Effect of Occupational Exposure to Aluminum on Parathyroid Hormone and Calcium Metabolism

Aims: Aluminum is widely used in industry and it has been associated with several health hazards among exposed workers. To study the effect of aluminum on the parathyroid gland and the disturbance in calcium and phosphorus metabolism among workers exposed to aluminum in aluminum industry.
Methodology: This study was conducted on fifty workers in an aluminum foundry, who were occupationally exposed to aluminum and were compared with fifty non-exposed individuals. Full history was taken, clinical examination and some laboratory investigations were done in the form of: CBC, kidney functions, serum PTH, serum calcium, serum phosphorus and serum aluminum. Plain X-ray was done for workers who were markedly complaining of musculoskeletal symptoms. Environmental measurement of aluminum dusts were carried out in selected workplaces.
Study Design: Case control study of aluminum exposed workers.
Place and Duration of Study: Aluminum industry in Ain-Helwan, Cairo, Egypt, 2012.
Results: Statistically significant differences were found between exposed and control as regards prevalence of parathyroid and musculoskeletal disorders, serum level of the parathyroid hormone (PTH), serum calcium, serum phosphorus, serum aluminum, creatinine, RBCs count and also there was a statistically significant difference between exposed workers with osteopenia and exposed workers without osteopenia as regards serum aluminum level. The environmental measurements in the workplace were within the permissible limits in Egypt.
Conclusion: The elevation of serum aluminum level in workers exposed to environmental level within the permissible limits was associated with disturbance in PTH, calcium and phosphorus metabolism, so these limits should be revised. Periodic medical examination of workers exposed to aluminum is a must; this should include clinical examination, analysis of aluminum in serum, measurement of serum electrolyte (calcium and phosphorus) and bone imaging.