treatment of surface water with alum has been in
operation for over 100 years all over the world, the
use of aluminum-based coagulants for the removal of
particulate, colloidal, and dissolved substances from
the water often leads to higher aluminum concentra-
tions in the treated water than in the raw water itself.
The maximum allowable concentration of aluminum
in drinking water established by the former European
Economic Community (now European Union) is
0.2 mg l
1
, while the US Environmental Protection
Agency promulgated a secondary maximum contam-
inated level range of 0.05–0.2 mg l
1
of aluminum in
drinking water. In turn, the World Health Organiza-
tion has proposed 0.2 mg l
1
as a guideline value.
These values are not based on any assessment of
risks to health, but they provide a compromise be-
tween the use of aluminum salts in water treatment
and discoloration of distributed water.
Other Contributors of Aluminum to Human Diet
0007 In addition to food containing natural aluminum or
additives containing aluminum, the intake of alumi-
num through diet can also be increased from contact
of food with containers, cookware, utensils, cans, and
foil wrappings. Although the amount of aluminum
ingested as a result of preparing food in aluminum
cookware (pans, pots, kettles, trays, and foil) does not
appear to be of significance in comparison with the
amount consumed from other sources, in some cases
release of aluminum from aluminum utensils has been
found to be remarkable if used frequently. In relation
to this, it has been demonstrated that increased
concentrations of complexing ions (organic acids,
fluoride ion, OH
, etc.) significantly enhance the
release of aluminum from cooking utensils.
0008 One of the possible routes through which alumi-
num can enter humans can be foods packed in alumi-
num containers, e.g., aluminum cans. Aluminum cans
are now widely used for packaging of different types
of food products, e.g., soft drinks, beers, fruit juices,
and mineral water. In general, the aluminum content
of beverages from aluminum cans has been found to
be higher than that from glass containers. However,
recent studies have shown that beers or soft drinks
packaged in aluminum cans are an insignificant
source of dietary aluminum intake – 0.4 and 1.3%,
respectively – of the tolerable daily intake according
to the JECFA.
Pharmaceutical Products
0009 Aluminum compounds have been widely used in
various nonprescription drugs. They include some
antacids, buffered aspirins, antidiarrheal products,
douches, and hemorrhoidal medications. Aluminum
compounds are also used as adjuvant in vaccines.
However, due to some doubts in relation to the
potential role of aluminum in some neurological dis-
orders, in recent years some companies are removing
aluminum from some of their pharmaceutical prod-
ucts. Among the aluminum compounds currently
used in nonprescription antacids, aluminum hydrox-
ide has been by far the most common. Although
aluminum hydroxide is considered safe its use should
be restricted in subjects with chronic renal insuffi-
ciency and probably also during pregnancy. On the
other hand, various substances administered intra-
venously, such as albumin, calcium salts, and phos-
phate salts, have been reported to contain significant
quantities of aluminum. Moreover, aluminum is a
known contaminant of total parenteral nutrition so-
lutions. In 1990, the US Food and Drug Administra-
tion recommended that aluminum concentrations in
parenteral feedings not exceed 25 mgl
1
.
Infant Formulae
0010In recent years, several studies have determined the
concentrations of aluminum in infant formulae and
compared with those found in human milk and cows’
milk. The lowest mean aluminum concentrations
have been observed in human milk (9.2–23.4 mgl
1
),
while the highest values corresponded to infant for-
mulae, which differed markedly among manufactur-
ers (mean, 551 mgl
1
; range, 302–1149 mgl
1
). It has
been reported that infants consuming milks contain-
ing more than 300 mgAll
1
had raised plasma alumi-
num concentrations. Although some researchers
suggested that this might indicate the maximum
intake tolerated by these infants, there is not a general
agreement about it.
Aluminum in Soils and Plants
0011Aluminum is one of the most abundant elements in
soil. Natural acidification processes result in increas-
ing solubility of aluminum and, as soils become mod-
erately acidic (pH < 5.5), aluminum begins to appear
as the exchangeable cation which dominates in the
lower mineral horizons. Concentrations of soluble
and exchangeable aluminum in acid soils may reach
many micrograms per gram of soil and can be toxic to
plants. Aluminum toxicity in agricultural plants is a
major problem that has been acknowledged at least
since 1918. Worldwide, it has been estimated that
40% of arable soils and perhaps about 70% of po-
tential new lands that can be brought under cultiva-
tion are acidic enough to have an aluminum toxicity
problem. Apart from the Al
3þ
cation, aluminum has
also the potential to form various hydroxy-aluminum
and polynuclear species in solution. While the
ALUMINUM (ALUMINIUM)/Toxicology 161