Chapter 1 - Aluminum

Abstract

Aluminum is environmentally ubiquitous, providing about 8% of the earth's crust. It can be absorbed from the gastrointestinal tract and lungs. Excretion is mainly by the kidneys, probably as aluminum citrate. Aluminum is a well-known neurotoxicant. Significant accumulation in the human body has been attributed to aluminum in dialysis fluids and intake of aluminum-containing drugs by those with significant renal impairment and to occupational exposure in some industrial settings. Accumulation in patients with renal impairment resulted in dialysis encephalopathy that was often fatal; a problem now well recognized and usually avoided. The population at greatest risk for aluminum intoxication are those with renal impairment, particularly premature infants receiving parenteral nutrition. Exposure-related cognitive and motor impairments have been observed in welders whose aluminum urine concentrations were ≥100μg/L. The upper reference limit among nonexposed individuals is 15μg/L urine. There is no consensus that aluminum is a significant contributor to Alzheimer's disease or good evidence that vaccines contribute to autism spectrum disorder. Occupational aluminum powder exposure has resulted in pulmonary fibrosis. Asthma has been associated with aluminum sulfate, aluminum fluoride, and potassium aluminum tetrafluoride inhalation, and exposure to the complex environment in potrooms during electrolytic aluminum production. Cancer and ischemic heart disease have been observed among aluminum production workers. However, it is unlikely that aluminum is the cause of these diseases.