MANGANESE

Editor's Note: This material is not listed in the Emergency Response Guidebook. Based on the material's physical and chemical properties, toxicity, or chemical group, a guide has been assigned. For additional technical information, contact one of the emergency response telephone numbers listed under Public Safety Measures.

MOLECULAR FORMULA

Mn (metal)

ERG GUIDE NUMBER

170-METALS (POWDERS, DUSTS, SHAVINGS, BORINGS, TURNINGS, OR CUTTINGS, ETC.)

SYNONYM REFERENCE

(Budavari, 2001; HSDB , 2002; Lewis, 2000; Lewis, 1998; NIOSH , 2002; RTECS , 2002)

USES/FORMS/SOURCES

USES

Metallic manganese is primarily used in the manufacture of steel and as an ingredient in the production of ferrous and nonferrous alloys. More than 90% of the world's manganese consumption is associated with iron and steel production. Manganese reagent is used to reduce oxygen and sulfur and thus remove sulfides and oxides during steel, cast iron, and nonferrous metal production. As an alloying agent, it imparts increased strength, hardness and abrasion resistance in finished steel (Bingham et al, 2001; ITI, 1995; Zenz, 1994; Harbison, 1998).
Manganese is also combined with aluminum, copper, nickel, silver and titanium. These alloys are mainly used in chemical/electrical resistance applications (Ashford, 1994).
Aluminum-manganese alloys provide strength, hardness, and stiffness when used as an ingredient in aluminum beverage container manufacturing (Bingham et al, 2001).
This element is also used as a bronze ingredient, in high-purity salts for various chemical processes, and as a scavenging and purifying agent in metal production (Ashford, 1994; Lewis, 2001).
Its use in phosphating of mild and galvanized steel and aluminum adds to adhesion and corrosion resistance of paint, wax, and oil finishes (ILO, 1998).
Manganese is used for electrode coating in welding rods and fluxes, for rock crushers, and railway points and crossings. Manganese salts are utilized in fertilizers, as driers for linseed oil, for glass and textile bleaching, and for leather tanning. Manganese chloride is used as a catalyst, in dry-cell batteries, and as an animal feed supplement (ILO, 1998; Zenz, 1994; ACGIH, 1996a).
Manganese and its compounds are utilized in the manufacture of dry cell batteries, paints, varnishes, inks, dyes, matches, and fireworks, as decolorizers and coloring agents in the glass and ceramics industry, and as a fertilizer, disinfectant, bleaching agent, and laboratory reagent. Manganese is used in the chemical industry as an oxidizing agent and for the production of potassium permanganate and other manganese-related chemicals (ILO, 1998; Baselt, 2000; ACGIH, 1996a).
Manganese is also used in the manufacture of rubber and wood preservatives and fungicides (Hathaway et al, 1996).
An organic manganese compound (manganese ethylene bisdithiocarbamate) is contained in the fungicide Maneb (Zenz, 1994). Other pesticides are reported to contain manganese and may cause manganism in agricultural workers (Lee, 2000).
Cases of manganese poisoning have been reported in patients on chronic total parenteral nutrition, with manganese added as a trace element (Masumoto et al, 2001).

FORMS

Manganese is a gray-white, silvery, hard, brittle, lustrous transition metal. It exists in four allotropic forms (alpha, beta, gamma, and delta), of which alpha is most important. Its physical characteristics vary depending on the allotropic form (Ashford, 1994; Bingham et al, 2001; Budavari, 2001; Lewis, 1998; Lewis, 2001).
Manganese is a widely-distributed, abundant element, constituting 0.085% of the earth's crust. As the twelfth most abundant element and the fifth most abundant metal, it can be found in numerous mineral forms. Mineral forms of manganese that are most common are oxides (pyrolusite, manganite, psilomelane, and hausmannite), silicates (braunite and rhodonite), sulfides (manganese blend and hauserite), and carbonates (manganoan calcite and rhodocrosite) (Bingham et al, 2001; Budavari, 2001).
There is one stable isotope of manganese, the natural isotope (55) (Budavari, 2001).
Available grades of manganese include: technical, pure or electrolytic, and powdered (Lewis, 2001).
Manganese can exist in inorganic and organic forms; inorganic forms in the oxidation states Mn(II), Mn(III), or Mn (IV) are most often encountered in the environment and in the workplace. Oxidation states ranging from -3 to +7 result in compound formation, of which the most common are salts, oxides, and organomanganese (Bingham et al, 2001; ATSDR, 2000).
Manganese is a trace element, and is considered essential for animal and plant life. However, well-defined deficiencies have not been demonstrated in humans (ACGIH, 1996a; Lewis, 2001; Lewis, 1998).

SOURCES

Manganese is found in minute quantities in water, plants and animals. It is normally ingested as a trace element in food (Budavari, 2001; Sittig, 1991).
The elemental form of manganese is normally not encountered in the workplace or in nature. It is found in nature in more than 100 various minerals. The most important ore of manganese is black dioxide (MnO2) or pyrolusite. Other important ores are manganite, psilomelane, and rhodochrosite. Open-hearth slags are an important source of manganese. Submarginal concentrations are also usually associated with iron ores (Lewis, 2001; ACGIH, 1996a; Bingham et al, 2001; Harbison, 1998).
The U.S. Bureau of Mines classifies manganese ores by their manganese content. Manganese ore contains 35% or more manganese; ferruginous manganese ore is 10% to 35% manganese; and manganiferous ore is 5% to 35% manganese. In 1986, the content of manganese in ore produced worldwide was estimated 8.8 million tons. This level did not change significantly until the 1995 to 1997 time frame, when there was a slight decline down to 7.7 million tons in 1997 (IPCS, 1999; Zenz, 1994).
Manganese can be derived from the reduction of the oxide with carbon or aluminum. Pure manganese is procured through the electrolytic processing of a sulfate or chloride solution (Lewis, 2001).
PATIENTS UNDERGOING HEMODIALYSIS - Elevated serum manganese, neurologic manifestations consistent with manganese toxicity, and MRI evidence of hyperintense changes in the basal ganglia have been reported in some patients on chronic hemodialysis (da Silva et al, 2007).
PATIENTS RECEIVING PARENTERAL NUTRITION - Hyperintense changes in the basal ganglia on MRI have been reported in patients receiving manganese-containing perioperative parenteral nutrition following gastrointestinal surgeries (Iwase et al, 2002).
METHCATHINONE (EPHEDRONE) ABUSE - Four cases of manganism, presented as impaired postural control, hypophonic dysarthria, hypokinesia and dystonia have been reported in persons using repeated intravenous injections of methcathinone solution, prepared by combining pseudoephedrine and potassium permanganate. Manganese content of the final mixture was 0.6 g/L with ephedrone yield of approximately 44% (Sikk et al, 2007). One man developed manganese-induced levodopa-resistant parkinsonism with profound hypophonia after intravenously injecting himself once or twice daily for several months with a methcathinone solution, prepared by combining 12 tablets containing 60 mg of pseudoephedrine hydrochloride with 0.3 g of potassium permanganate (deBie et al, 2007).

-CLINICAL EFFECTS

GENERAL CLINICAL EFFECTS

USES: Manganese is found in rock, soil, water, and food. Metallic manganese is used to harden and prevent corrosion and rusting of steel. It is also used in black paints and to decolorize glass. Manganese dioxide is used in dry cell batteries as a depolarizer. Potassium permanganate is covered in a separate management.

PHARMACOLOGY: Manganese is an essential nutrient and is a cofactor for many biologic enzyme systems.

TOXICOLOGY: Manganese deposition throughout the brain may lead to neurotoxicity. Manganese primarily deposits in the basal ganglia. Severe toxicity is characterized by a Parkinson's-like syndrome.

EPIDEMIOLOGY: Toxicity from acute ingestion or acute inhalation of manganese is rare. Chronic inhalation over many years, usually from occupational exposure, may lead to manganese toxicity. Chronic manganese toxicity is exceedingly rare in the developed world due to workplace regulations. Manganese toxicity has been rarely reported in individuals injecting methcathinone that has been synthesized by combining pseudoephedrine and potassium permanganate.

WITH POISONING/EXPOSURE

OVERDOSE: Little data is available regarding clinical effects in overdose. Most toxicity is due to chronic workplace exposure.
MILD TO MODERATE TOXICITY: Neurotoxicity is the primary manifestation of manganese toxicity. Patients may develop headaches, dizziness, memory loss, emotional instability, hyperreflexia, and a mild tremor. Chronic excess inhalational exposures may lead to pulmonary inflammation and subsequent reactive airway disease. Metal fume fever has been reported with manganese inhalation. Manganese is poorly absorbed dermally and systemic toxicity from this route is not expected. Dermal exposures may lead to a dermal irritation and contact dermatitis.
SEVERE ACUTE TOXICITY (INGESTION): Can cause mental status changes, vomiting, diarrhea, dehydration, hypotension, acute hepatic and renal failure, metabolic acidosis, multiorgan system failure and death.
SEVERE CHRONIC TOXICITY: Manganese may lead to neurotoxicity that resembles Parkinson disease. These patients may have bradykinesia, resting tremor, psychiatric disturbances, and shuffling gait. Manganese neurotoxicity has been shown to progress 10 years after cessation of exposure. "Manganese madness" is characterized by compulsiveness, anxiety, and aggressiveness. Pleuritis and/or severe or fatal pneumonia have been reported among manganese workers.

POTENTIAL HEALTH HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

Oxides from metallic fires are a severe health hazard.
Inhalation or contact with substance or decomposition products may cause severe injury or death.
Fire may produce irritating, corrosive and/or toxic gases.
Runoff from fire control or dilution water may cause pollution.

ACUTE CLINICAL EFFECTS

SUMMARY

PHARMACOLOGY: Manganese is an essential nutrient and is a cofactor for many biologic enzyme systems.
TOXICOLOGY: Manganese deposition throughout the brain may lead to neurotoxicity. Manganese primarily deposits in the basal ganglia. Severe toxicity is characterized by a Parkinson's-like syndrome.
EPIDEMIOLOGY: Toxicity from acute ingestion or acute inhalation of manganese is rare. Chronic inhalation over many years, usually from occupational exposure, may lead to manganese toxicity. Chronic manganese toxicity is exceedingly rare in the developed world due to workplace regulations. Manganese toxicity has been rarely reported in individuals injecting methcathinone that has been synthesized by combining pseudoephedrine and potassium permanganate.
OVERDOSE: Little data is available regarding clinical effects in overdose. Most toxicity is due to chronic workplace exposure.
MILD TO MODERATE TOXICITY: Neurotoxicity is the primary manifestation of manganese toxicity. Patients may develop headaches, dizziness, memory loss, emotional instability, hyperreflexia, and a mild tremor. Chronic excess inhalational exposures may lead to pulmonary inflammation and subsequent reactive airway disease. Metal fume fever has been reported with manganese inhalation. Manganese is poorly absorbed dermally and systemic toxicity from this route is not expected. Dermal exposures may lead to a dermal irritation and contact dermatitis.
SEVERE ACUTE TOXICITY (INGESTION): Can cause mental status changes, vomiting, diarrhea, dehydration, hypotension, acute hepatic and renal failure, metabolic acidosis, multiorgan system failure and death.
SEVERE CHRONIC TOXICITY: Manganese may lead to neurotoxicity that resembles Parkinson disease. These patients may have bradykinesia, resting tremor, psychiatric disturbances, and shuffling gait. Manganese neurotoxicity has been shown to progress 10 years after cessation of exposure. "Manganese madness" is characterized by compulsiveness, anxiety, and aggressiveness. Pleuritis and/or severe or fatal pneumonia have been reported among manganese workers.

CARDIOVASCULAR

HEART RATE VARIABILITY, CHRONIC EXPOSURE: Chronic occupational manganese exposure has resulted in significant decrease in heart rate variability in both time and frequency domains. It was suggested that heart rate variability be used as an index of autonomic dysfunction in occupational manganese workers (Angle & Barrington, 1995).

DERMATOLOGIC

DERMATITIS: Papular erythematous dermatitis can result from exposure, but manganese is generally nontoxic to intact skin (ITI, 1995).
DIAPHORESIS: Diaphoresis (excessive sweating) is a symptom seen in about 18% of cases (Rodier, 1955) and has been reported in chronic occupational exposures (Angle & Barrington, 1995).

ENDOCRINE

HYPOGLYCEMIA: Manganese may increase the hypoglycemic action of insulin (Dukes & Beeley, 1988).
HYPERPROLACTINEMIA: In one study, serum prolactin levels were higher in manganese-exposed workers than in non-exposed controls (Mutti et al, 1995). Prolactin levels were negatively related to age and positively related to blood and urine manganese levels but not to cumulative manganese exposure index.

FLUID ELECTROLYTE

HYPERCALCEMIA: Significant increases in serum calcium and adenosine deaminase have been reported (Chandra et al, 1974).

GASTROINTESTINAL

IRRITATION: Large doses of manganese can cause GI irritation (Casarett & Doull, 1975).
EXCESSIVE SALIVATION, CHRONIC EXPOSURE: Excessive salivation is reported with chronic toxicity (Nelson et al, 1993; Shuqin et al, 1992).
ACUTE PANCREATITIS: Acute pancreatitis with abdominal pain, hyperamylasemia and pancreatic enlargement developed in a patient who received manganese (3.2% manganese sulfate) in her dialysate solution (Taylor & Price, 1982).

GENITOURINARY

ACUTE RENAL FAILURE, CASE REPORT: A 64-year-old man developed acute renal failure (serum creatinine 3.4 mg/dL [normal range 0.4-1.4]; serum BUN 43 mg/dL [normal range 6-21]), abdominal pain, and mild methemoglobinemia after ingesting 700 mL of a manganese-containing fertilizer (155 mg of manganese). Following hemodialysis and supportive care, he recovered and was discharged after 1 week (Huang & Lin, 2004).

HEENT

As part of the chronic effects on the neurological system, exposure to manganese may cause decreased movement of the eyes and eyelids without paresis, nystagmus, oculogyric crisis or loss of Bell's palsy. Normal visual fields and ocular fundi are found (Grant & Schuman, 1993).
HEARING LOSS, CHRONIC EXPOSURE: Chronic manganese exposure has been associated with hearing loss; the effect seems to be exacerbated by exposure to noise (Rybak, 1992).

HEMATOLOGIC

METHEMOGLOBINEMIA, CASE REPORT: A 64-year-old man developed acute renal failure, abdominal pain, and mild methemoglobinemia (methemoglobin level 2.4%; normal 1.4%-1.5%) after ingesting 700 mL of a manganese-containing fertilizer (155 mg of manganese). His manganese blood and urine levels were 195 mcg/L (normal, less than 15) and 79.5 mcg/L (normal, 0-7.9), respectively. Following hemodialysis and supportive care, he recovered and was discharged after 1 week. The authors suggested that the mildly elevated methemoglobin level may have been caused by the nitrate or the manganese in the fertilizer (Huang & Lin, 2004).

