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Wide variation in reference values for aluminum levels in children
Michelle Zeager1, Alan D Woolf, Rose H Goldman
1Division of General Pediatrics, Department of Pediatrics and Environmental Health, Children's Hospital Boston, Boston, MA 02115, USA. michelle.zeager@childrens.harvard.edu
Pediatrics
|December 7, 2011
Summary
Laboratory reference ranges for aluminum testing in children are unreliable. Current ranges, often based on adult data, vary widely and may not accurately reflect healthy pediatric levels, necessitating further research.
Area of Science:
- Clinical Chemistry
- Environmental Health
- Pediatric Toxicology
Background:
- Growing parental concern prompts requests for aluminum testing in children with developmental issues.
- Existing scientific data on normal aluminum levels in children is limited.
- This study investigates the basis of laboratory reference ranges for aluminum and their applicability to pediatric populations.
Observation:
- Ten clinical laboratories performing aluminum tests were surveyed for their reference range establishment methods.
- Information on testing methodologies (atomic absorption spectrometry, inductively coupled plasma mass spectroscopy) and biological samples (serum, plasma, urine) was collected.
- Supporting literature for reference ranges was reviewed, noting the populations studied.
Findings:
- Significant variability exists in aluminum reference ranges across laboratories and methodologies.
- Reference ranges are predominantly derived from adult studies, adult dialysis patients, workers, or children on aluminum-containing therapies, not healthy children.
- The basis for current pediatric aluminum reference ranges is not clearly established from healthy pediatric populations.
Implications:
- Divergent and potentially non-representative aluminum reference ranges complicate clinical interpretation for children.
- Current laboratory standards may not accurately assess aluminum exposure or toxicity in pediatric populations.
- Further research on aluminum levels in healthy children is crucial, potentially integrated into national biomonitoring programs.
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