Abstract：
Micro-LiNiCoMnO2 (MNCM), a cathode material with highest market share, has increasing demand with the growth of lithium battery industry. However, whether MNCM exposure brings adverse effects to workers remains unclear. This study aimed to explore the association between MNCM exposure with systemic inflammation and cardiac function. A cross-sectional study of 347 workers was undertaken from the MNCM production industry in Guangdong province, China in 2020. Metals in urine were measured using ICP-MS. The associations between metals, systemic inflammation, and cardiac function were appraised using a linear or logistic regression model. Bayesian kernel machine regression (BKMR) and generalized weighted quantile sum (gWQS) models were used to explore mixed metal exposures. The analysis of interaction and mediation was adopted to assess the role of inflammation in the relation between urinary metals and cardiac function. We observed that the levels of lithium (Li) and cobalt (Co) were positively associated with systemic inflammation and heart rate. The amount of Co contributed the highest weight on the increased systemic immune-inflammation index (SII) (59.8%), the system inflammation response index (SIRI) (44.3%), and heart rate (65.0%). Based on the mediation analysis, we estimated that SII mediated 32.3% and 20.9% of the associations between Li and Co with heart rate, and SIRI mediated 44.6% and 22.2% of the associations between Li and Co with heart rate, respectively. This study demonstrated for the first time that MNCM exposure increased the risk of workers\' systemic inflammation and elevated heart rate, which were contributed by the excessive Li and Co exposure. Additionally, it indicates that systemic inflammation was a major mediator of the associations of Li and Co with cardiac function in MNCM production workers.
摘要：
微LiNiCoMnO2(MNCM),市场份额最高的阴极材料，随着锂电池行业的增长，其需求量不断增加。然而,MNCM暴露是否会给工人带来不良影响尚不清楚.本研究旨在探讨MNCM暴露与全身炎症反应及心功能的关系。对广东省MNCM生产行业的347名工人进行了横断面研究，2020年的中国。使用ICP-MS测量尿液中的金属。金属之间的联系，全身性炎症,使用线性或逻辑回归模型评估心功能。使用贝叶斯核机回归（BKMR）和广义加权分位数和（gWQS）模型来探索混合金属暴露。通过对相互作用和介导的分析来评估炎症在尿液金属与心脏功能之间的关系中的作用。我们观察到锂（Li）和钴（Co）的水平与全身性炎症和心率呈正相关。Co的量对增加的全身免疫炎症指数（SII）贡献最高（59.8％），系统炎症反应指数（SIRI）（44.3%），心率（65.0%）。根据调解分析，我们估计SII介导了32.3%和20.9%的Li和Co与心率之间的关联，SIRI介导了Li和Co与心率之间的关联的44.6%和22.2%，分别。这项研究首次证明MNCM暴露会增加工人全身炎症和心率升高的风险，这是由Li和Co的过度曝光造成的。此外,表明全身性炎症是MNCM生产工人Li和Co与心脏功能关联的主要介质。
