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In July 1988, 20 tonnes of aluminium sulphate were accidentally tipped into a reservoir containing water already treated for drinking. The accident happened when a relief driver was making the delivery to the Lower-moor treatment plant, which was unmanned. The aluminium sulphate normally used in the water treatment process was put into the wrong reservoir. The result was that the people of Camelford, a small town in Cornwall, received drinking water that was heavily contaminated with aluminium and highly acidic (pH 3.9-5). There was a delay in informing the public and in detecting and remedying the source of the accident. The aluminium level in the water was reported as being up to 620 mg/litre. The acidity of the drinking water compounded the problem by dissolving other metals, such as copper, from pipes. The water issuing from taps in the homes of residents thus contained not only aluminium at high levels, but other metals such as copper as well.

The residents complained of foul-tasting water and later of various symptoms such as gastrointestinal disturbances, skin rashes, arthritic pains, sore throats, and loss of memory. Animals, like fish, that were exposed to the water died. As a result of this accidental contamination, two committees evaluated the available information, and their reports concluded that there was no convincing evidence of harmful accumulation of aluminium, or of a greater prevalence of ill health in those exposed.

Other studies have found evidence of harmful effects, however, although some of these have been criticized. For example, a study published some years after the accident reported that forty-two of fifty-five residents studied had poor psychomotor performance. There were acknowledged flaws in the design of this study, which were beyond the control of the authors, but the conclusion was that 'aluminium poisoning probably led to long term cerebral impairment in some people in Camelford'.13

Aluminium is the third most abundant element on earth but it is known to have toxic effects that cause brain disease, bone disease, and anaemia. There is concern especially in relation to its possible role in Alzheimer's disease. The changes observed in animals exposed to aluminium are similar to those observed in patients with Alzheimer's disease. Aluminium has been found in some areas of the brain of victims of Alzheimer's at levels not too dissimilar from that in the brains of the animals exposed. Some of the findings and their interpretation are controversial. Unfortunately, the amounts of aluminium absorbed by the residents of Camelford are unknown. A further review of the information available is currently being considered by the Committee on Toxicity in the UK.

We are all exposed to aluminium from the metal utensils we use and also from the occasional use of medicinal preparations such as antacids, but it is poorly absorbed and the risk is probably very small. Dialysis patients with renal disease were found to be at risk of brain damage due to the aluminium derived from the equipment. Realization of this led to a lowering of the exposure of such patients, which decreased the occurrence of toxic effects of aluminium. Patients on dialysis with end stage renal disease, in whom some accumulation of aluminium occurred, showed evidence of metabolic abnormalities and in psychomotor function.

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