{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T20:14:58Z","timestamp":1790712898686,"version":"4.1.0"},"reference-count":58,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2019,5,22]]},"published-print":{"date-parts":[[2019,6]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To investigate the prevalence of mild cognitive impairment and the relationship with plasma aluminium among aluminium workers.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>This was a cross-sectional case-control study in the SH Aluminium Factory, China.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>The university and affiliated hospital cooperated in the study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>There were 910 aluminium workers on duty, among whom 853 participated in our study. Participants, such as those with cerebral vascular disease, epilepsy, brain trauma, Parkinson\u2019s and mental diseases, aluminium-containing drug and mental drug use, and any family history of dementia in first-degree relatives were excluded.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Primary and secondary outcome measures<\/jats:title>\n                    <jats:p>Blood samples were collected, and plasma aluminium was measured by inductively coupled plasma-mass spectrometry. For each case, four age-matched controls were evaluated to determine the relationship between aluminium exposure and mild cognitive impairment. Conditional logistic regression was used to explore influential factors in mild cognitive impairment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among 910 workers, 93.74% participated in stage 1; 53 cases were finally diagnosed. The crude prevalence of mild cognitive impairment among aluminium workers on duty was 6.21%. There was a significant difference in plasma aluminium concentration between the two groups. In the multivariate analysis, we found that a higher level of plasma aluminium was associated with a high risk of cognitive impairment when compared with a lower aluminium level (AOR=2.24, 95% CI=1.17\u2009to 4.26), and a high education level was a protective factor (AOR=0.36, 95% CI=0.18\u2009to 0.70). No other factor was statistically significant.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Mild cognitive impairment is no longer a disease specific to elderly people. High plasma aluminium exposure might be associated with an increased risk of cognitive impairment, but a reduced risk was observed with a high education level. The cognitive function of aluminium workers on duty must be considered seriously.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2018-027154","type":"journal-article","created":{"date-parts":[[2019,6,17]],"date-time":"2019-06-17T05:45:15Z","timestamp":1560750315000},"page":"e027154","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":24,"title":["Cognitive impairment of workers in a large-scale aluminium factory in China: a cross-sectional study"],"prefix":"10.1136","volume":"9","author":[{"given":"Huaxing","family":"Meng","sequence":"first","affiliation":[{"name":"School of Public Health, Shanxi Medical University, Taiyuan, China"},{"name":"Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shanshan","family":"Wang","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Junhong","family":"Guo","sequence":"additional","affiliation":[{"name":"Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yarong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Department of Neurology, First Hospital of Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuhui","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuqing","family":"Zhao","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiao","family":"Niu","sequence":"additional","affiliation":[{"name":"School of Public Health, Shanxi Medical University, Taiyuan, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2019,6,16]]},"reference":[{"key":"2025121402393811000_9.6.e027154.1","doi-asserted-by":"crossref","first-page":"367","DOI":"10.1016\/j.jalz.2018.02.001","article-title":"2018 Alzheimer\u2019s disease facts and figures","volume":"14","author":"Anon","year":"2018","journal-title":"Alzheimer\u2019s & Dementia"},{"key":"2025121402393811000_9.6.e027154.2","doi-asserted-by":"crossref","first-page":"51","DOI":"10.1001\/jamainternmed.2016.6807","article-title":"A Comparison of the Prevalence of Dementia in the United States in 2000 and 2012","volume":"177","author":"Langa","year":"2017","journal-title":"JAMA Intern Med"},{"key":"2025121402393811000_9.6.e027154.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.jalz.2012.11.007"},{"key":"2025121402393811000_9.6.e027154.4","doi-asserted-by":"crossref","first-page":"335","DOI":"10.1016\/j.jalz.2011.04.002","article-title":"Commentary on \"Recommendations from the National Institute on Aging-Alzheimer\u2019s Association workgroups on diagnostic guidelines for Alzheimer\u2019s disease.\" Addressing the challenge of Alzheimer\u2019s disease in the 21st century","volume":"7","author":"Herrup","year":"2011","journal-title":"Alzheimers Dement"},{"key":"2025121402393811000_9.6.e027154.5","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0142388","article-title":"The Prevalence of Mild Cognitive Impairment in Diverse Geographical and Ethnocultural Regions: The COSMIC Collaboration","volume":"10","author":"Sachdev","year":"2015","journal-title":"PLoS One"},{"key":"2025121402393811000_9.6.e027154.6","doi-asserted-by":"publisher","DOI":"10.1176\/ajp.152.10.1485"},{"key":"2025121402393811000_9.6.e027154.7","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.jtemb.2013.10.002","article-title":"Aluminium in human sweat","volume":"28","author":"Minshall","year":"2014","journal-title":"J Trace Elem Med Biol"},{"key":"2025121402393811000_9.6.e027154.8","unstructured":"Jakubowski M . 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