HEPATIC

LIVER DAMAGE: Liver changes, including prominent Golgi apparatus in hepatocytes, dilated biliary canaliculi, and lipid droplets and collagen in the space of Disse, were seen concomitantly with increases in manganese levels due to injection of potassium permanganate (Lustig et al, 1982).
CIRRHOSIS: Cirrhosis has been reported (Harbison, 1998).

METABOLIC

BASAL METABOLIC RATE: In a study by Rodier, 57% of the cases had increases in basal metabolism, and 81% had diminished excretion of 17-ketosteroids (Rodier, 1955).

NEUROLOGIC

EXTRAPYRAMIDAL SYMPTOMS: Early and established intoxications are manifested by neurologic changes and disorders of the extrapyramidal system resembling a dystonic parkinsonism (Lee, 2000; Clayton & Clayton, 1994), with the onset of neurological toxicity occurring over several months to several years after exposure (Sadek et al, 2003). Frequent symptoms include: apathy, generalized muscle weakness, a low monotonous voice, muscle twitching, and limb stiffness, followed by impairment of speech, insomnia, incoordination, difficulty with fine movements, diminished libido or impotence, back pain, headache, clumsiness, sweating and salivation, personality changes, inappropriate crying and laughing, and restlessness (Harbison, 1998). Symptoms resembling Parkinson's disease included tremor, masked face, generalized bradykinesia, and cogwheel rigidity (Bowler et al, 2007).
PARKINSON DISEASE VS PARKINSONIAN SYNDROME - MANGANISM

SIMILARITIES: Tremor, masked facies, generalized bradykinesia (abnormal slowed movement associated with movement initiation difficulties) and cogwheel rigidity (Bowler et al, 2007).
DIFFERENCES:

MANGANISM: More frequent dystonia; a tendency to fall forward; younger age of onset; little or no response to levodopa. MR imaging may show manganese deposition in the brain, exhibiting a T1-weighted signal hyperintensity, especially in the globus pallidus and striatum (Bowler et al, 2007).
PARKINSON DISEASE: Less frequent dystonia; a tendency to fall backward, MR imaging shows lesions in the substania nigra pars compacta (Bowler et al, 2007).

IMPAIRED COGNITION: Patients with manganese-induced parkinsonism may have impaired intellectual function as assessed by IQ tests and mini mental status exams, as well as defective information processing speed, micrographia (small, cramped handwriting) and hypophonia (soft speech) (Hua & Huang, 1991; Huang et al, 1993).
GAIT DISTURBANCES: Manganese-exposed workers without clinical evidence of parkinsonism have had poorer motor speed, visual scanning, visuomotor response speed, and impaired performance of rapid alternating movements in comparison with controls (Beuter et al, 1994; Chia et al, 1993; Hochberg et al, 1996; Wennberg et al, 1992; Wennberg et al, 1991).
MYOCLONUS, CHRONIC EXPOSURE: Chronic manganese poisoning has been associated with myoclonic involuntary movements, without parkinsonism, due to inhalation of welding fumes. Symptoms improved following 5 days of chelation therapy with calcium-EDTA (Ono et al, 2002).

PSYCHIATRIC

MANGANESE PSYCHOSIS: Manganese psychosis (madness; "locura manganical") is a transitory syndrome characteristic of intoxication (Hine & Pasi, 1975). Symptoms occur after variable periods of exposure and consist of nervousness, irritability, emotional lability, and compulsive behavior (Nelson et al, 1993; Shuqin et al, 1992). Patients are aware of their abnormal behavior but cannot modify it. Symptoms last approximately 1 to 2 months and may spontaneously disappear without residual effects (Mena et al, 1967).

RESPIRATORY

PNEUMONITIS: Inhalation has caused mild to moderate inflammation of the respiratory tract and manganese pneumonitis (Casarett & Doull, 1975). No known permanent pulmonary sequelae developed in these cases (Barceloux, 1999).
PNEUMONIA, CHRONIC EXPOSURE: A high incidence of pneumonia has been reported after exposure to manganese dust or fumes (ACGIH, 1996). "Manganese pneumonia" has been reported in mine workers (Tepper, 1961). Clinical signs include: acute alveolar inflammation, marked dyspnea, cough and bronchitis, shallow respiration and subsequent facial cyanosis (Barceloux, 1999).
BRONCHITIS: An increased prevalence of acute bronchitis and exercise-induced dyspnea has been observed in relationship to manganese inhalation exposure (Roels et al, 1987).
METAL FEVER: "Metal fume fever" can result from inhalation of manganese oxide fumes (Barceloux, 1999).

CHRONIC CLINICAL EFFECTS

The target organs for chronic manganese exposure are the CENTRAL NERVOUS SYSTEM and LUNGS; chronic liver failure may also occur (Bingham et al, 2001). The lowest exposure of manganese that will produce neurologic and pulmonary effects is not known (ACGIH, 1996). There are wide differences in susceptibility to manganese poisoning; the effects may or may NOT be reversible after removal from exposure (Bingham et al, 2001). Reversibility of effects may be related to liver function (Dickerson, 2001).

Chronic manganese poisoning (MANGANISM) was first reported from heavy occupational exposures in 1837 by Couper (Lee, 2000). Manganism may follow substantial heavy exposure for 6 months to 3 years (Hathaway et al, 1996). Severe manganism has been reported mainly in miners, persons processing manganese ore, and WELDERS (Oltramare, 1965).

Although gross clinical manganese poisoning occurs mainly after very heavy exposures, ferromanganese alloy workers had subtle abnormalities on neurobehavioral testing after exposures significantly below current occupational standards (Lucchini et al, 1995) Jucchini et al, 1997).

Manganese toxicity occurs in three stages, with behavioral changes initially, followed by motor changes, and finally dystonia and gait changes (Bingham et al, 2001).

Early signs of manganese poisoning include mood swings ('manganese madness'), nervousness, irritability, restlessness, fatigue, headache, apathy, languor, loss of appetite, insomnia and then somnolence, uncontrollable laughter followed by crying, hallucinations, delusions, compulsions, aggressiveness, weakness in the legs, memory loss, decreased libido, impotence, salivation and hearing loss (ACGIH, 1991; Baselt, 1997; Bingham et al, 2001; Friberg et al, 1986) Hathaway et al, 1991).
Motor signs include and expressionless, mask-like appearance of the face, speech impairment with a low-volume monotone, decreased manual dexterity, clumsy movements and a spastic or slow gait with a tendency to fall while walking (ACGIH, 1996; (Bingham et al, 2001).
Finally, parkinsonian changes develop, with cogwheel rigidity, gait changes ('cock walk') and a low-frequency, low-amplitude tremor (Bingham et al, 2001). Thus, although severe manganese poisoning may not be fatal, it produces permanent crippling effects that clinically resemble parkinsonism (Friberg et al, 1986). Progressive parkinsonism may occur many years after cessation of manganese exposure (Huan et al, 1993).

Although manganism and parkinsonism have similar clinical manifestations, they differ in that manganism features a 'cock walk', difficulty in walking backwards, a tendency to fall backward when displaced, and a fine nonresting tremor. Moreover, patients with manganism have a short-lived or absent response to dopamine therapy (Bingham et al, 2001).
In contrast to 'traditional' Parkinson disease, levodopa was effective for only 2 to 3 years in cases of manganism (Huang et al, 1993). Unlike in classical Parkinsonism, dopaminergic neurons may not be affected in manganism (Shintoh et al, 1997).
More than 20 years of occupational exposure to manganese was associated with Parkinson disease in one case-control study (Gorell, 1999).

Asymptomatic manganese miners greater than 50 years of age with a mean duration of 20.25 years exposure had detectable resting tremor, action tremor, and repetitive hand movements as compared with unexposed or mildly exposed controls (Hochberg et al, 1996).

Chronic inhalation of manganese dust can affect the lungs, causing manganese pneumonitis, bronchitis and nasal irritation, increased susceptibility to pneumonia, asthma, and a condition similar to 'metal fume fever' (with exposure to manganese oxides) (ACGIH, 1996; (Baselt, 1997; Bingham et al, 2001; Saakadze & Vasilov, 1977).

Anemia has been reported following chronic manganese exposure, perhaps due to interference with iron metabolism (HSDB , 2001).

Welders exposed to manganese scored more poorly on 5 motor function tests than unexposed controls, even though their blood manganese levels were not increased (Sjogren et al, 1996).

Chronic liver disease is associated with pallidal signal hyperintensity on T-1-weighted magnetic resonance imaging (MRI) and presence of extrapyramidal symptoms, which both correlate with blood manganese levels; similar signs are seen with chronic manganese intoxication in the absence of liver disease (Butterworth et al, 1995). In adults (Alves et al, 1997) and children (Fell at al, 1996) with hyperalimentation associated jaundice, hypermanganism can occur with both MRI and clinical abnormalities.

Chronic exposure to manganese in the drinking water at levels of less than 0.050 mg/L to 2.16 mg/L was not associated with adverse neurological effects, including parkinsonism and fine motor coordination (Vieregge et al, 1995).

Subtle neurological and motor effects correlating with blood manganese levels were seen in persons with environmental exposure to manganese, and may reflect a continuum of severity (Mergler et al, 1999). Early signs of environmental manganism may include slower responses and motor functions, memory and intellectual deficits, mood changes, and tremor (Mergler & Baldwin, 1997). The dose-response of environmental manganism has not been defined.

Levels of superoxide dismutase, malondialdehyde, and manganese were higher in manganese workers than in controls, and malondialdehyde was strongly correlated with plasma manganese levels. These results imply that manganese induces increased levels of lipid peroxidation (Yiin et al, 1996). The mechanism of its neurotoxicity may involve excitotoxic activity and disruption of metabolic oxidation, but because of the large number of manganese-containing enzymes, its neurotoxicity may be complex (Lee, 2000).

Manganese accumulates in the basal ganglia, and structural changes associated with deposition and elimination of manganese in that site can be detected with magnetic resonance imaging (Discalzi et al, 2000).

-FIRST AID

FIRST AID AND PREHOSPITAL TREATMENT

PREHOSPITAL: No gastrointestinal decontamination therapy is likely to alter the absorption of manganese significantly. Removal of the patient from the exposure is the most important action for prehospital providers. Wash dermal exposures with soap and water to remove any residual manganese as soon as possible.

-MEDICAL TREATMENT

LIFE SUPPORT

Support respiratory and cardiovascular function.

SUMMARY

FIRST AID - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

Move victim to fresh air.
Call 911 or emergency medical service.
Give artificial respiration if victim is not breathing.
Administer oxygen if breathing is difficult.
Remove and isolate contaminated clothing and shoes.
In case of contact with substance, immediately flush skin or eyes with running water for at least 20 minutes.
Keep victim warm and quiet.
Ensure that medical personnel are aware of the material(s) involved and take precautions to protect themselves.

FIRST AID

PREHOSPITAL: No gastrointestinal decontamination therapy is likely to alter the absorption of manganese significantly. Removal of the patient from the exposure is the most important action for prehospital providers. Wash dermal exposures with soap and water to remove any residual manganese as soon as possible.
INHALATION EXPOSURE: Inhalation is the predominant route of exposure. Removing the patient from the exposure/workplace is the most important factor in limiting further sequelae. Bronchodilators and oxygen therapy should be provided to patients with bronchospasm or acute pneumonitis. Anti-inflammatory therapies such as corticosteroids may be given for exacerbation of chronic inflammatory lung disease.
DERMAL EXPOSURE: Decontamination with soap and water is the mainstay of treatment of dermal exposures.
EYE EXPOSURE: Irrigation with isotonic fluid 1 to 2 L should be performed to remove debris and normalize pH.

-RANGE OF TOXICITY

MINIMUM LETHAL EXPOSURE

ATSDR (2000) states that no studies have been identified that conclusively link human inhalation exposure of manganese with death (ATSDR, 2000).

CASE REPORT: A 50-year-old man presented with lethargy, diffuse abdominal pain, vomiting and profuse diarrhea after ingesting Epsom salts (3 tablespoons with 3 glasses of water) containing hydrated manganese sulfate instead of magnesium sulfate heptahydrate. Despite supportive care, he developed fulminant liver failure with coagulopathy, acute renal failure, acute respiratory distress, myocardial dysfunction, and shock with lactic acidosis. He underwent continuous venovenous hemofiltration, and multiple transfusions; however, his condition deteriorated and he died 72 hours after onset of symptoms (Sanchez et al, 2012).

MAXIMUM TOLERATED EXPOSURE

GENERAL/SUMMARY

US Environmental Protection Agency (EPA) recommends not more than 0.05 ppm in drinking water and the US Occupational Safety and Health Administration (OSHA) recommends a 8-hour time weighted average of not more than 0.2 mg/m(3) for particulate matter. For exposure to manganese fumes, the National Institute for Occupational Safety and Health (NIOSH) recommends an 8-hour time weighted average of not more than 1 mg/m(3), a short term exposure limit of 3 mg/m(3) and considers 500 mg/m(3) immediately dangerous to life and health (American Conference of Governmental Industrial Hygienists, 2010; National Institute for Occupational Safety and Health, 2007).
Long-term occupational inhalation exposure to dusts containing manganese may cause progressive neurological dysfunction, leading to a disabling syndrome known as manganism. Advanced stages of neurological abnormalities resemble Parkinsonism (IPCS, 1999; Zenz, 1994).
CASE REPORT - A 64-year-old man developed acute renal failure, abdominal pain, and mild methemoglobinemia after ingesting 700 mL of a manganese-containing fertilizer (155 mg of manganese). His manganese blood and urine levels were 195 mcg/L (normal, less than 15) and 79.5 mcg/L (normal, 0-7.9), respectively. Following hemodialysis and supportive care, he recovered and was discharged after 1 week (Huang & Lin, 2004).
In some studies, blood levels as low as 7.5 mcg/L have been associated with neurological dysfunction. In one study (n=273), patients with Mn levels of 7.5 mcg/L or higher were more often associated with alterations in coordination of upper limb movement, and poorer learning and recall. Other studies have suggested that serum Mn levels poorly correlate with recent exposure or clinical symptoms (Sadek et al, 2003).
CASE SERIES/LACK OF EFFECT - In a study of 489 workers (both office workers and miners) employed in two manganese mining towns in South Africa, average exposure for total dust across all jobs was near the ACGIH TLV of 0.2 mg/m(3) with no manganese-related neurological effects reported at this level (Myers et al, 2003).
Studies of manganese toxicity generally evaluate effects through dosage of manganese compound formulations (i.e., manganese chloride, manganese dioxide, manganese sulfate, potassium permanganate, etc.). ATSDR (2000) provides lowest observed adverse effect levels (LOAELs) for numerous manganese compounds from animal and human studies. LOAELS are classified as "serious" when effects are those that evoke failure in a biological system and can lead to morbidity or mortality, and "less serious" when effects are not expected to cause significant dysfunction or death or when the effect's significance to the organism is not entirely clear (IPCS, 1999; ATSDR, 2000).
Most manganese intake from the environment is as Mn(II) or Mn(IV), and changes in oxidation state occurs within the body according to limited data. Redox reactions may be determinants in retention time in the body (IPCS, 1999).
Attempts to induce effects to the brain through oral dosing of manganese compounds showed that inorganic manganese is absorbed slowly and incompletely into the bloodstream when orally administered. Inhaled manganese compounds generally produce more severe toxicity than those that are ingested (ACGIH, 1996a; IPCS, 1999).
Manganese is considered a nutritionally essential element, supporting enzymes critical to the central nervous, skeletal, and reproductive systems. Food intake is estimated to be 2 to 9 mg/day for adults, with an absorbed amount of about 100 to 450 mcg/day based on 5% gastrointestinal absorption (Bingham et al, 2001; (IPCS, 1999) Baxter, 2000; (ATSDR, 2000).

