Aluminum Exposure and Health

Year 2023, Issue: 20, 735 - 747, 09.09.2023

Fatma Nizamlıoğlu Mustafa Nizamlıoğlu

https://doi.org/10.38079/igusabder.1228435

Abstract

Aluminum is an element that is taken regularly in the daily diet and used as an adjuvant in antiperspirants and vaccines. In this review, information is given about the sources of aluminum, its uptake into the body and its harmful effects on human health. This review is based on publications from the PubMed and SCOPUS databases. Professional and personal experiences of the authors are discussed. Aluminum occurs naturally in the environment, foodstuffs and drinking water. The probability of exceeding the reference values for aluminum is particularly high in people with occupational exposure. Accordingly, aluminum concentrations were found at high levels in the urine of aluminum welders and workers in the aluminum industry. Neuropsychological (attention, learning, and memory) tests on workers, however, revealed no encephalopathy characterized by dementia. Although high aluminum content is found in the brains of people with Alzheimer's disease, it remains unclear whether this is a cause or effect of the disease. There are conflicting results about the carcinogenicity effect of aluminum. The claim that aluminum-containing antiperspirants promote breast cancer could not be supported by scientific data. The critical adverse effect of aluminum can only be determined by demonstrating neurotoxicity in humans and animals. This includes encephalopathy with dementia syndrome, which is not the same as the pathophysiology of Alzheimer's type dementia. The relationship between aluminum-containing antiperspirants and breast risk can be obtained from large-scale epidemiological cancer studies.

Keywords

Aluminum, exposure, health

Alüminyum Maruziyeti ve Sağlık

Abstract

Alüminyum günlük diyetle düzenli olarak alınan, antiperspirantlarda, aşılarda adjuvan olarak kullanılan bir elementtir. Alüminyumun kaynakları, vücuda alınımı ve insan sağlığı üzerindeki zararlı etkileri hakkında bilgi vermek amacıyla PubMed ve SCOPUS veri tabanlarından elde edilen yayınlara dayanan bu derlemede yazarların mesleki ve kişisel deneyimleri ele alınmıştır. Alüminyum, çevrede, gıda maddelerinde ve içme suyunda doğal olarak bulunur. Alüminyum için referans değerleri aşma olasılığı özellikle mesleki maruziyeti olan kişilerde daha yüksektir. Buna bağlı olarak alüminyum kaynakçıları ve alüminyum endüstrisindeki işçilerin idrarlarında alüminyum konsantrasyonları yüksek seviyelerde bulunmuştur. Ancak, işçiler üzerinde yapılan nöropsiko mantıksal (dikkat, öğrenme, hafıza) testlerinde demansla tezahür eden ensefalopati bulunamamıştır. Alzheimer hastalığı olan kişilerin beyinlerinde yüksek alüminyum içeriği bulunmasına rağmen, bunun hastalığın bir nedeni veya etkisi olup olmadığı belirsizliğini korumaktadır. Alüminyumun kanserojenlik etkisi konusunda da çelişkili sonuçlar vardır. Alüminyum içeren antiperspiranların meme kanserini teşvik ettiği iddiası bilimsel verilerle desteklenememiştir. Alüminyumun kritik yan etkisi ancak insanlarda ve hayvanlarda nörotoksisite gösterilerek belirlenebilir. Buna Alzheimer tipi demansın patofizyolojisi ile aynı olmayan demans sendromlu ensefalopati dahildir. Alüminyum içeren ter önleyiciler ile meme riski arasındaki ilişki, geniş çaplı epidemiyolojik kanser çalışmalarından elde edilebilir.

