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Aziz, A. E., M. Talaat, M. F. El-Asmer, T. Mostafa, S. Mostafa, H. Atta, M. Abdel Aziz Wassef, H. Fouad, L. Rashed, D. Sabry, et al., "ORIGINAL RESEARCH—BASIC SCIENCE: Heme Oxygenase vs. Nitric Oxide Synthase in Signaling Mediating Sildenafil Citrate Action", The journal of sexual medicine, vol. 4, no. 4ii: Wiley Online Library, pp. 1098–1107, 2007. Abstract
Abdel Aziz, M. T., T. Mostafa, H. Atta, L. Rashed, S. A. Marzouk, E. M. Obaia, D. Sabry, A. A. Hassouna, A. M. El-Shehaby, and A. T. Abdel Aziz, "Oral phosphodiesterase-5 inhibitors: effect of heme oxygenase inhibition on cGMP signalling in rat cavernous tissue", Andrologia, vol. 39, no. 2: Wiley Online Library, pp. 66–70, 2007. Abstract
Mohammed, R. S., W. Ibrahim, D. Sabry, and S. I. El-Jaafary, "Occupational metals exposure and cognitive performance among foundry workers using tau protein as a biomarker.", Neurotoxicology, vol. 76, pp. 10-16, 2020. Abstract

INTRODUCTION: Human exposure to heavy metals is a potential risk for developing cognitive impairment. Aluminum (Al) foundry is one of industries that involve occupational exposure to different metals.

AIM OF THE WORK: to evaluate the cognitive performance of Aluminum foundry workers in relation to different metals exposure.

MATERIALS AND METHODS: a cross sectional study conducted on 75 Al foundry workers and 75 non-occupationally exposed subjects as controls. Personal interview with specially designed questionnaire, Assessment of cognitive functions done using Montreal cognitive assessment (MocA), Stress, depression and sleep were also assessed. Serum levels of Aluminum (AL), Lead (Pb), manganese (Mn), Zinc (Zn) and tau protein were measured.

RESULTS: Exposed group showed significant increase in serum levels of Aluminum, lead, Manganese and tau protein, p value < 0.005 (mean ± SD 0.56 ± 0.18, 22.3 ± 5.01, 42.04 ± 7.4, 1.53 ± 0.58 Vs 0.36 ± 0.11, 13.4 ± 1.29, 39.4 ± 4.4, 1.03 ± 0.44 respectively) with significant decrease of zinc level compared to control (mean ± SD 46.4 ± 5.2 Vs 88.8 ± 6.04, p value 0.005). There was a significant decrease MocA scores among exposed population, (mean ± SD 24.4 ± 3.4 compared to 28.4 ± 1.3 in non exposed, p value < 0.005). which was affected by serum levels of lead, aluminum, manganese and tau protein (β -0.165, -8.958, -.286, -2.341 respectively and p < 0.005).Stress scores was higher in exposed workers than control but not affecting cognitive performance.

CONCLUSION: occupational exposure to metals can cause cognitive dysfunction which may be subtle, so there is a need for formal cognitive testing at baseline, and on regular intervals during working period. Serum tau protein could be used as a prognostic biomarker for the hazardous effect of occupational exposure to these metals on the neuronal cells.