Abstract:
Objective To evaluate the impact of aluminum exposure on executive and visuospatial cognitive functions of workers and the influencing factors of potential mild cognitive impairment.
Methods A total of 838 workers selected from a large aluminum factory in Shanxi Province were measured for plasma aluminum mass concentration as an internal exposure indicator by inductively coupled plasma-mass spectrometry, and then divided into low and high aluminum exposure groups by the median (M) of plasma aluminum level. The subjects were asked to execute clock-drawing test (CDT) to evaluate their executive and visuospatial cognitive functions and to screen patients with potential mild cognitive impairment in executive and visuospatial functions. Non-conditional logistic regression analysis was used to explore the relationship between plasma aluminum level and executive and visuospatial cognitive impairment and the influencing factors of potential mild cognitive impairment.
Results The average M (P25, P75) of plasma aluminum of the subjects was 15.22 (8.26, 27.02) μg/L, and the positive rate of cognitive impairment in executive and visuospatial functions was 31.0%. The total score of clock-drawing test in the low aluminum exposure group (3.00±0.91) was higher than that in the high aluminum exposure group (2.78±1.00) (P=0.001). High aluminum exposure (versus low aluminum exposure) (OR=1.779, P=0.001), more than one year of electrolytic aluminum related working age (versus less than one year) (OR=2.012, P < 0.001), smoking (OR=1.489, P=0.018), high school education (versus middle school education and below) (OR=0.689, P=0.034), and college education (versus middle school education and below) (OR=0.339, P=0.001) were associated with mild cognitive impairment.
Conclusion Aluminum exposure may cause cognitive impairment in executive and visuospatial functions. High aluminum exposure, more than one year of related working age, and smoking may be risk factors, but high education level may be a protective factor of mild cognitive impairment.
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