ROUTE OF EXPOSURE

No cases of manganese poisoning occurred among mill workers exposed to airborne concentrations less than 30 mg/m(3) (ACGIH, 1996a).
Manganese exposure at low levels [0.19 to 1.39 mg/m(3)] for 1 to 45 years is reported to have caused pre-clinical signs of manganism, and worker exposure to levels less than 1 mg/m(3) caused an observed effect on performance of psychometric tests and neuropsychiatric symptoms (Hathaway et al, 1996) Baxter, 2000).
An estimate of a no observed adverse effect level (NOAEL) for neurological effects of 30 mcg/m(3) was used in the recent development of a 0.15 mcg/m(3) WHO guidance value for manganese in air. The NOAEL was calculated based on a benchmark dose in a study that examined neurobehavioral endpoints in workers exposed to manganese dioxide at an alkaline battery plant and workers without industrial manganese exposure. Manganese exposed workers exhibited significantly poorer hand-eye coordination, hand steadiness, and visual reaction time (IPCS, 1999).
The World Health Organization (WHO) concluded that adverse CNS effects associated with manganese exposure may occur at airborne manganese concentrations of 2-5 mg/m(3) (ACGIH, 1996a).

Carcinogenicity Ratings for CAS7439-96-5 :

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed ; Listed as: (Manganese and inorganic compounds, as Mn)
ACGIH (American Conference of Governmental Industrial Hygienists, 2010): Not Listed ; Listed as: (Manganese and inorganic compounds, as Mn)
ACGIH (American Conference of Governmental Industrial Hygienists, 2010): A4 ; Listed as: Manganese, elemental and inorganic compounds, as Mn

A4 :Not Classifiable as a Human Carcinogen: Agents which cause concern that they could be carcinogenic for humans but which cannot be assessed conclusively because of a lack of data. In vitro or animal studies do not provide indications of carcinogenicity which are sufficient to classify the agent into one of the other categories.

ACGIH (American Conference of Governmental Industrial Hygienists, 2010): A4 ; Listed as: Manganese, elemental and inorganic compounds, as Mn

A4 :Not Classifiable as a Human Carcinogen: Agents which cause concern that they could be carcinogenic for humans but which cannot be assessed conclusively because of a lack of data. In vitro or animal studies do not provide indications of carcinogenicity which are sufficient to classify the agent into one of the other categories.

EPA (U.S. Environmental Protection Agency, 2011): D ; Listed as: Manganese

D : Not classifiable as to human carcinogenicity.

IARC (International Agency for Research on Cancer (IARC), 2016; International Agency for Research on Cancer, 2015; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2010a; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2008; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2007; IARC Working Group on the Evaluation of Carcinogenic Risks to Humans, 2006; IARC, 2004): Not Listed
NIOSH (National Institute for Occupational Safety and Health, 2007): Not Listed ; Listed as: Manganese compounds and fume (as Mn)
MAK (DFG, 2002): Not Listed
NTP (U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project ): Not Listed

TOXICITY AND RISK ASSESSMENT VALUES

EPA IRIS

EPA Risk Assessment Values for CAS7439-96-5 (U.S. Environmental Protection Agency, 2011):

Oral:

Slope Factor:
RfD: 1.4x10(-1) mg/kg-day

Inhalation:

Unit Risk:
RfC: 5x10(-5) mg/m3

Drinking Water:

Unit Risk:

TOXICITY VALUES

References: ITI, 1995 Lewis, 2000 RTECS, 2002
- LD50- (ORAL)RAT:
- TCLo- (INHALATION)HUMAN:
- TCLo- (INHALATION)RAT:
- TDLo- (INHALATION)HUMAN:
- TDLo- (INTRAMUSCULAR)RAT:
- TDLo- (INTRAPERITONEAL)RAT:

CALCULATIONS

AMBIENT CONVERSIONS

CONVERSION FACTORS

1 mg/m(3) = 0.45 ppm (at 25 degrees C) (ACGIH, 1996a)

-STANDARDS AND LABELS

WORKPLACE STANDARDS

ACGIH TLV Values for CAS7439-96-5 (American Conference of Governmental Industrial Hygienists, 2010):

Editor's Note: The listed values are recommendations or guidelines developed by ACGIH(R) to assist in the control of health hazards. They should only be used, interpreted and applied by individuals trained in industrial hygiene. Before applying these values, it is imperative to read the introduction to each section in the current TLVs(R) and BEI(R) Book and become familiar with the constraints and limitations to their use. Always consult the Documentation of the TLVs(R) and BEIs(R) before applying these recommendations and guidelines.

Adopted Value

(Manganese and inorganic compounds, as Mn)

TLV:

TLV-TWA: (0.2 mg/m(3))
TLV-STEL:
TLV-Ceiling:

Notations and Endnotes:

Carcinogenicity Category: Not Listed
Codes: Not Listed
Definitions: Not Listed

TLV Basis - Critical Effect(s): (CNS impair)
Molecular Weight: 54.94

For gases and vapors, to convert the TLV from ppm to mg/m(3):

[(TLV in ppm)(gram molecular weight of substance)]/24.45

For gases and vapors, to convert the TLV from mg/m(3) to ppm:

[(TLV in mg/m(3))(24.45)]/gram molecular weight of substance

Additional information:

See Notice of Intended Changes; Adopted values enclosed in parentheses are those for which changes are proposed in the Notice of Intended Changes.

Adopted Value

(Manganese and inorganic compounds, as Mn)

TLV:

TLV-TWA: (0.2 mg/m(3))
TLV-STEL:
TLV-Ceiling:

Notations and Endnotes:

Carcinogenicity Category: Not Listed
Codes: Not Listed
Definitions: Not Listed

TLV Basis - Critical Effect(s): (CNS impair)
Molecular Weight: Varies

For gases and vapors, to convert the TLV from ppm to mg/m(3):

[(TLV in ppm)(gram molecular weight of substance)]/24.45

For gases and vapors, to convert the TLV from mg/m(3) to ppm:

[(TLV in mg/m(3))(24.45)]/gram molecular weight of substance

Additional information:

See Notice of Intended Changes; Adopted values enclosed in parentheses are those for which changes are proposed in the Notice of Intended Changes.

Notice of Intended Changes

Manganese, elemental and inorganic compounds, as Mn

TLV:

TLV-TWA: 0.02 mg/m(3)
TLV-STEL:
TLV-Ceiling:

Notations and Endnotes:

Carcinogenicity Category: A4
Codes: R
Definitions:

A4: Not Classifiable as a Human Carcinogen: Agents which cause concern that they could be carcinogenic for humans but which cannot be assessed conclusively because of a lack of data. In vitro or animal studies do not provide indications of carcinogenicity which are sufficient to classify the agent into one of the other categories.
R: Respirable fraction; see Appendix C, paragraph C (of TLV booklet).

TLV Basis - Critical Effect(s): CNS impair
Molecular Weight: Varies

For gases and vapors, to convert the TLV from ppm to mg/m(3):

[(TLV in ppm)(gram molecular weight of substance)]/24.45

For gases and vapors, to convert the TLV from mg/m(3) to ppm:

[(TLV in mg/m(3))(24.45)]/gram molecular weight of substance

Notice of Intended Changes

Manganese, elemental and inorganic compounds, as Mn

TLV:

TLV-TWA: 0.2 mg/m(3)
TLV-STEL:
TLV-Ceiling:

Notations and Endnotes:

Carcinogenicity Category: A4
Codes: I
Definitions:

A4: Not Classifiable as a Human Carcinogen: Agents which cause concern that they could be carcinogenic for humans but which cannot be assessed conclusively because of a lack of data. In vitro or animal studies do not provide indications of carcinogenicity which are sufficient to classify the agent into one of the other categories.
I: Inhalable fraction; see Appendix C, paragraph A (of TLV booklet).

TLV Basis - Critical Effect(s): CNS impair
Molecular Weight: 54.94

For gases and vapors, to convert the TLV from ppm to mg/m(3):

[(TLV in ppm)(gram molecular weight of substance)]/24.45

For gases and vapors, to convert the TLV from mg/m(3) to ppm:

[(TLV in mg/m(3))(24.45)]/gram molecular weight of substance

AIHA WEEL Values for CAS7439-96-5 (AIHA, 2006):

Not Listed

NIOSH REL and IDLH Values for CAS7439-96-5 (National Institute for Occupational Safety and Health, 2007):

Listed as: Manganese compounds and fume (as Mn)
REL:

TWA: 1 mg/m(3)
STEL: 3 mg/m(3)
Ceiling:
Carcinogen Listing: (Not Listed) Not Listed
Skin Designation: Not Listed
Note(s): [*Note: Also see specific listings for Manganese cyclopentadienyl tricarbonyl, Methyl cyclopentadienyl manganese tricarbonyl, and Manganese tetroxide.]

IDLH:

IDLH: 500 mg Mn/m3 (as Mn)
Note(s): Not Listed

OSHA PEL Values for CAS7439-96-5 (U.S. Occupational Safety, and Health Administration (OSHA), 2010):

Listed as: Manganese compounds (as Mn)
Table Z-1 for Manganese compounds (as Mn):

8-hour TWA:

ppm:

Parts of vapor or gas per million parts of contaminated air by volume at 25 degrees C and 760 torr.

mg/m3: 5

Milligrams of substances per cubic meter of air. When entry is in this column only, the value is exact; when listed with a ppm entry, it is approximate.

Ceiling Value: (C) - An employee's exposure to this substance shall at no time exceed the exposure limit given.
Skin Designation: No
Notation(s): Not Listed

Listed as: Manganese fume (as Mn)
Table Z-1 for Manganese fume (as Mn):

8-hour TWA:

ppm:

Parts of vapor or gas per million parts of contaminated air by volume at 25 degrees C and 760 torr.

mg/m3: 5

Milligrams of substances per cubic meter of air. When entry is in this column only, the value is exact; when listed with a ppm entry, it is approximate.

Ceiling Value: (C) - An employee's exposure to this substance shall at no time exceed the exposure limit given.
Skin Designation: No
Notation(s): Not Listed

OSHA List of Highly Hazardous Chemicals, Toxics, and Reactives for CAS7439-96-5 (U.S. Occupational Safety and Health Administration, 2010):

Not Listed

ENVIRONMENTAL STANDARDS

EPA CERCLA, Hazardous Substances and Reportable Quantities for CAS7439-96-5 (U.S. Environmental Protection Agency, 2010):

Listed as: Manganese Compounds

Additional Information:

EPA CERCLA, Hazardous Substances and Reportable Quantities, Radionuclides for CAS7439-96-5 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA RCRA Hazardous Waste Number for CAS7439-96-5 (U.S. Environmental Protection Agency, 2010b):

Not Listed
Editor's Note: The D, F, and K series waste numbers and Appendix VIII to Part 261 -- Hazardous Constituents were not included. Please refer to 40 CFR Part 261.

EPA SARA Title III, Extremely Hazardous Substance List for CAS7439-96-5 (U.S. Environmental Protection Agency, 2010):

Not Listed

EPA SARA Title III, Community Right-to-Know for CAS7439-96-5 (40 CFR 372.65, 2006; 40 CFR 372.28, 2006):

Listed as: Manganese Compounds: Includes any unique chemical substance that contains manganese as part of that chemical's infrastructure
Effective Date for Reporting Under 40 CFR 372.30: 1/1/87
Lower Thresholds for Chemicals of Special Concern under 40 CFR 372.28:

Listed as: Manganese
Effective Date for Reporting Under 40 CFR 372.30: 1/1/87
Lower Thresholds for Chemicals of Special Concern under 40 CFR 372.28:

DOT List of Marine Pollutants for CAS7439-96-5 (49 CFR 172.101 - App. B, 2005):

Not Listed

EPA TSCA Inventory for CAS7439-96-5 (EPA, 2005):

Listed as: Manganese

SHIPPING REGULATIONS

SURFACE

DOT -- Table of Hazardous Materials and Special Provisions (49 CFR 172.101, 2005):

Not Listed

ICAO International Shipping Name (ICAO, 2002):

Not Listed

LABELS

NFPA

NFPA Hazard Ratings for CAS7439-96-5 (NFPA, 2002):

Not Listed

-HANDLING AND STORAGE

SUMMARY

INDUSTRIAL CHEMICALS

Manganese is a highly reactive metal. In powder or dust forms, it is flammable and moderately explosive when exposed to flame. The dust may also be pyrophoric in air. It should be stored in tightly-sealed containers, in a cool and well-ventilated area that is protected from physical disruption. It is reactive with water and oxidizers and storage considerations should include an evaluation of incompatibilities (HSDB , 2002; Sittig, 1991; Budavari, 2000; ITI, 1995; Lewis, 2001; Lewis, 2000; ACGIH, 1996a).

HANDLING

Food and drink should be kept away from areas where manganese is stored or utilized. Storage containers should be properly handled to prevent physical damage (ITI, 1995; HSDB , 2002).

STORAGE

CONTAINER

Containers are to be kept tightly closed and protected against physical damage. Manganese will undergo superficial oxidation when exposed to air. Containers used for storage of manganese should prevent exposure to water and steam (ITI, 1995; Sittig, 1991; HSDB , 2002).

ROOM/CABINET RECOMMENDATIONS

Manganese should be stored in a cool, well-ventilated location away from water and oxidizers. Store away from oxidizers such as peroxides, perchlorates, permanganates, chlorates, and nitrates (ITI, 1995; Sittig, 1991).

