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تسجيل

Aluminium

المؤلف:  Sue Jickells , Adam Negrusz (Editors)

المصدر:  Clarkes Analytical Forensic Toxicology

الجزء والصفحة:  p102-103

2026-09-22

33

Metals

Aluminium

Aluminium is the most abundant metal in the earth’s crust, but its role in biology and medicine became understood only relatively recently (Martin 1986). The normal intake of aluminium from food and beverages is up to 100mg per day, but its absorption from the gut is relatively poor and depends on the speciation of the element and the presence of other substances (e.g. phosphate) in the diet. A number of over-the-counter antacid preparations that contain aluminium hydroxide are used widely which can increase the daily intake by several grams. Incidences of acute aluminium poisoning are relatively uncommon in the normal population. However, those exposed to aluminium through occupation and patients undergoing certain types of clinical treatment may be at risk. It has been established that excessive exposure in patients undergoing dialysis can cause ‘dialysis dementia’, a type of encephalopathy that can be rapidly progressive and lead to death within a few months (Alfrey et al. 1976). Use of aluminium sulfate as a flocculating agent in domestic water supplies is the major source of the metal in these patients, particularly if the water used for dialysis is not purified. The large quantities of oral aluminium salts that may be given to some renal patients to reduce the intestinal absorption of phosphate may also cause toxicity. Plasma aluminium concentrations should be monitored routinely in all patients in end-stage renal failure who receive dialysis therapy to ensure that absorption of aluminium is kept to an absolute minimum. In addition, regular testing is needed of water supplied to patients who have home dialysis. De Wolff et al. (2002) reported blood and tissue aluminium concentrations in four patients who had died as a result of the use of dialysate contaminated with aluminium, which indicates that this is an ongoing problem despite controls being in place and good general awareness of the requirements. Concern has developed as to the harmful effects of occupational exposure to aluminium. Where occupational exposure involves inhalation of fine particles or dusts, aluminium may be stored in the lung tissue and leach out very slowly over many months. As a result, plasma and urine aluminium concentrations can remain elevated for several weeks or months. There is also evidence of a dose-dependent association between increased aluminium body-burden and CNS effects in these workers (Akila et al. 1999), and thresholds for these effects in aluminium welders have been proposed (108–160 lg/L in urine and 7–10 lg/L in plasma) (Riihimäki et al. 2000). In situations of acute or chronic occupational or environmental exposure to aluminium, measurement of blood (plasma) and/or urine aluminium is an effective way to assess the degree of exposure.

Where renal function is normal, aluminium is excreted rapidly from the body and there is little possibility of accumulation. The reference value for urine aluminium in non-exposed healthy adults is<15 μg/L.