Keywords

Alüminyum, maruziyet, sağlık

References

• Deutsche Dermatologische Gesellschaft: Definition und Therapie der primären Hyperhidrose. AWMF Register Nr. 013/059. https://www.awmf.org/uploads/tx_szleitlinien/013-059l_S1_Hyperhidrose_Definition_Therapie_2018-01-verlaengert.pdf Erişim tarihi: 09 Mayıs 2022.
• Fakri S, Al-Azzawi A, Al-Tawil N. Antiperspirant use as a risk factor for breast cancer in Iraq. East Mediterr Health J. 2006;12:478–82.
• BfR (Bundesinistitut für Risikobewertung): Aluminiumhaltige Antitranspiranzien tragen zur Aufnahme von Aluminium bei. Stellungnahme. Nr. 007/2014 des Bundesinstituts für Risikobewertung vom 26. https://www.bfr.bund.de/cm/343/neue-studien-zu-aluminiumhaltigen-antitranspirantien-gesundheitliche-beeinträchtigungen-durch-aluminium-aufnahme-ueber-die-haut-sind-unwahrscheinlich.pdf Erişim tarihi: 09 Mayıs 2022
• EFSA (European Food Safety Authority): Safety of aluminium from dietary intake, scientific opinion of the panel on food additives, flavourings, processing aids and food contact materials (AFC). EFSA Journal. 2008:1–34.
• Yavuz CI, Vaizoğlu SA, Güler Ç. İçme suyunda alüminyum. TAF Prev Med Bull. 2013;12(5):589-596.
• Calvin CW, Gwendolyn LB, Clifton JM. Total allowable concentrations of monomeric inorganic aluminum and hydrated aluminum silicates in drinking water. Critical Reviews in Toxicology. 2012;42(5):358–442.
• Toxicological Profile for Aluminium. U.S. Department of Health and Human Services Public Health Service. Agency for Toxic Substances and Disease Registry. September 2008.
• Becking GC. Human health concerns related to aluminium exposure: An Overview. İçinde: National Health Forum. Aluminium. National Environmental Health Monographs Report of an International Meeting 20-21 April 1995 Edited by Paula Imray, Michael R. Moore, Philip W Callan, W. Lock.1998.
• WHO. Aluminium. Geneva, World Health Organization, International Programme on Chemical Safety (Environmental Health Criteria 194), 1997.
• Agency for Toxic Substances and Disease Registry. Toxicological Profile for Aluminium 2015. https://wwwn.cdc.gov/TSP/ToxProfiles/ToxProfiles.aspx?id=191&tid=34 Yayınlanma tarihi: Mart 2015. Erişim tarihi: 09 Mayıs 2022
• Tayfur M, Ünlüoğlu İ, Bener Ö. Alüminyum ve sağlık. Gıda. 2002;27(4):305-309.
• Kiesswetter E, Schaeper M, Buchta M, et al. Longitudinal study on potential neurotoxic effects of aluminium: I. Assessment of exposure and neurobehavioural performance of Al welders in the train and truck construction industry over 4 years. Int Arch Occup Environ Health. 2007;81:41–67.
• Buchta M, Kiesswetter E, Schaper M, et al. Neurotoxicity of exposures to aluminium welding fumes in the truck trailer construction industry. Environ Toxicol Pharmacol. 2005;19:677–85.
• Parkinson IS, Ward MK, Kerr DN. Dialysis encephalopathy, bone disease and anaemia: the aluminum intoxication syndrome during regular haemodialysis. J Clin Pathol. 1981;34:1285–94.
• Wang Z, Wei X, Yang J, et al. Chronic exposure to aluminum and risk of Alzheimer’s disease: A meta-analysis. Neurosci Lett. 2016;610:200–6.
• Kraus T, Schaller KH, Angerer J, Hilgers RD, Letzel S. Aluminosisdetection of an almost forgotten disease with HRCT. J Occup Med Toxicol. 2006;1:4.
• Flarend R, Bin T, Elmore D, Hem SL. A preliminary study of the dermal absorption of aluminium from antiperspirants using aluminium-26. Food Chem Toxicol. 2001;39:163–8.
