REVIEW OF THE TOXICOLOGY OF ALUMINIUM WITH REFERENCE TO DRINKING WATER
Report No FR0068

S Hunt and J K Fawell

Feb 1990

SUMMARY

I OBJECTIVES

To review all the relevant literature on the toxicity in drinking water of aluminium to man, and to discuss the level of aluminium that the WHO should set in its drinking water guideline.

II REASONS

The WHO is undertaking a major review of its drinking water guidelines for toxic substances. This review is part of the UK Water Industry contribution to that process of establishing nev WHO drinking water guidelines based on a proper scientific assessment of the latest available data.

III CONCLUSIONS

Under certain circumstances aluminium is toxic to humans. In most cases this appears to be related to highly elevated exposure to aluminium and a reduced ability to eliminate aluminium from the body.

Aluminium has also been implicated in the aetiology of Alzheimer's disease and its incidence correlated with aluminium in drinking water. Although aluminium is associated with the pathology of Alzheimer's disease, the present evidence is insufficient to explain fully its role. Only further research can clarify this. The importance of aluminium in drinking water in relation to Alzheimer's disease also requires further evaluation. Currently there are insufficient data to derive a standard for aluminium in drinking water based on health effects.

IV RECOMMENDATIONS

Further research is needed to establish the relationship between aluminium and Alzheimer's disease. This should include further epidemiological studies relating aluminium exposure, from water and other sources (such as food and air), with the incidence of the disease. Work is also needed to determine the relative bioavailability of aluminium in drinking water. Although there is insufficient evidence to conclude that aluminium in drinking water is a "cause" of Alzheimer's disease, there is a need to consider this possibility and to assess the medical, technical and economic implications for water treatment.

V RESUME OF CONTENTS

Aluminium exposure may occur by a variety of routes. Drinking water probably accounts for less than 5% of total dietary intake.

Copies of the Report are available from FWR, price 15.00 less 20% to FWR Members