Review of aluminium toxicity published by the Welsh National Poisons Unit

Aluminium is commonly found in everyday life but, surprisingly, can cause toxicity in humans in certain circumstance. Professor James Coulson and Bethan Hughes, from the Welsh National Poisons Unit, recently published an authoritative review of the toxicity of aluminium in humans in the journal Clinical Toxicology (2022;60(4):415-428).

Aluminium compounds were historically considered safe from a toxicological perspective. Although, the toxicological properties of aluminium were first described in furnace workers and potters, it wasn’t until the 1970s that aluminium ions (Al³⁺) were identified as the cause of microcytic anaemia, bone disease and a fatal encephalopathy in renal failure patients.

The recent review of aluminium toxicity by the WNPU staff looked at 37 published scientific studies, covering 179 patients who were exposed to aluminium from dialysis fluid, aluminium hydroxide, plasma exchange, infant formula feed, intravesically, and from drinking water. The review found that the way aluminium is handled by the human body is complex, with it being distributed widely in the body, being stored in bones, and binding to proteins. Overall it was found that toxic aluminium exposure can result in neurotoxicity and bone disease, especially in patients with chronic kidney disease and in those exposed to intravesical aluminium. However, the review also found that determining whether there is a risk to the general population is problematic and that the possibility that aluminium neurotoxicity may occur at concentrations lower than that the exposures experienced by patients with stage 5 chronic kidney disease cannot be excluded.

For further information, please see the full copy of the review:

Coulson JM, Hughes BW (2022) Dose-response relationships in aluminium toxicity in humans. Clinical Toxicology 60(4): 415-428.