INCOMPATIBILITIES

Hazardous reactions may occur upon contact with water or steam, producing flammable hydrogen gas. However, pure electrolytic manganese is not attacked by water and only slightly by steam at ordinary temperatures (Budavari, 2000; Lewis, 2000).
Aqueous solutions of sodium or potassium bicarbonate will react with manganese (Budavari, 2000).
It will also react with dilute mineral acids, generating hydrogen and forming divalent manganous salts (Budavari, 2000).
Manganese may react with oxidizing materials (Lewis, 2000).
The powdered metal ignites on contact with fluorine, chlorine or sulfur dioxide and heat, hydrogen peroxide, and bromine pentafluoride (Lewis, 2000).
The powder will reduce metallic oxides on heating. Heating will cause direct reaction with carbon, phosphorus, antimony, or arsenic (Budavari, 2000).
It undergoes a violent reaction with nitrogen dioxide and oxidants, and manganese powder reacts with concentrated nitric acid with incandescence and potential explosive properties (HSDB , 2002; Lewis, 2000).
Manganese is incompatible with hydrogen peroxide, where contact with manganese or its salts may cause violent decomposition (HSDB , 2002).
Mixtures of manganese dust with ammomium nitrate may be explosive when heated (Lewis, 2000).

-PERSONAL PROTECTION

SUMMARY

RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

Wear positive pressure self-contained breathing apparatus (SCBA).
Structural firefighters' protective clothing will only provide limited protection.

Skin contact with manganese should be avoided by wearing protective clothing and gloves (Sittig, 1991; ITI, 1995).

NIOSH (2002) does not provide recommendations concerning personal protection for manganese compounds and fume (as Mn).

EYE/FACE PROTECTION

When working with dusts or powders, dust-proof goggles should be worn, unless full facepiece respiratory protection is utilized (Sittig, 1991; ITI, 1995).

RESPIRATORY PROTECTION

Refer to "Recommendations for respirator selection" in the NIOSH Pocket Guide to Chemical Hazards on TOMES Plus(R) for respirator information.

The size of airborne manganese dust particles varies widely. Dust particles can range from the submicron level to >10 microns. Manganese fume particles, generated in meting and steelmaking operations, are mostly in the submicron range (ACGIH, 1996a).

PROTECTIVE CLOTHING

CHEMICAL PROTECTIVE CLOTHING. Search results for CAS 7439-96-5.

Specific recommendations and test data for this chemical were not found in the available manufacturers' product literature. A complete list of consulted manufacturers and references is presented below.

ENGINEERING CONTROLS

HSDB's Scientific Review Panel suggests the following: "Local exhaust ventilation should be applied wherever there is an incidence of point source emissions or dispersion of regulated contaminants in the work area. Ventilation control of the contaminant as close to its point of generation is both the most economical and safest method to minimize personnel exposure to airborne contaminants." (HSDB , 2002)

-PHYSICAL HAZARDS

FIRE HAZARD

SUMMARY

Editor's Note: This material is not listed in the Emergency Response Guidebook. Based on the material's physical and chemical properties, toxicity, or chemical group, a guide has been assigned. For additional technical information, contact one of the emergency response telephone numbers listed under Public Safety Measures.
POTENTIAL FIRE OR EXPLOSION HAZARDS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)
- May react violently or explosively on contact with water.
- Some are transported in flammable liquids.
- May be ignited by friction, heat, sparks or flames.
- Some of these materials will burn with intense heat.
- Dusts or fumes may form explosive mixtures in air.
- Containers may explode when heated.
- May re-ignite after fire is extinguished.
Manganese is flammable in the powder or dust form. These forms are also moderately explosive when exposed to flame. The dust may be pyrophoric in air. Mixtures of manganese dust with ammomium nitrate may be explosive when heated. The powdered metal ignites on contact with fluorine, chlorine or sulfur dioxide and heat, hydrogen peroxide, and bromine pentafluoride. Hazardous reactions may occur upon contact with water or steam, producing flammable hydrogen gas (Sittig, 1991; Lewis, 2001; Lewis, 2000).

FLAMMABILITY CLASSIFICATION

NFPA Flammability Rating for CAS7439-96-5 (NFPA, 2002):

Not Listed

INITIATING OR CONTRIBUTING PROPERTIES

Because manganese is a highly reactive metal, contact or mixture with certain chemical substances can lead to fire, explosion, or generation of flammable hydrogen gas. Heating may contribute to the reactivity of manganese. Hazardous reactions may occur upon contact with water or steam, producing flammable hydrogen gas (HSDB , 2002; Sittig, 1991; Budavari, 2000; Lewis, 2001; Lewis, 2000).
Section 8.0 discusses manganese incompatiblities, and reactivity hazards of manganese are presented later in this document.

FIRE CONTROL/EXTINGUISHING AGENTS

FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

DO NOT USE WATER, FOAM OR CO2.
Dousing metallic fires with water may generate hydrogen gas, an extremely dangerous explosion hazard, particularly if fire is in a confined environment (i.e., building, cargo hold, etc.).
Use DRY sand, graphite powder, dry sodium chloride based extinguishers, G-1® or Met-L-X® powder.
Confining and smothering metal fires is preferable rather than applying water.
Move containers from fire area if you can do it without risk.

TANK OR CAR/TRAILER LOAD FIRE PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

If impossible to extinguish, protect surroundings and allow fire to burn itself out.

NFPA Extinguishing Methods for CAS7439-96-5 (NFPA, 2002):

Not Listed

To fight a fire involving manganese, utilize dry chemicals that are suitable for extinguishing metal fires. Do NOT use water (ITI, 1995; Lewis, 2000; Sittig, 1991).

EXPLOSION HAZARD

When exposed to flame, manganese dust is a moderate explosion hazard. The dust may be pyrophoric in air and can also explode when heated in the presence of carbon dioxide. Aluminum dust mixed with manganese dust may explode in air (HSDB , 2002; Lewis, 2000).

For manganese dust, the minimum explosive concentration is 125 oz/1000 ft(3). This level produces a maximal explosion pressure of 50 psi. Manganese dust clouds have a minimal ignition temperature of 450 degrees C. These clouds need at least 15% ambient oxygen for ignition (HSDB , 2002; Clayton & Clayton, 1994).

Mixture with ammomium nitrate may be explosive when heated. Manganese undergoes a violent reaction with nitrogen dioxide and oxidants. Hydrogen peroxide (52% weight or greater) may violently decompose upon contact with manganese or its salts. Fire and explosion may result when manganese reacts with nitric acid, oxidizers, nitrogen, sulfur dioxide, or finely divided aluminum or other metals (HSDB , 2002; Lewis, 2000; Pohanish & Greene, 1997).

See the REACTIVITY HAZARD Section for additional information.

DUST/VAPOR HAZARD

In powder or dust forms, it is flammable and moderately explosive when exposed to flame. The dust may also be pyrophoric in air. Powdered manganese will ignite on contact with hydrogen peroxide, fluorine, bromine pentafluoride, and chlorine or sulfur dioxide and heat. Manganese dust and aluminum dust have reportedly caused an explosion, and fire and explosion may result upon contact with finely divided particles of other metals (Lewis, 2001; Lewis, 2000; Pohanish & Greene, 1997).

See the EXPLOSION HAZARD and REACTIVITY HAZARD Sections for full information.

REACTIVITY HAZARD

Manganese reacts with water or steam to form hydrogen gas. However, pure electrolytic manganese is not attacked by water and only slightly by steam at ordinary temperatures (Lewis, 2000; Sittig, 1991; Pohanish & Greene, 1997; Budavari, 2000).

Manganese is a highly reactive metal, existing in seven oxidation states. Its reaction with oxidizers, nitric acid, nitrogen, sulfur dioxide, or finely divided metal particles may cause fire and explosion (ACGIH, 1996a; Lewis, 2000; Pohanish & Greene, 1997).

Aqueous solutions of sodium or potassium bicarbonate will react with manganese. It will also react with dilute mineral acids, generating hydrogen and forming divalent manganous salts. It undergoes a violent reaction with nitrogen dioxide and oxidants, and manganese powder reacts with concentrated nitric acid with incandescence and potential explosive properties. Manganese is incompatible with hydrogen peroxide (52% weight or greater), where contact with manganese or its salts may cause violent decomposition. Mixtures with ammonium nitrate may be explosive when heated (Budavari, 2000; HSDB , 2002; Lewis, 2001; Lewis, 2000).

Manganese can react violently with nitrogen dioxide and oxidizing materials (e.g., chlorates, perchlorates, permanganates, peroxides and nitrates). Manganese can also ignite in the presence of nitrogen dioxide (NFPA, 2002a; Lewis, 2000; Sittig, 1991).

Powdered manganese ignites on contact with (Lewis, 2000):

bromine pentafluoride
chlorine (solid manganese + heat also ignites in chlorine)
fluorine
hydrogen peroxide
sulfur dioxide vapor + heat

Manganese powder will reduce metallic oxides on heating. Heating will cause direct reaction with carbon, phosphorus, antimony, or arsenic. The dust form of manganese may be pyrophoric in air and may explode when heated in the presence of carbon dioxide. A mixture of manganese and aluminum dust was reported to explode in air (Budavari, 2000; Lewis, 2000; NFPA, 2002a).

Manganese is converted by fluorine into the tri- and difluoride, and by chlorine into the dichloride (Budavari, 2000).

Reaction with manganese exhibits incandescence when the powder is exposed to fluorine or concentrated nitric acid (also reacting with a feeble explosion), and when manganese is heated in the vapor of phosphorus. Heating of manganese in chlorine will ignite and burn brilliantly. Manganese powder behaves similarly, but does not require heat for ignition (NFPA, 2002a; HSDB , 2002).

EVACUATION PROCEDURES

SUMMARY

Editor's Note: This material is not listed in the Table of Initial Isolation and Protective Action Distances.

LARGE SPILL - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

Consider initial downwind evacuation for at least 50 meters (160 feet).

FIRE - PUBLIC SAFETY EVACUATION DISTANCES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

If tank, rail car or tank truck is involved in a fire, ISOLATE for 800 meters (1/2 mile) in all directions; also, consider initial evacuation for 800 meters (1/2 mile) in all directions.

PUBLIC SAFETY MEASURES - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)

CALL Emergency Response Telephone Number on Shipping Paper first. If Shipping Paper not available or no answer, refer to appropriate telephone number:

MEXICO:

SETIQ:

01-800-00-214-00 in the Mexican Republic;
For calls originating in Mexico City and the Metropolitan Area: 5559-1588;
For calls originating elsewhere, call: 011-52-555-559-1588.

CENACOM:

01-800-00-413-00 in the Mexican Republic;
For calls originating in Mexico City and the Metropolitan Area: 5550-1496, 5550-1552, 5550-1485, or 5550-4885;
For calls originating elsewhere, call: 011-52-555-550-1496, or 011-52-555-550-1552; 011-52-555-550-1485, or 011-52-555-550-4885.

ARGENTINA:

CIQUIME:

0-800-222-2933 in the Republic of Argentina;
For calls originating elsewhere, call: +54-11-4613-1100.

BRAZIL:

PRÓ-QUÍMICA:

0-800-118270 (Toll-free in Brazil);
For calls originating elsewhere, call: +55-11-232-1144 (Collect calls are accepted).

COLUMBIA:

CISPROQUIM:

01-800-091-6012 in Colombia;
For calls originating in Bogotá, Colombia, call: 288-6012;
For calls originating elsewhere, call: 011-57-1-288-6012.

CANADA:

CANUTEC:

613-996-6666 (Collect calls are accepted);
*666 cellular (in Canada only).

UNITED STATES:

CHEMTREC®:

1-800-424-9300 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
703-527-3887 for calls originating elsewhere (Collect calls are accepted).

CHEM-TEL, INC.:

1-800-255-3924 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
813-248-0585 for calls originating elsewhere (Collect calls are accepted).

INFOTRAC:

1-800-535-5053 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
352-323-3500 for calls originating elsewhere (Collect calls are accepted).

3E COMPANY:

1-800-451-8346 (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
760-602-8703 for calls originating elsewhere (Collect calls are accepted).

NATIONAL RESPONSE CENTER (NRC):

1-800-424-8802 - (24 hours) (Toll-free in the U.S., Canada, and the U.S. Virgin Islands);
202-267-2675 for calls in the District of Columbia.

MILITARY SHIPMENTS:

703-697-0218 - Explosives/ammunition incidents (Collect calls are accepted);
1-800-851-8061 - All other dangerous goods incidents.

NATIONWIDE POISON CONTROL CENTER (United States only):

1-800-222-1222 (Toll-free in the U.S.).

For additional details see the section entitled "WHO TO CALL FOR ASSISTANCE" under the ERG Instructions.
As an immediate precautionary measure, isolate spill or leak area in all directions for at least 50 meters (150 feet) for liquids and at least 25 meters (75 feet) for solids.
Stay upwind.
Keep unauthorized personnel away.

AIHA ERPG Values for CAS7439-96-5 (AIHA, 2006):

Not Listed

DOE TEEL Values for CAS7439-96-5 (U.S. Department of Energy, Office of Emergency Management, 2010):

Listed as Manganese
TEEL-0 (units = mg/m3): 0.2
TEEL-1 (units = mg/m3): 3
TEEL-2 (units = mg/m3): 5
TEEL-3 (units = mg/m3): 500
Definitions:

TEEL-0: The threshold concentration below which most people will experience no adverse health effects.
TEEL-1: The airborne concentration (expressed as ppm [parts per million] or mg/m(3) [milligrams per cubic meter]) of a substance above which it is predicted that the general population, including susceptible individuals, could experience notable discomfort, irritation, or certain asymptomatic, nonsensory effects. However, these effects are not disabling and are transient and reversible upon cessation of exposure.
TEEL-2: The airborne concentration (expressed as ppm or mg/m(3)) of a substance above which it is predicted that the general population, including susceptible individuals, could experience irreversible or other serious, long-lasting, adverse health effects or an impaired ability to escape.
TEEL-3: The airborne concentration (expressed as ppm or mg/m(3)) of a substance above which it is predicted that the general population, including susceptible individuals, could experience life-threatening adverse health effects or death.

AEGL Values for CAS7439-96-5 (National Research Council, 2010; National Research Council, 2009; National Research Council, 2008; National Research Council, 2007; NRC, 2001; NRC, 2002; NRC, 2003; NRC, 2004; NRC, 2004; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; United States Environmental Protection Agency Office of Pollution Prevention and Toxics, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2009; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2008; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2007; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2005; National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances, 2006; 62 FR 58840, 1997; 65 FR 14186, 2000; 65 FR 39264, 2000; 65 FR 77866, 2000; 66 FR 21940, 2001; 67 FR 7164, 2002; 68 FR 42710, 2003; 69 FR 54144, 2004):

Not Listed

NIOSH IDLH Values for CAS7439-96-5 (National Institute for Occupational Safety and Health, 2007):

IDLH: 500 mg Mn/m3 (as Mn)
Note(s): Not Listed

CONTAINMENT/WASTE TREATMENT OPTIONS

SUMMARY

SPILL OR LEAK PRECAUTIONS - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)
- ELIMINATE all ignition sources (no smoking, flares, sparks or flames in immediate area).
- Do not touch or walk through spilled material.
- Stop leak if you can do it without risk.
- Prevent entry into waterways, sewers, basements or confined areas.
RECOMMENDED PROTECTIVE CLOTHING - EMERGENCY RESPONSE GUIDEBOOK, GUIDE 170 (ERG, 2004)
- Wear positive pressure self-contained breathing apparatus (SCBA).
- Structural firefighters' protective clothing will only provide limited protection.
Spills of powdered manganese should be collected in a safe manner and sealed in an appropriate container for disposal (Sittig, 1991).
Refer to the Handling and Storage section for additional information.

