Longitudinal study of the effects of occupational aluminium exposure on workers' cognition.

Objective: To explore the effects of occupational aluminium(Al) exposure on workers' cognition through a longitudinal study.

Methods: The study population consisted of 276 workers in an Al factory. In 2014, we used inductively coupled plasma mass spectrometry (ICP-MS) to determine the plasma aluminium (P-Al) concentration of the workers, and a combined questionnaire to test the workers' cognitive function. Followed-up in 2016, the workers were tested again for cognitive function. Generalized linear regression was used to assess the association between P-Al concentration and cognitive scores, and multivariable logistic regression was used to assess the risk of cognitive decline caused by Al exposure.

Results: Generalized linear regression results showed that a non-significant association was found between the P-Al concentration and cognitive test scores (P > 0.05) in 2014. Two years later, each 10-fold increase in P-Al concentration was inversely associated with the score of Mini-Mental state examination (MMSE) (β: -0.53, 95% CI: -0.86, -0.20) and Fuld object memory evaluation (FOME) (β: -0.93, 95% CI: -1.62, -0.24). Each 10-fold increase in P-Al concentration was inversely associated with MMSE (β: -0.38, 95% CI: -0.74, -0.01) and FOME (β: -1.20, 95% CI: -1.95, -0.45). There was a statistically significant difference in the average annual rate of change of MMSE and FOME with the tertile of P-Al concentration increase (P < 0.05). The multivariable logistic regression results showed that as the P-Al concentration increased, the risk of a FOME score decline increased (P = 0.009).

Conclusions: Continuous occupational Al exposure can damage workers' overall cognitive ability, especially episodic memory function.