AA AHCI1:2003 Edition

INTRODUCTION
In 1886, the first practical and economic process for producing aluminum metal was discovered. Cookware was the first commercial application for the new metal. It was not long after that salesman of competing cookware alleged various adverse health effects from exposure to aluminum.
The first comprehensive treatise on aluminum compounds in food was published in 1927. The author, Dr. E.E. Smith, then a fellow and former president of the New York Academy of Sciences, presented considerable evidence that aluminum is not injurious to health. He added, "Unfortunately, this question has become controversial by reason of conflicting commercial interests."
These claims have persisted despite the fact that the vast majority of the scientific and medical communities neither originate nor support them. To the contrary, the U.S. Food and Drug Administration considers metallic aluminum and a number of aluminum compounds as "GRAS": Generally Recognized As Safe.
The Aluminum Association in 1955 asked scientists at the Kettering Laboratory of the University of Cincinnati to search out and review the world's literature on aluminum and health. The investigators reviewed more than 800 books and technical articles, and published their findings in 1957 in the American Medical Association's Archives of Industrial Health. They concluded that there is no need for concern among the public regarding hazards to human health from exposure to aluminum products. The review was updated in 1974 by Kettering researchers to include an additional 700 publications, and the results were published in Environmental Health perspective, a publication of the National Institute of Environmental Health Sciences. The basic conclusions were reaffirmed.
Allegations concerning neurological effects of aluminum began appearing in the media in the mid-1970's. Aluminum, it was claimed, caused senility and was deemed a factor in Alzheimer's disease (AD), then known as "presenile dementia." Recommendations were made to avoid aluminum in the diet and to avoid aluminum products for cooking or storing foods.
These claims and "medical recommendations" did not come from the scientific or medical communities but were loosely based on results of a few scientific studies then in progress.
A task force of the Aluminum Association's Health Committee visited several leading investigators for first-hand discussions of these studies. We learned that aluminum was also being linked with two conditions occurring in some patients with kidney failure: "dialysis dementia," a fatal neurological disorder, and "osteomalacia," a bone disease.
In 1979, the Association again turned to the Kettering Laboratory staff for an in-depth review of the neurological implications of aluminum. The Kettering team published its report in 1981, entitled "Neurotoxicity of Aluminum." Based on a critical review of about 90 articles, the report concluded that "there is at present no direct clinical or experimental evidence that aluminum is neurotoxic to humans or animals under ordinary conditions of environmental exposure." It was, however, felt that gaps exist in the knowledge of the significance of aluminum in the human body. This is principally because aluminum was not generally regarded as posing a health problem in the past and, hence, drew little scientific interest or study.
Between 1980 and 1988, a research team at the University of Cincinnati continuously monitored and reviewed the literature on all aspects of aluminum and health. Since 1988, the search and review of the literature has been conducted for the Association at the New York State Institute for Basic Research in Developmental Disabilities (IBR).
The need was recognized for basic information on the way aluminum gets into the body, how much typically is absorbed, where it goes, and what happens once it gets there. To obtain this information, the Association set into place a long-range research program, including:
• The establishment of a Center for Trace Element Studies at IBR to provide basic research into effects of aluminum in the brain and continuing review of the world's literature on aluminum and health;
• Fundamental studies of Alzheimer's disease at laboratories of the National Institute on Aging (NIA);
• Studies of absorption of aluminum in the human body at the Harwell Laboratories of AEA Technologies in the U.K.;
• A study of clearance and translocation of aluminum oxide from lungs at the New York University School of Medicine;
• Analysis of aluminum in the body and brain at the Universities of Kentucky and Virginia and the IBR and NIA Laboratories;
• Analysis of aluminum in body fluids following occupational exposure at the Universities of North Carolina and Pittsburgh;
• Estimation of dietary intake of aluminum at Hazleton Laboratories and the University of Wisconsin; and
• Studies of the effects of aluminum on bone at Duke University.
In order to encourage open discussion on the subject, the Association sponsored and participated in a number of conferences on aluminum and health. The Association also sponsored a monograph, "Aluminum and Health – A Critical Review," edited by Dr. Hillel Gitelman of the University of North Carolina. Published in 1989, it represented a compendium of what was known about aluminum and its interaction with human biology.
In 2000, the Association joined in with the International Aluminum Institute and a number of national aluminum associations to form a Global Health Research Working Committee to fund and provide oversight for needed health studies on an international basis.
This paper is an attempt to present for the lay audience a review of the issues and the efforts by the aluminum industry to develop a better understanding of the role of aluminum, if any, in the human body.