The interaction between plasma polymetals and lifestyle on cognitive dysfunction in occupational aluminum exposed workers: A cross-sectional study in China

Objective

To investigate the interaction between plasma polymetallic exposure and lifestyle factors on cognitive function abnormalities in occupational aluminum workers. The aim is to develop a new occupational health management model that integrates lifestyle behaviors with occupational activities to comprehensively protect the health of these workers.

Method

476 Participants were recruited from an aluminum factory in Shanxi, China. Cognitive functioning was assessed using the Montreal Cognitive Assessment Scale (MoCA). Plasma polymetallic levels were measured using ICP-MS. Logistic regression analyzed the relationship between nine plasma metals, lifestyle factors, and cognitive abnormalities. A 3D model validated the interaction between metals and analyzed the combined effects of plasma metals and lifestyle on MoCA scores. The Chi-squared Automatic Interaction Detector (CHAID) decision tree was used to identify factors influencing cognitive dysfunction.

Results

High blood aluminum concentration (>47.85 μg/L), high blood lithium concentration(>3.15 μg/L), as well as sleep time(≤7 h and > 8 h), smoking, alcohol consumption, and length of mobile phone use(≥2 h) were risk factors for abnormal cognitive functioning. In addition aluminum and lithium have a multiplicative interaction on cognitive function(OR=1.86,95 %CI:1.14,3.050). There was an interaction between high plasma levels of aluminum and lithium and smoking on cognitive function in workers, and an interaction between high plasma levels of aluminum and lithium and sleep duration ≤7 or >8 h on cognitive function in workers.

Conclusion

The levels of blood metal elements aluminum and lithium, as well as sleep time, smoking, drinking, and length of mobile phone use, are risk factors for cognitive dysfunction in occupational aluminum workers. There are the synergetic effect to increase the risk of cognitive dysfunction between blood aluminum concentration ≥50.59μg/L and blood lithium concentration ≥3.44μg/L, sleep duration ≤7h& >8 h, smoking, drinking, mobile phone use ≥2 h.