Depression and anxiety in a manganese-exposed community

Neurotoxicology. 2021 Jul;85:222-233. doi: 10.1016/j.neuro.2021.05.017. Epub 2021 Jun 2.


Objective: To characterize the association between residential environmental manganese (Mn) exposure and depression and anxiety, given prior associations among occupationally-exposed workers.

Methods: We administered the Beck Depression Inventory (BDI) and the State-Trait Anxiety Inventory (STAI) to 697 study participants in their preferred languages. These participants represented a population-based sample of residents aged ≥40 from two predominantly Black African communities in Gauteng province, South Africa: 605 in Meyerton, adjacent to a large Mn smelter, and 92 in Ethembalethu, a comparable non-exposed community. We investigated the associations between community (Meyerton vs. Ethembalethu) and severity of depression and anxiety, using linear regression, adjusting for age and sex. To document community-level differences in Mn exposure, we measured airborne PM2.5-Mn.

Results: Meyerton residents had BDI scores 5.63 points (95 % CI 3.07, 8.20) higher than Ethembalethu residents, with all questions contributing to this significant difference. STAI-state scores were marginally higher in Meyerton than Ethembalethu residents [2.12 (95 % CI -0.17, 4.41)], whereas STAI-trait scores were more similar between the communities [1.26 (95 % CI -0.82, 3.35)]. Mean PM2.5-Mn concentration was 203 ng/m3 at a long-term fixed site in Meyerton and 10 ng/m3 in Ethembalethu.

Conclusion: Residence near Mn emission sources may be associated with greater depression symptomatology, and possibly current, but not lifetime, anxiety.

Keywords: Beck depression inventory; Manganese; PM2.5-Mn; South Africa; State-trait anxiety inventory.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anxiety / chemically induced*
  • Anxiety / epidemiology
  • Anxiety / psychology
  • Depression / chemically induced*
  • Depression / epidemiology
  • Depression / psychology
  • Environmental Exposure / adverse effects*
  • Female
  • Humans
  • Independent Living* / trends
  • Male
  • Manganese / adverse effects*
  • Middle Aged
  • Psychiatric Status Rating Scales*
  • South Africa / epidemiology


  • Manganese