Neurodevelopmental effects in animal studies
The critical endpoint used by EFSA and SCHEER to set the tolerable intake for aluminium is neurodevelopmental toxicity observed in animal studies. A key 12-month rat study by Poirier et al. (2011) found adverse neurodevelopmental effects at doses from 100mg/kg body weight per day, establishing a no-observed-adverse-effect level (NOAEL) at 30mg/kg/day. SCHEER used this NOAEL plus a safety factor of 100 to set a tolerable daily intake. EFSA separately derived a tolerable weekly intake in 2008 using a weight-of-evidence approach across neurotoxicity, developmental toxicity, and other studies.
EFSA established a tolerable weekly intake (TWI) of 1mg aluminium per kg body weight per week in 2008, based primarily on neurotoxicity and developmental neurotoxicity data from animal studies. This was a seven-fold reduction from the previous JECFA provisional TWI of 7mg/kg/week.
2008RegulatoryEFSA Panel on Food Additives, Flavourings, Processing Aids and Food Contact Materials (AFC), EFSA Journal (2008) 754
SCHEER (EU Scientific Committee on Health, Environmental and Emerging Risks) identified neurodevelopmental effects in a GLP-compliant rat study (Poirier et al. 2011) as the critical endpoint, deriving a tolerable daily intake of 0.3mg/kg body weight per day using that study's NOAEL.
2018Regulatory reviewSCHEER, Final Opinion on Tolerable Intake of Aluminium with Regards to Adapting the Migration Limits for Aluminium in Toys, European Commission
TWI exceeded in a significant part of the population
EFSA's 2008 assessment found that the tolerable weekly intake it had just set was likely already being exceeded in a significant part of the European population, particularly children. Average estimated dietary exposure in children ranged from 0.7 to 2.3mg aluminium per kg body weight per week, which can exceed the 1mg/kg TWI at the upper end. Adult exposure was estimated at 0.2 to 1.5mg/kg/week. Main dietary sources are cereals and cereal products, vegetables, and beverages rather than food additives. Some soya-based infant formulae showed aluminium concentrations up to four times higher than average.
Children's estimated dietary aluminium exposure ranged from 0.7 to 2.3mg/kg body weight per week, with high consumers potentially exceeding the 1mg/kg TWI. Adults ranged from 0.2 to 1.5mg/kg/week.
2008RegulatoryEFSA Panel (AFC), Safety of aluminium from dietary intake, EFSA Journal (2008) 754
EFSA noted that some highly exposed consumers may exceed the TWI by up to two-fold, and recommended reviewing conditions of use for aluminium-containing food additives to reduce population exposure.
2008RegulatoryEFSA Journal (2008) 754; reported in BakeryAndSnacks, July 2008
Bone accumulation and effects on bone mineralisation
Absorbed aluminium accumulates primarily in bone tissue. In patients with impaired kidney function (who cannot excrete aluminium efficiently), aluminium deposits at the bone-osteoid interface and inhibits normal mineralisation, producing a painful condition called aluminium-induced osteomalacia. This bone toxicity is established at high systemic doses seen in dialysis patients but has not been demonstrated from ordinary dietary exposure in people with normal kidney function. EFSA nonetheless identified bone effects as one of the endpoints informing the TWI.
In people with chronic renal failure and in dialysis patients exposed to high aluminium loads, aluminium accumulates at the bone-osteoid interface and inhibits mineralisation, leading to osteomalacia and adynamic bone disease.
2002ObservationalSprague et al., Aluminium and bone disease in chronic renal failure, Nephrology Dialysis Transplantation
Aluminium's primary accumulation site in the body is bone; absorbed dietary aluminium is sequestered there for long periods, and EFSA included bone effects in the weight-of-evidence basis for the TWI.
2008RegulatoryEFSA Panel (AFC), EFSA Journal (2008) 754
Reproductive and developmental toxicity in animal studies
Multiple animal studies show that high doses of aluminium compounds can disrupt reproductive function in male rodents, including reduced sperm counts, lower testicular weights, and altered hormone levels. Two-generation studies have shown decreased pregnancy rates when males were exposed at 100mg/kg/day or above. These effects were found at doses far higher than typical dietary exposure, and EFSA did not establish a specific reproductive toxicity endpoint for its TWI, but considered the data as part of its overall weight of evidence.
