Toxicity of Systemic Aluminum

The toxicity of aluminum has been extensively reviewed both by WHO and by the US Department of Health and Human Services. Exposure to aluminum at environmental levels produces no known adverse effects in man. There is little evidence to suggest that aluminum may produce adverse effects under conditions of chronic, excess, occupational exposure. Under conditions of high medical exposure, resulting in large aluminum body burdens, the metal is toxic. Aluminum intoxication is characterized by aluminum-induced bone disease (AIBD), microcytic anemia, and encephalopathy. Most information concerning these has been obtained by the study of dialyzed renal failure patients. These patients had lost their ability to excrete aluminum and accumulated large body burdens of aluminum by transfer of the metal from contaminated dialy-zates (most commonly tap water) during hemodia-lysis. The amount of transfer, and resultant body burdens, depended on the duration of treatment and the concentration of aluminum in the dialyzate.

In addition, toxic effects of aluminum have been demonstrated in four groups of patients with normal kidney function: patients supported by total parent-eral feeding, patients with hepatic insufficiency receiving aluminum antacids, premature infants receiving prolonged intravenous therapy, and other patients receiving parenteral therapy. Aluminum-induced toxicity has also been claimed in some occu-pationally exposed groups, but evidence supporting these claims is not conclusive.

Studies on developing mice and rats that had been exposed to aluminum either during gestation or during lactation indicate that this metal may have an adverse effect on the development of some regions of the brain. In such animals, adverse effects on reflexes and simple motor behaviors, but not consistently on learning and memory, have been demonstrated.

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