Introduction Manganese is an essential micronutrient but excessive levels are harmful, and have been associated with parkinsonism. We sought to confirm the association between parkinsonism and quality of life (QoL), previously described in manganese-exposed welders, in a cohort of manganese mine workers, thereby also testing the usefulness of a tool originally designed for use in clinical settings.
Methods The study population comprised 418 manganese mine workers in South Africa. Parkinsonism was defined as a Unified Parkinson Disease Rating Scale motor score (UPDRS3) >15. The 39–item Parkinson Disease Questionnaire (PDQ-39) was used to assess miners’ health status and/or QoL – our primary outcome. For this analysis, violation of the constant variance assumption led to a ‘square root’ transformation of the outcome variable. We used Mann-Whitney and Pearson’s Chi-Square (or Fishers exact) tests to compare participants’ parkinsonism status regarding baseline continuous and categorical characteristics. Multiple linear regression modelling was used to quantify associations.
Results The mean age of participants was 41.5 years; 97.6% were male. The prevalence of parkinsonism was 29.4%. QoL sub-scores and total scaled PDQ-39 score means were higher in mine workers with parkinsonism, relative to the rest of the cohort. Age (β=−0.48, p=0.031) and parkinsonism (β=0.63, p=0.004) were strong predictors of QoL. QoL was negatively associated with age; and parkinsonism predicted poorer QoL and/or health status.
Conclusion We found a strong association between parkinsonism and QoL abnormalities in manganese mine workers, confirming previous reports in manganese–exposed welders. The PDQ-39 proved to be a robust tool for assessing QoL in these workers.
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