Manganism, Parkinson's Disease, Welders Disease

Manganism Overview

The medical literature is repleat with studies and individual cases showing the link between manganism (manganese poisoning) and parkinsonism. Many welders have elevated Manganese levels from the welding rod fumes.

For example, an abstract from Department of Neurology, Chang Gung Memorial Hospital and Medical College, Taipei, Taiwan in 1998 showed that the mean scores of the King's College Hospital Rating Scale for Parkinson's disease increased from 15.0 +/- 4.2 in 1987 to 28.3 +/- 6.70 in 1991 and then to 38.1 +/- 12.9 in 1995. This study is one of many that documents the close link between manganism and Parkinsonism. They studied the long-term clinical course of five patients with chronic manganese intoxication. They found significant deterioration in gait, rigidity, speed of foot tapping, and writing. The data indicate that clinical progression in patients with manganese parkinsonism continues even 10 years after cessation of exposure.

Another study showing Parkinsonism due to manganism in a welders. This study, was of a 33-ycan ear-old right-handed male who presented complaining of a 2-year history of progressive cognitive slowing, rigidity, tremors, slowing of movements, and gait instability leading to falls. On examination, he had a Mini-Mental Status Examination (MMSE) score of 29, slowed saccadic eye pursuit, hypomimia, cogwheel rigidity, a 3- to 4-Hz tremor, and a "cock-walk" gait. His symptoms and signs were similar to idiopathic Parkinson's disease; however, he was young, inattention and forgetfulness occurred early in the course of the disorder, levodopa was unhelpful, and his gait was atypical. His work up for secondary causes of parkinsonism was negative, except for increased signal intensity on T1-weighted magnetic resonance image (MRI) in the bilateral basal ganglia. Typical etiologies for that finding were ruled-out, which led to further inquiries into the patient's lifestyle. He was a welder, and discussion with his employer revealed that he used a steel-manganese alloy, he often worked in a confined ship's hold, and he did not use a respiratory mask. Because manganese toxicity can produce increased T1-weighted signal intensities in the basal ganglia, the authors tested his serum and urine manganese, and both were elevated. This patient emphasizes the importance of a careful occupational history in persons presenting with atypical manifestations of a neurodegenerative disorder. It also lends support to the hypothesis that welding can produce enough exposure to manganese to produce neurologic impairment. This study was conducted by the Department of Neurology, Baylor College of Medicine, Houston, Texas.

One year before the Baylor case, a case was reported with Secondary progressive chronic manganism associated with markedly decreased striatal D2 receptor density, which supports the hypothesis that manganese intoxication may trigger a neurodegenerative disease process.

Manganism is of great concern because of the severe injury - parkinsonism. The manganese does damage over a long period of time, since it has a long half life (the amount of time it takes the body to reduce its manganese load by half). Thus, manganese remains in the central nervous system for a long time, and the effects of mangansim are seen later in life (onset of the disease typically is between the ages of 45 and 65). Levy describes three stages that are differentiated in manganism, including behavioral changes, parkinsonian features, and dystonia and gait disturbances. The onset of manganism includes:

  • Tremor
  • Gait disturbance
  • Impaired coordination
  • Speech impairment
  • Impaired memory and judgment
  • Facial rigidity.

Do I have a Manganism, welder's-disease, case?

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Does your doctor believe that you may be suffering the health effects of welding rod fumes or gases? Yes No


Has your doctor diagnosed you with any of the following conditions?  
Parkinson's Disease Parkinsonsim
Parkinson's Syndrome Neuropathy
Manganese Poisoning Manganism
Welding Disease Sickness No Diagnosis
What was the date of the initial diagnosis:  

How were you exposed to welding fumes?
   Worked as a Welder
   Worked Around Welders.

What is the date range when you were exposed to welding fumes?
    Start Date of Exposure:   
    End Date of Exposure:     

Identify the types of symptoms you have experienced from among the known conditions that may be caused by past exposure to welding fumes:
Tremors; shaky movements Loss of motor skills
Impaired hand-eye coordination Slurred speech or lack of facial expression
Difficulty walking; clumsiness Weakness and tiredness; mood problems
When did you start noticing the symptoms?

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Manganism and Parkinsons Disease Legal Information
Manganese Exposure
Parkinson's Disease from Welding?

Manganism symptoms / Parkinsonism

(c) Copyright 2004 Monheit Law: Manganism Section