , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0009-4767-1817","authenticated-orcid":true,"given":"Baolong","family":"Pan","sequence":"additional","affiliation":[{"name":"Sixth Hospital of Shanxi Medical University (General Hospital of Tisco) , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chanting","family":"He","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5538-1299","authenticated-orcid":true,"given":"Xiaoting","family":"Lu","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jing","family":"Song","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linping","family":"Wang","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huifang","family":"Zhang","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0015-3341","authenticated-orcid":true,"given":"Qiao","family":"Niu","sequence":"additional","affiliation":[{"name":"Shanxi Medical University , , , ,","place":["Taiyuan, Shanxi, China, 030001"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"316","published-online":{"date-parts":[[2026,7,29]]},"reference":[{"issue":"12","key":"2026090307140768800_cit1","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph14121511","article-title":"The Metal\nNeurotoxins: An Important Role in Current Human Neural Epidemics?","volume":"14","author":"Schofield","year":"2017","journal-title":"Int. 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Bull."},{"issue":"2","key":"2026090307140768800_cit37","doi-asserted-by":"publisher","first-page":"131","DOI":"10.1007\/BF02990421","article-title":"Tissue distribution and urinary excretion of essential\nelements in rats orally exposed to aluminum chloride","volume":"31","author":"Chmielnicka","year":"1991","journal-title":"Biol. Trace Elem. Res."},{"key":"2026090307140768800_cit38","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1016\/j.jtemb.2019.06.013","article-title":"Homeostatic\nchanges of some trace\nelements in geriatric rats in the condition of oxidative stress induced\nby aluminum and the beneficial role of resveratrol","volume":"55","author":"Muselin","year":"2019","journal-title":"J. Trace Elem. Med. 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