WASTE TREATMENT OPTIONS

RECYCLING/RECLAMATION

To minimize waste generation, manganese may be salvaged for reuse or sold as scrap metal (ITI, 1995).
Surface mining operations may include development of leach dumps in which solution mining is applied to the mined ore. A lixiviant of aqueous sulfur dioxide is used to extract manganese (ILO, 1998).
Waste management activities associated with material disposition are unique to individual situations. Proper waste characterization and decisions regarding waste management should be coordinated with the appropriate local, state, or federal authorities to ensure compliance with all applicable rules and regulations.

CHEMICAL TREATMENT

Water purification will remove natural contaminants in water, which may include manganese. Deionization, reverse osmosis, or distillation can be used to purify water used as rinsate in plating operations, thereby reducing the volume of bath sludges requiring treatment (ILO, 1998).
HSDB (2002) states that the recommended disposal method is through a landfill. However, the following HSDB statement should be noted: "SRP: At the time of review, criteria for land treatment or burial (sanitary landfill) disposal practices are subject to significant revision. Prior to implementing land disposal of waste residue (including waste sludge), consult with environmental regulatory agencies for guidance on acceptable disposal practices."

-ENVIRONMENTAL HAZARD MANAGEMENT

POLLUTION HAZARD

Manganese is ubiquitous in the environment, occurring in air, soil, water, and food. All humans are exposed to manganese, and it is a normal component of the human body. The most important exposure route for humans is food consumption, with typical daily intakes ranging from 1 - 5 mg/day. Release of significant amounts of manganese dust into the atmosphere from factories and hazardous waste sites results in above-average exposures to manganese. Manganese can also be released into the air by combustion of unleaded gasoline containing the anti-knock agent MMT (ATSDR, 2000).

Manganese was identified in varous environmental media (air, surface water, groundwater, soil, and sediment) at approximately 600 of the nearly 1,500 current or former EPA National Priorities List (NPL) hazardous waste sites. Data are not available regarding the number of sites where manganese was evaluated. In some cases, it may be associated with natural levels rather than disposial of manganese waste, but some sites had levels significantly higher than average (ATSDR, 2000).

Industrial manufacturers, processors, and users of manganese and manganese compounds are required to report on environmental releases including emissions, transfers, and waste management data according to the Emergency Planning and Community Right to Know Act (EPCRA), Section 313 Toxic Chemicals/Specific Toxic Chemical List which includes manganese (EPA, 2002b).

The EPA's Toxic Release Inventory 2000 reported the following for facilities in all industries for manganese (EPA, 2000f):

Total Air Emissions - 933,473 lbs
Total Surface Water Discharges - 347,249 lbs
Underground Injections - 2600 lbs
Releases to Land - 14,587,907 lbs
Total On-site Releases - 15,871,229 lbs
Total Off-site Releases - 12,342,466 lbs

Other than industrial emissions, additional environmental releases of manganese occur from natural sources, combustion of fossil fuels, waste incineration, cement production, and re-entrainment of manganese containing soils. Manganese is released to the air mainly as particulate matter, and the principal source of industrial air emissions is metallurgical processes. Combustion emissions of manganese are released to the atmosphere primarily from power plants and coke ovens. Surface water may be impacted by industrial discharges of manganese or from leachate emanating from landfills and soil. Land disposal is the principal source of manganese releases to soil (ATSDR, 2000; IPCS, 1999).

ENVIRONMENTAL FATE AND KINETICS

Soil particulates containing manganese can become entrained and transported in air as suspended particulate matter. The duration and length of atmospheric transport will depend on particle size and atmospheric conditions. Gravitational settling, or dry deposition, is the process by which manganese-containing particles are removed from the atmosphere. Particle size varies by source, with small particles being associated with ferromanganese and dry-cell battery plants and large particles predominating near mining operations. Wet deposition, or rain washout mechanisms, are of minor significance. Little information is available on atmospheric reactions of manganese in air, although manganese will primarily undergoe oxdation/reduction reactions in the environment. For example, it is known, but not demonstrated, that manganese can react with sulfur dioxide and nitrogen dioxide (ATSDR, 2000; IPCS, 1999).
A study of heavy metal behavior in combustion gases of urban waste incinerators found manganese in the form of oxides and chlorides within the gaseous fly ash. Airborne release of these soluble compounds could lead to leaching and mobility in other environmental media (ATSDR, 2000).

WATER

SURFACE WATER
- Manganese transport and partitioning in water is determined by the solubility of the particular manganese compound. Manganese metal may occur in any of four oxidation states in water, with Mn(II) predominating in most waters at pH 4-7. In water, Mn(II) is usually associated with the insoluble carbonate anion, limiting its solubility. In an oxidized water system, manganese solubility will be controlled by manganese oxide equilibria, with manganese converted through oxidation to Mn(II) or Mn(IV). Formation of a poorly soluble sulfide will control manganese solubility in reduced water (ATSDR, 2000; IPCS, 1999).
- In groundwater with low levels of dissolved oxygen, Mn(IV) was found to undergo reduction to Mn(II) through chemical and bacterial means. The Mn(II) oxidation state is soluble (without the presence of carbonate) and its release will allow groundwater transport (ATSDR, 2000).
- In rivers, manganese is generally transported via sediment flow as it will adsorb to suspended sediments (ATSDR, 2000; IPCS, 1999).

SOIL

TERRESTRIAL
- Manganese can exist in soil as Mn(II), Mn(III), or Mn (IV), depending on the oxidation-reduction status of the soil. The observed range of the Kd value for manganese in soils and clays is 0.2 - 10,000 ml/g (Dragun, 1988).
- Soil adsorption is quite variable for the miscellaneous forms of manganese and will depend on cation exchange capacity and soil organic content. It has been shown that desorption of manganese in clay type soils is not easily accomplished at low concentrations. Higher concentrations of manganese may undergoe desorption by ion exchange mechanisms with other ions in solution (ATSDR, 2000).
- Microbial activity can alter the oxidation state of manganese in soil and sediment. This has been shown to increase dissolution in subsurface environments, thereby increasing mobility (ATSDR, 2000).

OTHER

OTHER
- Elemental manganese and inorganic compounds can exist as suspended particulate matter in air with a half-life of a few days (ATSDR, 2000).
- Microbial metabolism of manganese in water through oxidation is likely a function of pH, temperature, and other factors (ATSDR, 2000).
- Thermodynamic equilibrium concepts can be used to predict partitioning of manganese between water and soil. However, studies of the reaction kinetics are not available (ATSDR, 2000).

BIODEGRADATION

Microbial activity can transform the oxidation state of manganese in soil and sediment. One study observed that Mn(II) in suspensions of silt or clay loams was oxidized by microorganisms with precipitation of manganese minerals (ATSDR, 2000).

Bacterial reduction of Mn(IV) to Mn(II)was observed in groundwater containing low levels of dissolved oxygen (ATSDR, 2000).

BIOACCUMULATION

HUMANS

Human adults generally maintain stable tissue levels of manganese through a homeostatic mechanism that regulates excretion of excess manganese. Manganese may undergo changes in oxidation state within the body. This is based on limited data and the finding that the oxidation state of the manganese ion in several enzymes appears to be Mn(III), but most intake from the environment is as Mn(II) or Mn(IV) (IPCS, 1999).
Human breast milk concentrations of manganese are reportedly in the range of 3-10 ppb (ATSDR, 2000).

FISH

A water quality criterion of 0.1 mg/l for marine waters was set by EPA to protect consumers from the risk of manganese bioaccumulation in marine mollusks (ATSDR, 2000).
Manganese was detected in muscle samples of bluefin tuna (Thunnus thynnus) in a 1992 survey by the Canadian Department of Fisheries and Oceans. Concentrations ranged from 0.16 to 0.31 mcg manganese/g dry weight, with a mean of 0.22 mcg/g (ATSDR, 2000).

PLANTS

AQUATIC
- Bioconcentration of manganese in water is significant at lower trophic levels (ATSDR, 2000; IPCS, 1999).
- Manganese bioaccumulation in plants was evaluated in a study of oats (Avena nova) and beans (Phaseolus vularis) planted in sandy and organic soil in a controlled greenhouse environment and in locations near high traffic volume (an area with <20,000 vehicles/day and another with 132,000 vehicles/day). Highest accumulation was found in the fruits and stems of oats grown in the organic and sandy soil at the station with the highest traffic density (ATSDR, 2000).
- A field survey that examined terrestrial and aquatic plant samples taken from areas along motorways and local urban roadways in Utah found concentrations in plants near the motorways ranging from 30.2 to 13,680 mcg/g dry weight (ATSDR, 2000).

MAMMALS

Concentrations of manganese were found to be at 30 ppb in cow's milk (ATSDR, 2000).

BIOCONCENTRATION FACTOR

The following bioconcentration factors (BCFs) have been estimated for manganese (ATSDR, 2000; IPCS, 1999):
- 10,000 to 20,0000 for marine and freshwater plants
- 2,500 to 6,300 for phytoplankton
- 300 to 5,500 for marine algae
- 800 to 830 for intertidal mussels
- 35 to 930 for coastal fish

ENVIRONMENTAL TOXICITY

Ecotoxicity values (EPA, 2002g):

LD50 - (FRESHWATER) SILVERSIDE (Basilichthys australis): total Mn >50,000 mcg/L for 96 hours-static -- mortality
LC50 - (FRESHWATER) EASTERN NARROW-MOUTHED TOAD (Gastrophryne carolinensis): total Mn 1,420 mcg/L for 7 days-renewal -- increased mortality
LC01 - (FRESHWATER) RAINBOW TROUT, DONALDSON TROUT (Oncorhynchus mykiss): total Mn 388 mcg/L for 4 days post-hatch -- increased mortality
LC10 - (FRESHWATER) RAINBOW TROUT, DONALDSON TROUT (Oncorhynchus mykiss): total Mn 958 mcg/L for 4 days post-hatch -- increased mortality
LC50 - (FRESHWATER) RAINBOW TROUT, DONALDSON TROUT (Oncorhynchus mykiss): total Mn >170 - <15,610 mcg/L for 28 days-renewal -- increased mortality

-PHYSICAL/CHEMICAL PROPERTIES

MOLECULAR WEIGHT

54.94

DESCRIPTION/PHYSICAL STATE

Manganese is a hard, brittle, lustrous, silver-gray, metallic element with atomic number 25. It exists in four allotropic forms (alpha, beta, gamma, and delta). The physical characteristics vary from hard and brittle to soft and flexible depending on the allotropic form of the pure metal. Manganese has one stable isotope (55), and eight radioisotopes. It is a highly reactive metal and can exist in seven different oxidation states (ACGIH, 1996a; Ashford, 1994; Budavari, 2001; Bingham et al, 2001).

The four allotropic forms are described as follows (Budavari, 2001):

alpha-form: body-centered cubic crystals that are stable below approximately 710 degrees C.
beta-form: cubic crystals that are stable in the range of 710-1079 degrees C.
gamma-form (electrolytic manganese): can exist in two crystalline structures, as face-centered cubic crystals that are stable in the range of 1079-1143 degrees C or as face-centered tetragonal crystals when stabilized at room temperature.
delta-form: body-centered cubic crystals that are stable from 1143 degrees C to its melting point.

Manganese can exist in inorganic and organic forms; inorganic forms in the oxidation states Mn(II), Mn(III), or Mn(IV) are most often encountered in the environment and in the workplace. Oxidation states ranging from -3 to +7 result in compound formation, of which the most common are salts, oxides, and organomanganese (Bingham et al, 2001; ATSDR, 2000).

VAPOR PRESSURE

approximately 0 mmHg (NIOSH , 2002)

1 mmHg (at 1292 degrees C) (Lewis, 2000)

1 Pa at 955 degrees C (sub); 10 Pa at 1074 degrees C (sub); 100 Pa at 1220 degrees C (sub); 1 kPa at 1418 degrees C; 10 kPa at 1682 degrees C; 100 kPa at 2060 degrees C (HSDB , 2002)

SPECIFIC GRAVITY

TEMPERATURE AND/OR PRESSURE NOT LISTED

7.21 to 7.4 (depending on allotropic form) (ACGIH, 1996a)
7.44 (ITI, 1995)
7.20 (metal) (NIOSH , 2002)

DENSITY

OTHER TEMPERATURE AND/OR PRESSURE

alpha-form: 7.47 g/cm(3) (at 20 degrees C) (Budavari, 2001)
beta-form: 7.26 g/cm(3) (at 20 degrees C) (Budavari, 2001)
7.21 g/cm(3) (at 20 degrees C) (Budavari, 2001)
6.37 g/cm(3) (at 1100 degrees C) (Budavari, 2001)
delta-form: 6.28 g/cm(3) (at 1143 degrees C) (Budavari, 2001)

TEMPERATURE AND/OR PRESSURE NOT LISTED

7.20 g/cm(3) (Lewis, 2000)
7.44 g/cm(3) (HSDB , 2002) Lewis, 2001)

FREEZING/MELTING POINT

FREEZING POINT

2271 degrees F (NIOSH , 2002)

MELTING POINT

1244 degrees C (ACGIH, 1996a; Budavari, 2001; Lewis, 2000)
1245 degrees C (ITI, 1995; Lewis, 2001)
1233 degrees C (Bingham et al, 2001)

BOILING POINT

1962 degrees C (ACGIH, 1996a; Bingham et al, 2001)

2060 degrees C (Lewis, 2000)

2095 degrees C (Budavari, 2001)

2097 degrees C (ITI, 1995; Lewis, 2001)

3564 degrees F (NIOSH , 2002)

AUTOIGNITION TEMPERATURE

Manganese dust clouds have a minimal ignition temperature of 450 degrees C. These dust clouds need at least 15% ambient oxygen for ignition (HSDB , 2002).

EXPLOSIVE LIMITS

LOWER

Manganese has a minimum explosive concentration of 125 oz/1000 ft(3) generating a maximal explosion pressure of 50 psi (HSDB , 2002).

SOLUBILITY

IN WATER

Insoluble in water (NIOSH , 2002)
Manganese decomposes water slowly at room temperature and rapidly with heating, producing hydrogen. Pure electrolytic manganese is not attacked by water and only slightly by steam at ordinary temperatures (Ashford, 1994; Budavari, 2001; Lewis, 2000; Sittig, 1991; Pohanish & Greene, 1997)

OTHER

Manganese readily dissolves in dilute acids and dilute mineral acids; the latter reaction forms divalent manganous salts and hydrogen (ACGIH, 1996a; Budavari, 2001; ITI, 1995; Lewis, 2001).
It is soluble in aqueous solutions of potassium or sodium bicarbonate (ITI, 1995).