• Klotz K, Weistenhöfer W, Neff F, Hartwig A, van Thriel C, Drexler H. The health effects of aluminum exposure. Dtsch Arztebl Int. 2017;114:653–9. doi:10.3238/arztebl.2017.0653.
• Weisser K, Heymans L, Keller-Stanislawski B. Paul-Ehrlich Institut: Sicherheitsbewertung von Aluminium in Impflösungen. Bulletin zur Arzneimittelsicherheit. 2015;03:7–11.
• Paul-Ehrlich-Institut: Sicherheitsbewertung von Aluminium in Therapieallergenen. https://www.pei.de/DE/newsroom/veroffentlichungen-arzneimittel/sicherheitsinformationen-human/2014/ablage2014/2014-01-21-sicherheitsbewertung-von-aluminium-in-therapieallergenen.html#:~:text=Wissenschaftliche%20Daten%20lassen%20nicht%20auf,bis%202013%20ergibt%20kein%20Sicherheitssignal Yayınlanma tarihi: Ocak 2014. Erişim tarihi: 09 Mayıs 2022
• WHO (World Health Organization): Aluminium. International programme on chemical safety (IPCS), environmental health criteria 194. Genf: WHO1997. https://stg-wedocs.unep.org/bitstream/handle/20.500.11822/29470/EHC194Alum.pdf?sequence=1&isAllowed=y Erişim tarihi: 09 Mayıs 2022
• Srinivasan PT, Viraraghavan T, Subramanian KS. Aluminium in drinking water: An overview. Water SA. 1999;25(1):47-56.
• Onur E. Alüminyum toksisitesinin kalite kontrol açısından değerlendirilmesi. Türk Nefroloji Diyaliz ve Transplantasyon Dergisi. 1997;3-4:164-170.
• Şahin G, Duru S. Alüminyum toksisitesi. Yeni Tıp Dergisi. 1994;11(3):23-32.
• Prior JC, Cameron EC, Knickerbocker W, et al. Dialysis encephalopathy and osteomalacic bone disease. The Am J Med. 1982;72:33-42.
• Domingo JL. Aluminium in relation to Alzheimer's disease. Rev Toxicol. 1993;10(3):121-128.
• Yokel RA. Aluminium Exposure Produces Learning And Memory Deficits. A Model Of Alzheimer's Disease. Toxin-Induced Models Neurol Disord. In:Woodruff, Michael L.; Nonneman, Arthur J.Plenum. New York, 1994, pp 301-318.
• Winship KA. Toxicity of aluminium: a historical review, part 2. Adverse Drug React Toxicol Rev. 1993;12(3):177-211.
• Gannata JB, Junor BJR, Briggs JD, et al. Effect of acute aluminium overload on calcium and parathyroid-hormone metabolism. Lancet. 1983;501-503.
• Driieke TB. Adynamic bone disease, anemia, resistance to erythropoietin and iron-aluminium interaction. Nephrol Dial Transplant. l993;(suppl.l):12- 16.
• Iwamoto N, Yamazaki S, Fukuda T, et al. Two cases of parathyroid carcinoma in patients on long-term hemodialysis. Nephron. 1990;55:429-431
• Alfrey AC, Legendre GR, Kaehny WD. Dialysis encephalopathy syndrome – possible aluminum intoxication. New Engl J Med. 1976;294:184–8.
• Kawahara M, Kato-Negishi M. Link between aluminum and the pathogenesis of Alzheimer’s disease: The integration of the aluminum and amyloid cascade hypotheses. Int J Alzheimers Dis. 2011:276393.
• Suwalsky M, Ungerer B, Villena F, Norris B, Cardenas H, Zatta P. 84 Interactions of Al(acac)3 with cell membranes and model phospholipid bilayers. Journal of Inorganic Biochemistry. 1999;75(4):263-268.
• Yumoto S, Nagai H, Matsuzaki H, et al. Aluminium incorporation into the brain of rat fetuses and sucklings. Brain Research Bulletin. 2001:55(2):229-234.
• Ghetti B, Musicco M, Morton J, Bugiani O. Nerve cell loss in the progressive encephalopathy induced by aluminum powder: A morphologic and semiquantitative study of the purkinje cells. Neropathology and Applied Neurobiology. 1985;11(1):31-53.
• Savory J, Herman MM, Katsetos CD, Wills MR. Aluminum and Neurodegenerative Disorders. In Aluminum in Chemistry, Biology and Medicine, 1991:45- 52.
