Case Reports Indicate That Exposure to Manganese Among Miners May

Case reports indicate that exposure to manganese among miners may lead to central nervous system damage, particularly a Parkinson-like syndrome.  This syndrome, thought to be associated with increased mortality, is characterized by cogwheel rigidity, neuropsychiatric and cognitive manifestations, balance and speech changes, dystonia more pronounced than that seen with Parkinson disease, and resting tremors less pronounced than those seen with Parkinson disease.  A group of investigators are further investigating the association between exposure to manganese and increased mortality among miners.  As part of their statistical analysis, they calculate a standardized mortality ratio of 1.75 among manganese miners compared to the general population.  Which of the following statements is most applicable to this study result?

A) Manganese miners are 75% more likely to develop Parkinson-like syndrome.
B) The crude rate of death is 75 times higher among miners compared to the general population.
C) The observed number of deaths among miners is 75% higher than expected.
D) The standardized mortality ratio is an unadjusted measure of overall mortality.
E) The standardized mortality ratio is not generally applicable to occupational studies.

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