OTHER/PHYSICAL

ODOR THRESHOLD

Not Listed (CHRIS , 1999)

HEAT OF FUSION

3.5 kcal/g-atom (Budavari, 2001)

-REFERENCES

GENERAL BIBLIOGRAPHY

40 CFR 372.28: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Lower thresholds for chemicals of special concern. National Archives and Records Administration (NARA) and the Government Printing Office (GPO). Washington, DC. Final rules current as of Apr 3, 2006.

40 CFR 372.65: Environmental Protection Agency - Toxic Chemical Release Reporting, Community Right-To-Know, Chemicals and Chemical Categories to which this part applies. National Archives and Records Association (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Apr 3, 2006.

49 CFR 172.101 - App. B: Department of Transportation - Table of Hazardous Materials, Appendix B: List of Marine Pollutants. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 29, 2005.

49 CFR 172.101: Department of Transportation - Table of Hazardous Materials. National Archives and Records Administration (NARA) and the Government Printing Office (GPO), Washington, DC. Final rules current as of Aug 11, 2005.

62 FR 58840: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 1997.

65 FR 14186: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 39264: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

65 FR 77866: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2000.

66 FR 21940: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2001.

67 FR 7164: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2002.

68 FR 42710: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2003.

69 FR 54144: Notice of the National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances - Proposed AEGL Values, Environmental Protection Agency, NAC/AEGL Committee. National Archives and Records Administration (NARA) and the Government Publishing Office (GPO), Washington, DC, 2004.

ACGIH: Documentation of the Threshold Limit Values and Biological Exposure Indices, 6th ed (Supplement), Am Conference of Govt Ind Hyg, Inc, Cincinnati, OH, 1996a.

ACGIH: Documentation of the Threshold Limit Values and Biological Exposure Indices, 6th ed, Am Conference of Govt Ind Hyg, Inc, Cincinnati, OH, 1991, pp 876-878.

AIHA: 2006 Emergency Response Planning Guidelines and Workplace Environmental Exposure Level Guides Handbook, American Industrial Hygiene Association, Fairfax, VA, 2006.

ATSDR: Toxicological Profile for Manganese, Agency for Toxic Substances and Disease Registry, US Dept of Health and Human Services, Atlanta, GA, 2000.

Alves G, Thiebot J, & Tracqui A: Neurologic disorders due to brain manganese deposition in a jaundiced patient receiving long-term parenteral nutrition. J Parenter Enteral Nutr 1997; 21:41-45.

American Conference of Governmental Industrial Hygienists : ACGIH 2010 Threshold Limit Values (TLVs(R)) for Chemical Substances and Physical Agents and Biological Exposure Indices (BEIs(R)), American Conference of Governmental Industrial Hygienists, Cincinnati, OH, 2010.

Angle C & Barrington W: Heart rate variability as an index of autonomic dysfunction in manganese workers (abstract). Clin Toxicol 1995; 33:534-535.

Angle C & Nelson K: Manganese encephalopathy. Utility of early magnetic resonance imaging (Abstract). Vet Human Toxicol 1992; 34:355.

Angle CR & McIntire MS: DMSA: neglibible effect on manganese excretion (abstract) . Przeglad Lekarski 1995; 52:191-192.

Arjona A, Mata M, & Bonet M: Diagnosis of chronic manganese intoxication by magnetic resonance imaging (letter). N Engl J Med 1997; 336:964-965.

Ashford R: Ashford's Dictionary of Industrial Chemicals, Wavelength Publications Ltd, London, England, 1994.

Baranowska H: Mutat Res 1977; 42:343-348.

Barceloux DG: Manganese. Clin Toxicol 1999; 37:293-307.

Barlow SM & Sullivan FM: Reproductive Hazards of Industrial Chemicals. An Evaluation of Animal and Human Data, Academic Press, London, 1982.

Barron TF, Devenyi AG, & Mamourian AC: Symptomatic manganese neurotoxicity in a patient with chronic liver disease: correlation of clinical symptoms with MRI findings. Pediatr Neruol 1994; 10:145-148.

Baselt RC & Cravey RH: Disposition of Toxic Drugs and Chemicals in Man, 4th ed, Year Book Medical Publishers, Chicago, IL, 1995.

Baselt RC: Biological Monitoring Methods for Industrial Chemicals, 3rd ed, PSG Publishing Company, Littleton, MA, 1997.

Baselt RC: Disposition of Toxic Drugs and Chemicals in Man, 5th ed, Chemical Toxicology Institute, Foster City, CA, 2000.

Beckman RA: Biochemistry 1985; 24:5810-5817.

Beuter A, Mergler D, & De Geoffroy A: Diadochokinesimetry: a study of patients with Parkinson's disease and manganese exposed workers. Neurotoxicology 1994; 15:655-664.

Bingham E, Cohrssen B, & Powell CH: Patty's Toxicology, Vol 2, 3, and 8. 5th ed, John Wiley & Sons, New York, NY, 2001.

Bouchard M, Mergler D, Baldwin M, et al: Blood manganese and alcohol consumption interact on mood states among manganese alloy production workers. NeuroToxicology 2003; 24:641-647.

Bouchard MF, Sauve S, Barbeau B, et al: Intellectual impairment in school-age children exposed to manganese from drinking water. Environ Health Perspect 2011; 119(1):138-143.

Bowler RM, Nakagawa S, Drezgic M, et al: Sequelae of fume exposure in confined space welding: a neurological and neuropsychological case series. Neurotoxicology 2007; 28(2):298-311.

Budavari S: The Merck Index, 12th ed. on CD-ROM. Version 12:3a. Chapman & Hall/CRCnetBASE. Whitehouse Station, NJ. 2000.

Budavari S: The Merck Index, 13th ed, Merck & Co, Inc, Whitehouse Station, NJ, 2001.

Butterworth RF, Spahr L, & Fontaine S: Manganese toxicity, dopaminergic dysfunction and hepatic encephalopathy. Met Brain Dis 1995; 10:259-267.

Butterworth RF: Complications of cirrhosis III. Hepatic encephalopathy. J Hepatol 2000; 32:171-180.

CHRIS : CHRIS Hazardous Chemical Data. US Department of Transportation, US Coast Guard. Washington, DC (Internet Version). Edition expires January/31/1999; provided by Truven Health Analytics Inc., Greenwood Village, CO.

Canavan MM, Cobb S, & Drinker CK: Chronic manganese poisoning. Report of a case with autopsy. Arch Neurol Psychiatry 1934; 32:501.

Casarett LJ & Doull J: Toxicology: The Basic Science of Poisons, Macmillan Publishing Company, New York, NY, 1975.

Cawte J, Hams G, & Kilburn C: Manganism in a neurological ethnic complex in northern Australia. Lancet 1987; 1:1257.

Chalela JA, Bonillha L, Neyens R, et al: Manganese Encephalopathy: An Under-Recognized Condition in the Intensive Care Unit. Neurocrit Care 2010; Epub:Epub.

Chandra SV, Murphy RC, & Saxena DK: Effects of pre- and post-natal exposure to Pb and Mn on brain development in rats. Ind Health 1983; 21:273.

Chandra SV, Seth PK, & Mankeshwar JK: Manganese poisoning: clinical and biochemical observations. Environ Res 1974; 7:374-380.

Chandra SV, Shukla GS, & Singh H: An exploratory study of manganese exposure to welders. Clin Toxicol 1981; 18:407-416.

Chandra SV: Ind Health 1975; 13:51-56.

Chia SE, Foo SC, & Gan SL: Neurobehavioral functions among workers exposed to manganese ore. Scand J Work Environ Health 1993; 19:264-270.

Clayton GD & Clayton FE: Patty's Industrial Hygiene and Toxicology, Toxicology, 3rd ed, 2B, John Wiley & Sons, New York, NY, 1981a.

Clayton GD & Clayton FE: Patty's Industrial Hygiene and Toxicology, Vol 2A, Toxicology, 3rd ed, John Wiley & Sons, New York, NY, 1981.

Clayton GD & Clayton FE: Patty's Industrial Hygiene and Toxicology, Vol 2C, Toxicology, 4th ed, John Wiley & Sons, New York, NY, 1994.

Cook DG, Fahn S, & Bratt KA: Chronic manganese intoxication. Arch Neurol 1974; 30:59-64.

Cotzias GC, Horiuchi K, & Fuenzalida S: Chronic manganese poisoning: clearance of tissue manganese concentrations with persistence of neurological picture. Neurology 1968; 18:376-382.

DFG: List of MAK and BAT Values 2002, Report No. 38, Deutsche Forschungsgemeinschaft, Commission for the Investigation of Health Hazards of Chemical Compounds in the Work Area, Wiley-VCH, Weinheim, Federal Republic of Germany, 2002.

Davis CD & Greger JL: Longitudinal changes of manganese-dependent superoxide dismutase and other indexes of manganese and iron status in women. Am J Clin Nutr 1992; 55:747-752.

Dickerson RN: Manganese intoxication and parenteral nutrition. Nutrition 2001; 17:689-693.

Discalzi G, Pira E, & Herrero Hernandez E: Occupational Mn parkinsonism: magnetic resonance imaging and clinical patterns following CaNa2-EDTA chelation. Neurotoxicology 2000; 21:863-866.

Donaldson J & Barbeau A: Manganese neurotoxicity: possible clues to the etiology of human brain disorders, in: Gabay S, Harris J, Beng TH (Eds), Heavy Ions in Neurology and Psychiatry, Alan R Liss, New York, NY, 1985.

Dragun J: The Soil Chemistry of Hazardous Materials, Hazardous Materials Control Research Institute, Silver Spring, MD, 1988.

Dukes MNG & Beeley L: Meyler's Side Effects of Drugs, Ann 12, Elsevier, Amsterdam, The Netherlands, 1988, pp 890.

Dyer IA, Casatt WA, & Rao RR: Manganese deficiency in the etiology of deformed calves. Bioscience 1964; 14:31-32.

EPA: Search results for Toxic Substances Control Act (TSCA) Inventory Chemicals. US Environmental Protection Agency, Substance Registry System, U.S. EPA's Office of Pollution Prevention and Toxics. Washington, DC. 2005. Available from URL: http://www.epa.gov/srs/.

ERG: Emergency Response Guidebook. A Guidebook for First Responders During the Initial Phase of a Dangerous Goods/Hazardous Materials Incident, U.S. Department of Transportation, Research and Special Programs Administration, Washington, DC, 2004.

Ejima A, Imamura T, & Nakamura S: Manganese intoxication during total parenteral nutrition. Lancet 1992; 339:426.

Elbetieha A, Bataineh H, & Darmani H: Effects of long-term exposure to manganese chloride on fertility of male and female mice. Toxicol Lett 2001; 119:193-201.

Fell JM, Reynolds AP, & Meadows N: Manganese toxicity in children receiving long-term parenteral nutrition. Lancet 1996; 347:1218-1221.

Finkel AJ: Hamilton and Hardy's Industrial Toxicology, 4th ed, John Wright, PSG Inc, Boston, MA, 1983.

Fishbein L: Natural non-nutrient substances in the food chain. Sci Total Environ 1972; 1:211-244.

Florence TM & Stauber JL: Neurotoxicity of manganese. Lancet 1988; 1:363.

Fredstrom S, Rogosheske J, & Gupta P: Extrapyramidal symptoms in a BMT recipient with hyperintense basal ganglia and elevated manganese. Bone Marrow Transplant 1995; 15:989-992.

Friberg L, Norberg GF, & Vouk V: Handbook on the Toxicology of Metals, 2nd ed, Elsevier Science Publishers, New York, NY, 1986.

Friberg L, Nordberg GF, & Vouk VB: Handbook on The Toxicology of Metals, Elsevier/North-Holland Biomedical Press, New York, NY, 1979.

Gilman AG, Rall TW, & Nies AS: The Pharmacological Basis of Therapeutics, 8th ed, Pergamon Press, New York, NY, 1990.

Grant D, Blazak WF, & Brown GL: The reproductive toxicology of intravenously administered MnDPDP in the rat and rabbit. ACTA Radiol 1997; 38:759-769.

Grant WM & Schuman JS: Toxicology of the Eye, 4th ed, Charles C Thomas, Springfield, IL, 1993.

Gray LE Jr & Laskey JW: Multivariate analysis of the effects of manganese on the reproductive physiology and behavior of the male house mouse. J Toxicol Environ Health 1980; 6:861-867.

Greenhouse AH: Manganese intoxication in the United States. Trans Am Neurol Assoc 1971; 96:248-249.

HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 1991; provided by Truven Health Analytics Inc., Greenwood Village, CO.

HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2001; provided by Truven Health Analytics Inc., Greenwood Village, CO.

HSDB : Hazardous Substances Data Bank. National Library of Medicine. Bethesda, MD (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.

Harbison RM: Hamilton and Hardy's Industrial Toxicology, 5th ed, Mosby, St. Louis, MO, 1998.

Hardy HL & Tabershaw IR: Delayed chemical pneumonitis occurring in workers exposed to beryllium compounds. J Ind Hyg Toxicol 1946; 28:197-211.

Hathaway GJ, Proctor NH, & Hughes JP: Chemical Hazards of the Workplace, 4th ed, Van Nostrand Reinhold Company, New York, NY, 1996.

Hauser RA & Zesiewicz TA: Manganese and chronic liver disease. Mov Disord 1996; 11:589.

Hauser RA, Zesiewicz TA, & Rosemurgy AS: Manganese intoxication and chronic liver failure. Ann Neurol 1994; 36:871-875.

Hernandez EH, Discalzi G, Dassi P, et al: Manganese intoxication: The cause of an inexplicable epileptic syndrome in a 3 year old child. Neuro Toxicol 2003; 24:633-639.

Hine CH & Pasi A: Manganese intoxication. West J Med 1975; 123:101-107.

Hochberg F, Miller G, & Valenzuela R: Late motor deficits of Chilean manganese miners -- a blinded control study. Neurology 1996; 47:788-795.

Horiuchi K: Osaka City Med J 1970; 16:29-37.

Horvat DJ: Arhiv Za Higijenu Rada I Toksikologiju 1981; 32:147-156.

Hua M-S & Huang CC: Chronic occupational exposure to manganese and neurobehavioral function. J Clin Exp Neuropsychol 1991; 13:495-507.

Huang CC, Chu NS, & Lu CS: Chronic manganese intoxication. Arch Neurol 1989; 46:1104-1106.

Huang CC, Chu NS, & Lu CS: Long-term progression in chronic manganism. Ten years of follow-up. Neurology 1998; 50:698-700.