• Zatta PF, Nicolini M, Corain B. Aluminum (III) Toxicity and Blood-brain Barrier Permeability. In Aluminum in Chemistry, Biology and Medicine, 1991:97-112.
• Varner JA, Jensen KF, Hovarth W, Issacson RL. Chronic administration of aluminium-fluoride or sodium-fluoride to rats in drinking water: alterations in neuronal and cerebrovascular integrity. Brain Research. 1998;784(1-2):284-298.
• Jankowska A, Madziar B, Tomaszewicz M, Szutowicz A. Acute and chronic effects of aluminum on acetyl-CoA and acetylcholine metabolism in differentiated and nondifferentiated SN56 cholinergic cells. J Neurosci Res. 2000;62:615–22.
• Virk SA, Eslick GD. Occupational exposure to aluminum and Alzheimer disease: A meta-analysis. J Occup Environ Med. 2015;57:893–6.
• Salib E, Hillier V. A case-control study of alzheimer’s disease and aluminium occupation. Br J Psychiatry. 1996;168:244–9.
• Yegambaram M, Manivannan BG, Beach TU, Halden R. Role of environmental contaminants in the etiology of Alzheimer‘s disease: a review. Curr Alzheimer Res. 2015;12(2):116-46.
• Darbre PD. Underarm cosmetics and breast cancer. J Appl Toxicol. 2003;23:89–95.
• Darbre PD. Aluminium, antiperspirants and breast cancer. J Inorg Biochem. 2005;99:1912–9.
• Hussain MA, Ali S, Tyagi SP, Reza H. Incidence of cancer breast at Aligarh. J Indian Med Assoc. 1994;92:296–7.
• Patterson SK, Helvie MA, Joynt LK, Roubidoux MA, Strawderman M. Mammographic appearance of breast cancer in African-American women: report of 100 consecutive cases. Acad Radiol. 1998;5:2–8.
• Jaiyesimi IA, Buzdar AU, Sahin AA, Ross MA. Carcinoma of the male breast. Ann Intern Med. 1992;117:771–7.
• Rizk SN, Assimacopoulos CA, Ryan JJ. Male breast cancer: Three case reports and review of the literature. SDJ Med. 1994;47:343–6.
• Azzena A, Zen T, Ferrara A, Brunetti V, Vasile C, Marchetti M. Risk factors for breast cancer. case-control study results. Eur J Gynaecol Oncol. 1994;15:386–92.
• Raju GC, Naraynsingh V. Breast cancer in West Indian women in Trinidad. Trop Geogr Med. 1989;41:257–60.
• Mannello F, Tonti GA, Medda V, Simone P, Darbre PD. Analysis of aluminium content and iron homeostasis in nipple aspirate fluids from healthy women and breast cancer-affected patients. J Appl Toxicol. 2011;31:262–9.
• Millos J, Costas-Rodriguez M, Lavilla I, Bendicho C. Multiple small volume microwave-assisted digestions using conventional equipment for multielemental analysis of human breast biopsies by inductively coupled plasma optical emission spectrometry. Talanta. 2009;77:1490.
• Bradley DA, Looi LM. Elevated trace element concentrations in malignant breast tissues. Br J Radiol. 1997;70:375–82.
• Mulay IL, Roy R, Knox BE, Suhr NH, Delaney WE. Trace-metal analysis of cancerous and noncancerous human tissues. J Natl Cancer Inst. 1971;47:1–13
• Mandriota SJ, Tenan M, Ferrari P, Sappino AP. Aluminium chloride promotes tumorigenesis and metastasis in normal murine mammary gland epithelial cells. Int J Cancer. 2016;19:30393.
• McGrath KG. An earlier age of breast cancer diagnosis related to more frequent use of antiperspirants/deodorants and underarm shaving. Eur J Cancer Prev. 2003;12:479–85.
• Mirick DK, Davis S, Thomas DB. Antiperspirant use and the risk of breast cancer. J Natl Cancer Inst. 2002;94:1578–80.
• Namer M, Luporsi E, Gligorov J, Lokiec F, Spielmann M. The use of deodorants/ antiperspirants does not constitute a risk factor for breast cancer. Bull Cancer. 2008;95:871–80.