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Abstract：
OBJECTIVE: We reviewed the scientific background for the current health-based World Health Organization (WHO) guideline value for manganese in drinking water.
METHODS: The initial starting point was the background document for the development of the WHO\'s guideline value for manganese in drinking water as well as other regulations and recommendations on manganese intake levels. Data referred to in these documents were traced back to the original research papers. In addition, we searched for scientific reports on manganese exposure and health effects.
RESULTS: The current health-based guideline value for manganese in drinking water is based partly on debatable assumptions, where information from previous reports has been used without revisiting original scientific articles. Presently, preparation of common infant formulas with water containing manganese concentrations equivalent to the WHO guideline value will result in exceeding the maximum manganese concentration for infant formula. However, there are uncertainties about how this maximum value was derived. Concurrently, there is increasing evidence of negative neurologic effects in children from excessive manganese exposure.
CONCLUSIONS: The increasing number of studies reporting associations between neurologic symptoms and manganese exposure in infants and children, in combination with the questionable scientific background data used in setting the manganese guideline value for drinking water, certainly warrant a re-evaluation of the guideline value. Further research is needed to understand the causal relationship between manganese exposure and children\'s health, and to enable an improved risk assessment.
METHODS: The initial starting point was the background document for the development of the WHO\'s guideline value for manganese in drinking water as well as other regulations and recommendations on manganese intake levels. Data referred to in these documents were traced back to the original research papers. In addition, we searched for scientific reports on manganese exposure and health effects.
RESULTS: The current health-based guideline value for manganese in drinking water is based partly on debatable assumptions, where information from previous reports has been used without revisiting original scientific articles. Presently, preparation of common infant formulas with water containing manganese concentrations equivalent to the WHO guideline value will result in exceeding the maximum manganese concentration for infant formula. However, there are uncertainties about how this maximum value was derived. Concurrently, there is increasing evidence of negative neurologic effects in children from excessive manganese exposure.
CONCLUSIONS: The increasing number of studies reporting associations between neurologic symptoms and manganese exposure in infants and children, in combination with the questionable scientific background data used in setting the manganese guideline value for drinking water, certainly warrant a re-evaluation of the guideline value. Further research is needed to understand the causal relationship between manganese exposure and children\'s health, and to enable an improved risk assessment.
摘要：
目的：我们回顾了当前基于健康的世界卫生组织（WHO）饮用水中锰指导值的科学背景。
方法：最初的出发点是制定世界卫生组织饮用水中锰指导值的背景文件，以及其他有关锰摄入水平的法规和建议。这些文件中提到的数据可以追溯到原始研究论文。此外,我们搜索了有关锰暴露和健康影响的科学报告。
结果：当前基于健康的饮用水中锰的指导值部分基于有争议的假设，在没有重新审视原始科学文章的情况下，使用了以前报告中的信息。目前,用含锰浓度等于WHO指导值的水制备普通婴儿配方食品将导致超过婴儿配方食品的最大锰浓度。然而,关于这个最大值是如何得出的，存在不确定性。同时,越来越多的证据表明，锰暴露对儿童的神经系统有负面影响。
结论：越来越多的研究报告了婴儿和儿童神经系统症状与锰暴露之间的关联，结合用于设定饮用水锰指导值的可疑科学背景数据，当然需要重新评估指导方针的价值。需要进一步的研究来了解锰暴露与儿童健康之间的因果关系，并改进风险评估。
方法：最初的出发点是制定世界卫生组织饮用水中锰指导值的背景文件，以及其他有关锰摄入水平的法规和建议。这些文件中提到的数据可以追溯到原始研究论文。此外,我们搜索了有关锰暴露和健康影响的科学报告。
结果：当前基于健康的饮用水中锰的指导值部分基于有争议的假设，在没有重新审视原始科学文章的情况下，使用了以前报告中的信息。目前,用含锰浓度等于WHO指导值的水制备普通婴儿配方食品将导致超过婴儿配方食品的最大锰浓度。然而,关于这个最大值是如何得出的，存在不确定性。同时,越来越多的证据表明，锰暴露对儿童的神经系统有负面影响。
结论：越来越多的研究报告了婴儿和儿童神经系统症状与锰暴露之间的关联，结合用于设定饮用水锰指导值的可疑科学背景数据，当然需要重新评估指导方针的价值。需要进一步的研究来了解锰暴露与儿童健康之间的因果关系，并改进风险评估。