Huang CC, Lu CS, & Chu NS: Progression after chronic manganese exposure. Neurology 1993; 43:1479-1483.

Huang CC, Weng YH, Lu CS, et al: Dopamine transporter binding in chronic manganese intoxication. J Neurol 2003; 250:1335-1339.

Huang WH & Lin JL: Acute renal failure following ingestion of manganese-containing fertilizer. J Toxicol Clin Toxicol 2004; 42(3):305-307.

Hudnell HK: Effects from environmental Mn exposures: a review of the evidence from non-occupational exposure studies. Neurotoxicology 1999; 20:379-397.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: 1,3-Butadiene, Ethylene Oxide and Vinyl Halides (Vinyl Fluoride, Vinyl Chloride and Vinyl Bromide), 97, International Agency for Research on Cancer, Lyon, France, 2008.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Formaldehyde, 2-Butoxyethanol and 1-tert-Butoxypropan-2-ol, 88, International Agency for Research on Cancer, Lyon, France, 2006.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Household Use of Solid Fuels and High-temperature Frying, 95, International Agency for Research on Cancer, Lyon, France, 2010a.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Smokeless Tobacco and Some Tobacco-specific N-Nitrosamines, 89, International Agency for Research on Cancer, Lyon, France, 2007.

IARC Working Group on the Evaluation of Carcinogenic Risks to Humans : IARC Monographs on the Evaluation of Carcinogenic Risks to Humans: Some Non-heterocyclic Polycyclic Aromatic Hydrocarbons and Some Related Exposures, 92, International Agency for Research on Cancer, Lyon, France, 2010.

IARC: List of all agents, mixtures and exposures evaluated to date - IARC Monographs: Overall Evaluations of Carcinogenicity to Humans, Volumes 1-88, 1972-PRESENT. World Health Organization, International Agency for Research on Cancer. Lyon, FranceAvailable from URL: http://monographs.iarc.fr/monoeval/crthall.html. As accessed Oct 07, 2004.

ICAO: Technical Instructions for the Safe Transport of Dangerous Goods by Air, 2003-2004. International Civil Aviation Organization, Montreal, Quebec, Canada, 2002.

ILO: Encyclopaedia of Occupational Health and Safety, 4th ed, Vols 1-4. Stellman JM (Ed), International Labour Organization, Geneva, Switzerland, 1998.

IPCS: International Programme on Chemical Safety (IPCS), Concise International Chemical Assessment Document (CICAD) No. 12., Manganese and its Compounds, United Nations Environment Programme, International Labour Organisation, and World Health Organization, Geneva, Switzerland, 1999.

ITI: Toxic and Hazardous Industrial Chemicals Safety Manual, The International Technical Information Institute, Tokyo, Japan, 1995.

Ikeda S, Sera Y, & Yoshida M: Manganese deposits in patients with biliary atresia after hepatic porto-enterostomy. J Pediatr Surg 2000; 35:450-453.

International Agency for Research on Cancer (IARC): IARC monographs on the evaluation of carcinogenic risks to humans: list of classifications, volumes 1-116. International Agency for Research on Cancer (IARC). Lyon, France. 2016. Available from URL: http://monographs.iarc.fr/ENG/Classification/latest_classif.php. As accessed 2016-08-24.

International Agency for Research on Cancer: IARC Monographs on the Evaluation of Carcinogenic Risks to Humans. World Health Organization. Geneva, Switzerland. 2015. Available from URL: http://monographs.iarc.fr/ENG/Classification/. As accessed 2015-08-06.

Iregren A: Manganese neurotoxicity in industrial exposures: proof of effects, critical exposure level, and sensitive tests. Neurotoxicology 1999; 20:315-323.

Iregren A: Psychological test performance in foundry workers exposed to low levels of manganese. Neurotoxicol Teratol 1990; 12:673-675.

Iregren A: Using psychological tests for the early detection of neurotoxic effects of low level manganese exposure. Neurotoxicology 1994; 15:671-678.

Iwase K, Higaki J, Mikata S, et al: Manganese deposition in basal ganglia due to perioperative parenteral nutrition following gastrointestinal surgeries. Dig Surg 2002; 19(3):174-183.

Jiang YM, Mo XA, Du FQ, et al: Effective treatment of manganese-induced occupational Parkinsonism with p-aminosalicylic acid: a case of 17-year follow-up study. J Occup Environ Med 2006; 48(6):644-649.

Kilburn CJ: Manganese, malformations and motor disorders: findings in a manganese-exposed population. Neurotoxicology 1987; 8:421-430.

Koizumi A, Shiojima S, & Omiya M: Acute renal failure and maneb (manganous ethylenebis(dithiocarbamate)) exposure. JAMA 1979; 242:2583-2585.

Kosai MF & Boyle AJ: Ethylenediaminetetraacetic acid in manganese poisoning of rats. Ind Med Surg 1956; 25:1-3.

Kristiansen J, Christensen JM, & Iversen BS: Toxic trace element reference levels in blood and urine: influence of gender and lifestyle factors. Sci Total Environ 1997; 204:147-160.

Laskey JW, Rehnberg GL, & Hein JF: Assessment of the male reproductive system in the preweanling rat following Mn3O4 exposure. J Toxicol Environ Health 1985; 15:339-350.

Laskey JW, Rehnberg GL, & Hein JF: Effects of chronic manganese (manganese oxide) exposure on selected reproductive parameters in rats. J Toxicol Environ Health 1982; 9:677-687.

Lauwerys R, Roels H, & Genet P: Fertility of male workers exposed to mercury vapor or to manganese dust: a questionnaire study. Am J Ind Med 1985; 7:171-176.

Lee JW: Manganese intoxication. Arch Neurol 2000; 57:597-599.

Lewis RA: Lewis' Dictionary of Toxicology, Lewis Publishers, Boca Raton, FL, 1998.

Lewis RJ: Hawley's Condensed Chemical Dictionary, 14th ed, John Wiley & Sons, Inc, New York, NY, 2001.

Lewis RJ: Sax's Dangerous Properties of Industrial Materials, 9th ed, Van Nostrand Reinhold Company, New York, NY, 2000.

Lill DW, Mountz JM, & Darji JT: Technetium-99m-HMPAO brain SPECT evaluation of neurotoxicity due to manganese toxicity. J Nucl Med 1994; 35:863-866.

Louria DB, Joselow MM, & Browder AA: Human toxicity of certain trace elements. Ann Intern Med 1972; 76:307-319.

Lown BA, Morganti JB, & D'Agostino R: Effects on the postnatal development of the mouse of preconception, postconception and/or suckling exposure to manganese via maternal inhalation exposure to manganous dioxide dust. Neurotoxicology 1984; 5:119-131.

Lu CS, Huang CC, & Chu NS: Levodopa failure in chronic manganism. Neurology 1994; 44:1600-1602.

Lu MH & Kennedy GL Jr: Teratogenic evaluation of mancozeb in the rat following inhalation exposure. Toxicol Appl Pharmacol 1986; 84:355-368.

Lucchini R, Bergamaschi E, & Smargiassi A: Motor function, olfactory threshold, and hematological indices in manganese-exposed ferroalloy workers. Environ Res 1997; 73:175-180.

Lucchini R, Selis L, & Folli D: Neurobehavioral effects of manganese in workers from a ferroalloy plant after temporary cessation of exposure. Scand J Work Environ Health 1995; 21:143-149.

Lustig S, Pitlik SD, & Rosenfeld JB: Liver damage in acute self-induced hypermanganemia. Arch Intern Med 1982; 142:405-406.

Martin JC, Benaich N, & LeNouvel JB: Magnetic resonance images in the follow-up of occupational manganese-exposed workers (abstract). Clin Toxicol 2001; 39:555.

Marzin DR & Phi HV: Mutat Res 1985; 155:49-51.

Massaro EJ, D'Agostino RB, & Stineman CH: Alterations in behavior of adult offspring of female mice exposed to MnO2 dust during gestation. Fed Proc 1980; 39:623.

Masumoto K, Suita S, & Taguchi T: Manganese intoxication during intermittent parenteral nutrition: report of two cases. J Parenteral Enteral Nutr 2001; 25:95-99.

Mehta R & Reilly JJ: Manganese levels in a jaundiced long-term total parenteral nutrition patient: potentiation of haloperidol toxicity?: case report and literature review. J Parenter Enteral Nutr 1990; 14:428-430.

Mena I, Court J, & Fuenzalida S: Modification of chronic manganese poisoning: Treatment with L-dopa or 5-OH-Trypotophane. N Engl J Med 1970; 282:5-10.

Mena I, Court J, & Fuenzalida S: Modification of chronic manganese poisoning: Treatment with L-dopa or 5-OH-Tryptothane. N Engl J Med 1970a; 282:5-10.

Mena I, Horiuchi K, & Burke K: Individual susceptibility and absorption of iron. Neurology 1969; 19:1000-1006.

Mena I, Marin O, & Fuenzalida S: Chronic manganese poisoning. N Engl J Med 1967a; 282:5.

Mena I, Marin O, & Fuenzalida S: Chronic manganese poisoning: clinical picture and manganese turnover. Neurology 1967; 17:128-136.

Mergler D & Baldwin M: Early manifestations of manganese neurotoxicity in humans: an update. Environ Res 1997; 73:92-100.

Mergler D, Baldwin M, & Belanger S: Manganese neurotoxicity, a continuum of dysfunction: results from a community based study. Neurotoxicology 1999; 20:327-342.

Mirowitz SA, Westrich TJ, & Hirsch JD: Hyperintense basal ganglia on T1-weighted MR images in patients receiving parenteral nutrition. Radiology 1991; 181:117-120.

Mutti A, Bergamaschi E, & Alinovi R: Serum prolactin in subjects occupationally exposed to manganese (Abstract), Presented at the Vth COMTOX Symposium on Toxicology and Clinical Chemistry of Metals, Vancouver, BC, 1995.

Mutti A, Bergamaschi E, & Alinovi R: Serum prolactin in subjects occupationally exposed to manganese. Ann Clin Lab Sci 1996; 26:10-17.

Myers JE, teWaterNaude J, Fourie M, et al: Nervous system effects of occupational manganese exposure on South African manganese mineworkers. Neuro Toxicol 2003; 24:649-656.

NFPA: Fire Protection Guide to Hazardous Materials, 12th ed, National Fire Protection Association, Quincy, MA, 2002a.

NFPA: Fire Protection Guide to Hazardous Materials, 13th ed., National Fire Protection Association, Quincy, MA, 2002.

NIOSH : Pocket Guide to Chemical Hazards. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires Aug/31/2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 1, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2001.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 2, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2002.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 3, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2003.

NRC: Acute Exposure Guideline Levels for Selected Airborne Chemicals - Volume 4, Subcommittee on Acute Exposure Guideline Levels, Committee on Toxicology, Board on Environmental Studies and Toxicology, Commission of Life Sciences, National Research Council. National Academy Press, Washington, DC, 2004.

Nabi Abdel SD & Kayed KS: EMG and conductive velocity studies in chronic manganese poisoning. ACTA Neurol Scand 1965; 41:159.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,3-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2,4-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Butylene Oxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648083cdbb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,2-Dibromoethane (Proposed). United States Environmental Protection Agency. Washington, DC. 2007g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802796db&disposition=attachment&contentType=pdf. As accessed 2010-08-18.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 1,3,5-Trimethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d68a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for 2-Ethylhexyl Chloroformate (Proposed). United States Environmental Protection Agency. Washington, DC. 2007b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037904e&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Acrylonitrile (Proposed). United States Environmental Protection Agency. Washington, DC. 2007c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648028e6a3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Adamsite (Proposed). United States Environmental Protection Agency. Washington, DC. 2007h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Agent BZ (3-quinuclidinyl benzilate) (Proposed). United States Environmental Protection Agency. Washington, DC. 2007f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ad507&disposition=attachment&contentType=pdf. As accessed 2010-08-18.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Allyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039d9ee&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Arsenic Trioxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480220305&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Automotive Gasoline Unleaded (Proposed). United States Environmental Protection Agency. Washington, DC. 2009a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cc17&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Biphenyl (Proposed). United States Environmental Protection Agency. Washington, DC. 2005j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1b7&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bis-Chloromethyl Ether (BCME) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648022db11&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Boron Tribromide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae1d3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromine Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2007d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648039732a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Bromoacetone (Proposed). United States Environmental Protection Agency. Washington, DC. 2008e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187bf&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Calcium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803ae328&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Carbonyl Sulfide (Proposed). United States Environmental Protection Agency. Washington, DC. 2007e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648037ff26&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Chlorobenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064803a52bb&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Cyanogen (Proposed). United States Environmental Protection Agency. Washington, DC. 2008f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809187fe&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Dimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbf3&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Diphenylchloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091884e&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyl Phosphorodichloridate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480920347&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethylbenzene (Proposed). United States Environmental Protection Agency. Washington, DC. 2008g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809203e7&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ethyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Germane (Proposed). United States Environmental Protection Agency. Washington, DC. 2008j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963906&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Hexafluoropropylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064801ea1f5&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Ketene (Proposed). United States Environmental Protection Agency. Washington, DC. 2007. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ee7c&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Aluminum Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Magnesium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Malathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2009k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064809639df&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Mercury Vapor (Proposed). United States Environmental Protection Agency. Washington, DC. 2009b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a087&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Isothiocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a03&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963a57&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyl tertiary-butyl ether (Proposed). United States Environmental Protection Agency. Washington, DC. 2007a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064802a4985&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methylchlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5f4&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Methyldichlorosilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2005a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c646&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN1 CAS Reg. No. 538-07-8) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006a. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN2 CAS Reg. No. 51-75-2) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006b. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Mustard (HN3 CAS Reg. No. 555-77-1) (Proposed). United States Environmental Protection Agency. Washington, DC. 2006c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6cb&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Tetroxide (Proposed). United States Environmental Protection Agency. Washington, DC. 2008n. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648091855b&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Nitrogen Trifluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009l. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e0c&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Parathion (Proposed). United States Environmental Protection Agency. Washington, DC. 2008o. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480963e32&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perchloryl Fluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e268&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Perfluoroisobutylene (Proposed). United States Environmental Protection Agency. Washington, DC. 2009d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26a&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008p. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dd58&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2006d. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020cc0c&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phenyldichloroarsine (Proposed). United States Environmental Protection Agency. Washington, DC. 2007k. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020fd29&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phorate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008q. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096dcc8&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene (Draft-Revised). United States Environmental Protection Agency. Washington, DC. 2009e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a8a08a&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Phosgene Oxime (Proposed). United States Environmental Protection Agency. Washington, DC. 2009f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e26d&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Potassium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005c. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Propargyl Alcohol (Proposed). United States Environmental Protection Agency. Washington, DC. 2006e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec91&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Selenium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec55&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Silane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006g. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d523&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Cyanide (Proposed). United States Environmental Protection Agency. Washington, DC. 2009h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7cbb9&disposition=attachment&contentType=pdf. As accessed 2010-08-15.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sodium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Strontium Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005f. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Sulfuryl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2006h. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020ec7a&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tear Gas (Proposed). United States Environmental Protection Agency. Washington, DC. 2008s. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e551&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tellurium Hexafluoride (Proposed). United States Environmental Protection Agency. Washington, DC. 2009i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7e2a1&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tert-Octyl Mercaptan (Proposed). United States Environmental Protection Agency. Washington, DC. 2008r. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5c7&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Tetramethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-17.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethoxysilane (Proposed). United States Environmental Protection Agency. Washington, DC. 2006i. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d632&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethyl Phosphite (Proposed). United States Environmental Protection Agency. Washington, DC. 2009j. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=0900006480a7d608&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Trimethylacetyl Chloride (Proposed). United States Environmental Protection Agency. Washington, DC. 2008t. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648096e5cc&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for Zinc Phosphide (Proposed). United States Environmental Protection Agency. Washington, DC. 2005e. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020c5ed&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

National Advisory Committee for Acute Exposure Guideline Levels for Hazardous Substances: Acute Exposure Guideline Levels (AEGLs) for n-Butyl Isocyanate (Proposed). United States Environmental Protection Agency. Washington, DC. 2008m. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=09000064808f9591&disposition=attachment&contentType=pdf. As accessed 2010-08-12.