High-dose aluminium exposure in male mice produced significantly decreased testicular and epididymal weights, reduced sperm and spermatid counts, and decreased pregnancy rates in mated females.
1995AnimalLione, Reproductive toxicology of aluminum in male mice, PubMed 7601326
A review of aluminium reproductive toxicity found consistent evidence across animal studies of adverse effects on spermatogenesis and steroidogenesis at high doses, including through oxidative stress and disruption of the blood-testis barrier, but concluded human evidence at dietary levels is insufficient to determine risk.
2020AnimalTietz et al., Aluminum reproductive toxicity: a summary and interpretation of scientific reports, Critical Reviews in Toxicology
Neurotoxicity mechanisms and the Alzheimer's question
Laboratory studies show aluminium damages neural tissue through oxidative stress, mitochondrial dysfunction, and neuroinflammation. The link to Alzheimer's disease has been debated for decades. EFSA's 2008 opinion and subsequent reviews by JECFA and the European SCCS concluded that dietary aluminium exposure has not been shown to cause Alzheimer's disease in humans, though the question has not been fully closed. A 2025 systematic review and meta-analysis found associations between environmental aluminium exposure and Alzheimer's risk in some studies, but the overall evidence remains inconclusive.
EFSA concluded in 2008 that it did not consider exposure to aluminium via food to constitute a risk for developing Alzheimer's disease, based on the available evidence at that time.
2008RegulatoryEFSA Panel (AFC), EFSA Journal (2008) 754
Laboratory and animal research identifies aluminium-induced oxidative stress, mitochondrial dysfunction, and neuroinflammation as mechanisms capable of damaging neural tissue, though whether these translate to harm at dietary exposure levels in healthy humans remains debated.
2021Lab + animalKawahara and Kato-Negishi, Molecular mechanisms of aluminum neurotoxicity, PMC8276946
A 2025 systematic review and meta-analysis found observational associations between environmental aluminium exposure and Alzheimer's disease risk but noted significant heterogeneity and methodological limitations across included studies.
2025Meta-analysisEnvironmental aluminium exposure and Alzheimer's disease risk: Evidence from a systematic review and meta-analysis, Science of the Total Environment
EU authorisation expired in 2014; FSA register retains expired entries
Commission Regulation (EU) No 380/2012 amended Annex II to Regulation (EC) No 1333/2008 specifically to reduce aluminium intake from food additives in response to EFSA's 2008 finding that the TWI was being exceeded. For E173, the regulation permitted it only as external coating of sugar confectionery for cake decoration, and only until 1 February 2014. After that date, no food category in the consolidated EU regulation lists E173 as a permitted colour. The UK FSA's own guidance on its register explicitly acknowledges that 'the period of application for some food additives have expired but they have not been removed from the domestic list' -- citing aluminium silicate (E559) and calcium aluminium silicate (E556), which had the same 31 January 2014 sunset, as named examples. The 'Authorised' label in the UK data register therefore reflects the additive's presence in the colours list, not any currently active food use permission.
Commission Regulation (EU) No 380/2012 set a sunset date of 1 February 2014 for E173 aluminium as an external coating for sugar confectionery. The stated reason was to reduce population aluminium exposure in light of EFSA's 2008 finding that the TWI was being exceeded.
2012RegulatoryCommission Regulation (EU) No 380/2012, EUR-Lex CELEX:32012R0380
The UK FSA's register guidance states: 'The period of application for some food additives have expired but they have not been removed from the domestic list e.g. the authorisations for calcium aluminium silicate (E 556) and aluminium silicate (Kaolin) (E 559) ended on 31 January 2014.' This confirms the register's 'Authorised' status for E173 does not indicate active food use permission.
2025RegulatoryUK FSA, Guidance on using the Register of Food Additive Authorisations, data.food.gov.uk/regulated-products/food_authorisations/guidance
The UK FSA approved additives list includes E173 in its colours section and the UK data.food.gov.uk register records it as 'Authorised' as of 31 December 2020; however, the detailed conditions of use in Annex II of assimilated Regulation 1333/2008 contain no current food category permitting E173.
2025RegulatoryUK Food Standards Agency, Approved Additives and E Numbers; data.food.gov.uk/regulated-products/food_authorisations/e-173