National Institute for Occupational Safety and Health: NIOSH Pocket Guide to Chemical Hazards, U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, Cincinnati, OH, 2007.

National Research Council : Acute exposure guideline levels for selected airborne chemicals, 5, National Academies Press, Washington, DC, 2007.

National Research Council: Acute exposure guideline levels for selected airborne chemicals, 6, National Academies Press, Washington, DC, 2008.

National Research Council: Acute exposure guideline levels for selected airborne chemicals, 7, National Academies Press, Washington, DC, 2009.

National Research Council: Acute exposure guideline levels for selected airborne chemicals, 8, National Academies Press, Washington, DC, 2010.

Nelson K, Golnick J, & Korn T: Manganese encephalopathy: utility of early magnetic resonance imaging. Br J Ind Med 1993; 50:510-513.

Newland MC, Ceckler TL, & Kordower JH: Visualizing manganese in the primate basal ganglia with magnetic resonance imaging. Exp Neurol 1989; 106:251-258.

Newland MC: Animal models of manganese's neurotoxicity. Neurotoxicology 1999; 20:415-432.

Nilubol MLA, Chayawatanagkur K, & Kritalugsana S: Manganese toxication in the human body determined by activation analysis. J Nucl Med 1968; 9:178.

Oltramare M: Internat Arch Gewerbepathol Gewerbehyg 1965; 21:124-140.

Ono K, Komai K, & Yamada M: Myoclonic involuntary movement associated with chronic manganese poisoning. J Neur Sci 2002; 199:93-96.

Papavasilion PS, Miller ST, & Cotzias GC: Role of liver in regulation, distribution and excretion of manganese. Am J Physiol 1966; 211:211-216.

Parenti M, Flauto C, & Parati E: Manganese neurotoxicity: effects of L-DOPA and pargyline treatments. Brain Res 1986; 367:8-13.

Park HK, Kim SM, Choi CG, et al: Effect of trientine on manganese intoxication in a patient with acquired hepatocerebral degeneration. Mov Disord 2008; 23(5):768-770.

Penalver R: Diagnosis and treatment of manganese intoxication. Arch Ind Health 1957; 16:64-66.

Pohanish RP & Greene SA: Rapid Guide to Chemical Incompatibilities, Van Nostrand Reinhold Company, New York, NY, 1997.

Ponnapakkam TP, Bailey KS, Graves KA, et al: Assessment of male reproductive system in the CD-1 mice following oral manganese exposure. Reprod Toxicol 2003; 17:547-551.

Proctor NH, Hughes JP, & Fischman ML: Chemical Hazards of the Workplace, 2nd ed, JB Lippincott Co, Philadelphia, PA, 1988.

RTECS : Registry of Toxic Effects of Chemical Substances. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 1/31/2001; provided by Truven Health Analytics Inc., Greenwood Village, CO.

RTECS : Registry of Toxic Effects of Chemical Substances. National Institute for Occupational Safety and Health. Cincinnati, OH (Internet Version). Edition expires 2002; provided by Truven Health Analytics Inc., Greenwood Village, CO.

Racette BA & Perlmutter JS: Welding-related parkinsonism: clinical features, treatment, and pathophysiology (letter). Neurology 2001; 57:1739.

Raffle PA, Adams PH, & Baxter PJ: Hunter's Diseases of Occupations, Little, Brown & Co, Boston, MA, 1994.

Rasmuson A: Mutat Res 1985; 157:157-162.

Reynolds AP, Fell J, & Meadows N: 5th COMTOX Symposium on Toxicology and Clinical Chemistry of Metals, Vancouver, BC, 1995.

Reynolds JEF: Martindale: The Extra Pharmacopoeia, 28th ed, The Pharmaceutical Press, London, England, 1982.

Rodier J: Manganese poisoning in Moroccan miners. Br J Ind Med 1955; 12:21-35.

Roels H, Lauwerys R, & Buchet JP: Epidemiological survey among workers exposed to manganese: effects on lung, central nervous system, and some biological indices. Am J Ind Med 1987; 11:307-327.

Rosenstock HA, Simons DG, & Meyer JS: Chronic manganism: neurologic & laboratory studies during treatment with levodopa. JAMA 1971; 217:1354-1358.

Rubenstein AH, Levin NW, & Elliott GA: Hypoglycemia induced by manganese. Nature 1962; 194:188-189.

Rybak LP: Hearing: the effects of chemicals. Otolaryngol Head Neck Surg 1992; 106:677-686.

Saakadze VP & Vasilov BG: Gig Tr Prof Zabol 1977; 6:19-23.

Sadak AH & Schulz PE: Welding-related parkinsonism: clinical features, treatment, and pathophysiology (letter). Neurology 2001; 57:1738-1739.

Sadek AH, Rauch R, & Schulz PE: Parkinsonism due to manganism in a welder. Internat J Toxicol 2003; 22:393-401.

Sanchez B, Casalots-Casado J, Quintana S, et al: Fatal manganese intoxication due to an error in the elaboration of Epsom salts for a liver cleansing diet. Forensic Sci Int 2012; 223(1-3):e1-e4.

Sanchez DJ, Domingo JL, & Llobet JM: Maternal and developmental toxicity of manganese in the mouse. Toxicol Lett 1993; 69:45-52.

Sandstrom B, Davidsson L, & Cederblad A: Manganese absorption and metabolism in man. ACTA Pharmacol Toxicol 1986; 59:60-62.

Schardein JL: Chemically Induced Birth Defects, 2nd ed, Marcel Dekker, Inc, New York, NY, 1993.

Schardein JL: Chemically Induced Birth Defects, 3rd ed, Marcel Dekker, Inc, New York, NY, 2000.

Schaumburg HH, Herskovitz S, & Cassano VA: Occupational manganese neurotoxicity provoked by hepatitis C. Neurology 2006; 67(2):322-323.

Schroeder HA, Balassa JJ, & Tipton IH: Essential trace metals in man. Manganese -- a study of homeostasis. J Chron Dis 1966; 19:545.

Seth PK & Chandra SV: Neurotoxic effects of manganese, in: Bondy SC & Prasad KN (Eds), Metal Neurotoxicity, CRC Press, Boca Raton, FL, 1988.

Seth PK: Environ Physiol Biochem 1973; 3:263-267.

Shuqin K, Haishang D, & Peiyi X: A report of two cases of chronic serious manganese poisoning treated with sodium para-aminosalicylic acid. Br J Ind Med 1992; 49:66-69.

Sikk K, Taba P, Haldre S, et al: Irreversible motor impairment in young addicts--ephedrone, manganism or both?. Acta Neurol Scand 2007; 115(6):385-389.

Singh I: Mutat Res 1984; 137:47-49.

Sirover MA & Loeb LA: Science 1976; 194:1434-1436.

Sittig M: Handbook of Toxic and Hazardous Chemicals and Carcinogens, 3rd ed, Noyes Publications, Park Ridge, NJ, 1991.

Sjogren B, Iregren A, & Frech W: Effects on the nervous system among welders exposed to aluminium and manganese. Occup Environ Med 1996; 53:32-40.

Smargiassi A & Mutti A: Peripheral biomarkers and exposure to manganese. Neurotoxicology 1999; 20:401-406.

Stokinger HE: The Metals: Manganese, in Clayton GD & Clayton FE (eds): Patty's Industrial Hygiene and Toxicology, 3rd ed, John Wiley & Sons, New York, NY, 1981.

Taylor PA & Price JDE: Acute pancreatitis in a patient treated with a contaminated dialysate. Canad Med Assoc J 1982; 126:503-504.

Taylor S & Manara AR: Manganese toxicity in a patient with cholestasis receiving total parenteral nutrition (Letter). Anaesthesia 1994; 49:1013.

Tepper LB: Manganese. N Engl J Med 1961; 264:347-348.

Treinen KA, Gray TJB, & Blazak WF: Developmental toxicity of mangafodipir trisodium and manganese chloride in Sprague-Dawley rats. Teratology 1995; 52:109-115.

Tsuchiya H: Arch Environ Health 1984; 39:11-17.

Tutkun E, Abusoglu S, Yilmaz H, et al: Prolactin levels in maganese-exposed male welders. Pitutiary 2014; 17(6):564-568.

U.S. Department of Energy, Office of Emergency Management: Protective Action Criteria (PAC) with AEGLs, ERPGs, & TEELs: Rev. 26 for chemicals of concern. U.S. Department of Energy, Office of Emergency Management. Washington, DC. 2010. Available from URL: http://www.hss.doe.gov/HealthSafety/WSHP/Chem_Safety/teel.html. As accessed 2011-06-27.

U.S. Department of Health and Human Services, Public Health Service, National Toxicology Project : 11th Report on Carcinogens. U.S. Department of Health and Human Services, Public Health Service, National Toxicology Program. Washington, DC. 2005. Available from URL: http://ntp.niehs.nih.gov/INDEXA5E1.HTM?objectid=32BA9724-F1F6-975E-7FCE50709CB4C932. As accessed 2011-06-27.

U.S. Environmental Protection Agency: Discarded commercial chemical products, off-specification species, container residues, and spill residues thereof. Environmental Protection Agency's (EPA) Resource Conservation and Recovery Act (RCRA); List of hazardous substances and reportable quantities 2010b; 40CFR(261.33, e-f):77-.

U.S. Environmental Protection Agency: Integrated Risk Information System (IRIS). U.S. Environmental Protection Agency. Washington, DC. 2011. Available from URL: http://cfpub.epa.gov/ncea/iris/index.cfm?fuseaction=iris.showSubstanceList&list_type=date. As accessed 2011-06-21.

U.S. Environmental Protection Agency: List of Radionuclides. U.S. Environmental Protection Agency. Washington, DC. 2010a. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.

U.S. Environmental Protection Agency: List of hazardous substances and reportable quantities. U.S. Environmental Protection Agency. Washington, DC. 2010. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-sec302-4.pdf. As accessed 2011-06-17.

U.S. Environmental Protection Agency: The list of extremely hazardous substances and their threshold planning quantities (CAS Number Order). U.S. Environmental Protection Agency. Washington, DC. 2010c. Available from URL: http://www.gpo.gov/fdsys/pkg/CFR-2010-title40-vol27/pdf/CFR-2010-title40-vol27-part355.pdf. As accessed 2011-06-17.

U.S. Occupational Safety and Health Administration: Part 1910 - Occupational safety and health standards (continued) Occupational Safety, and Health Administration's (OSHA) list of highly hazardous chemicals, toxics and reactives. Subpart Z - toxic and hazardous substances. CFR 2010 2010; Vol6(SEC1910):7-.

U.S. Occupational Safety, and Health Administration (OSHA): Process safety management of highly hazardous chemicals. 29 CFR 2010 2010; 29(1910.119):348-.

United States Environmental Protection Agency Office of Pollution Prevention and Toxics: Acute Exposure Guideline Levels (AEGLs) for Vinyl Acetate (Proposed). United States Environmental Protection Agency. Washington, DC. 2006. Available from URL: http://www.regulations.gov/search/Regs/contentStreamer?objectId=090000648020d6af&disposition=attachment&contentType=pdf. As accessed 2010-08-16.

Vieregge P, Heinzow B, & Korf G: Long term exposure to manganese in rural well water has no neurological effects. Canad J Neurol Sci 1995; 22:286-289.

Wang JD, Huang CC, & Hwang Y: Manganese induced parkinsonism: an outbreak due to an unrepaired ventilation control system in a ferromanganese smelter. Br J Ind Med 1989; 46:856-859.

Wasserman GA, Liu X, Parvez F, et al: Water manganese exposure and children's intellectual function in Araihazar, Bangladesh. Environ Health Perspect 2006; 114(1):124-129.

Webster WS & Valois AA: Reproductive toxicology of manganese in rodents, including exposure during the postnatal period. Neurotoxicology 1987; 8:437-444.

Wennberg A, Hagman M, & Johansson L: Preclinical neurophysiological signs of Parkinsonism in occupational manganese exposure. Neurotoxicology 1992; 13:271-274.

Wennberg A, Iregren A, & Struwe G: Manganese exposure in steel smelters a health hazard to the nervous system. Scand J Work Environ Health 1991; 17:255-262.

Whitlock DM, Amuso SJ, & Bittenbender JB: Chronic neurological disease in two manganese steel workers. Am Ind Hyg Assoc J 1966; 27:454-459.

Wolters EC, Huang CC, & Clark C: Positron emission tomography in manganese intoxication. Ann Neurol 1989; 26:647-651.

Wynter JE: The prevention of manganese poisoning. Ind Med Surg 1962; 31:308-310.

Yiin SJ, Lin TH, & Shih TS: Lipid peroxidation in workers exposed to manganese. Scand J Work Environ Health 1996; 22:381-386.

Zenz C: Occupational Medicine, 3rd ed, Mosby, St. Louis, MO, 1994.

Zheng W, Kim H, & Zhao Q: Comparative toxicokinetics of manganese chloride and methylcyclopentadienyl manganese tricarbonyl (MMT) in Sprague-Dawley rats. Toxicol Sci 2000; 54:295-301.

da Silva CJ, da Rocha AJ, Jeronymo S, et al: A preliminary study revealing a new association in patients undergoing maintenance hemodialysis: manganism symptoms and T1 hyperintense changes in the basal ganglia. AJNR Am J Neuroradiol 2007; 28(8):1474-1479.

deBie RM, Gladstone RM, Strafella AP, et al: Manganese-induced Parkinsonism associated with methcathinone (Ephedrone) abuse. Arch Neurol 2007; 64(6):886-889.

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