Lead, cadmium and aluminum in Canadian infant formulae, oral electrolytes and glucose solutions

Abstract

Lead (Pb), cadmium (Cd) and aluminum (Al) were determined in 437 individual samples of infant formulae, oral electrolytes and 5% glucose solutions available in Canada. In the electrolytes, Cd and Pb concentrations were all below 0.01 and 0.041 ng g−1, respectively. In the 5% glucose solutions, Pb and Cd levels averaged 0.01 and 0.09 ng g−1, respectively. Reported on an as-consumed basis, Pb levels in milk- and soya-based formulae averaged 0.90 and 1.45 ng g−1, respectively, while Cd levels averaged 0.23 and 1.18 ng g−1, respectively Average Al levels on an as-consumed basis were 440 ng g−1 (range 10–3400 ng g−1) in milk-based formulae and 730 ng g−1 (range 230–1100 ng g−1) in soy-based formulae. Al concentrations increased in the following order: plain formula < low-iron formula < iron-supplemented formula < casein hydrolysate formula ≈ premature formula ≤ soy formula. For example, in the powdered formulae, average Al concentrations were 18 ng g−1 for plain milk-based, 37 ng g−1 for low-iron, 128 ng g−1 for iron supplemented, 462 ng g−1 for lactose-free, 518 ng g−1 for hypoallergenic and 619 ng g−1 for soy-based formula. Al concentrations, as-consumed, increased with decreasing levels of concentration: powder < concentrated liquid < ready-to-use. Formulae stored in glass bottles contained between 100 and 300 ng g−1 more Al than the same formulae stored in cans. The source of the increased Al did not appear to be the glass itself, because most electrolytes and glucose solutions, also stored in glass, contained less than 8 ng g−1 Al. Corresponding differences in Pb and Cd levels were not observed. Al concentrations varied substantially among manufacturers; however, all manufacturers were able to produce plain milk-based formulae containing less than 50 ng g−1 Al, i.e. within the range of Al concentrations found in human milk. Next to soya-based and hypoallergenic formulae, premature formulae contained among the highest concentrations of Al, ranging 851–909 ng g−1 from one manufacturer and 365–461 ng g−1 from another.

Toxic and Essential Trace Element Content of Commonly Administered Pediatric Oral Medications

“…The median aluminum concentration in 5% glucose solutions was 5 ng/g. 9 The aluminum concentration has been reported in numerous drugs, 34,35 but in only 3 medications similar to those used in the present study. The median aluminum concentration in electrolyte and flavored electrolyte solutions was 5 ng/g, comparable to the 6.2 mcg/L of the present study.…”

“…None of these medications would be expected to deliver more than 1% of aluminum's provisional tolerable weekly intake. 25 Although it has been noted that medications contribute to pediatric lead poisoning, 37 median lead concentrations in 5% glucose, electrolyte, and flavored electrolyte solutions were 0.14, 0.16, and 0.08 ng/g, respectively, 9 and were very low in the present study. Cadmium concentration in these 3 classes of products was 0.01 ng/g.…”

“…The median aluminum concentration in electrolyte and flavored electrolyte solutions was 5 ng/g, comparable to the 6.2 mcg/L of the present study. 9 A ferrous sulfate solution contained 130 mcg/L aluminum. 34 The aluminum concentration was reported to be 11 and 36 mcg/L in 2 lots of Poly-vi-sol, 36 compared to 4900 and 3800 mcg/L in 2 generic equivalent products in this study.…”

“…8 Lead is a potent neurotoxicant that irreversibly affects central nervous system development, leading to reduced IQ and learning disabilities. 8,9 Oral bioavailability is factored into the risk assessment that generates permissible/permitted daily exposures, evidenced by the different exposure values for the oral and parenteral routes in USP 232 and the FDA's Q3D Elemental Impurities Guidance for Industry. 2 There is little information on the content of toxic metals in medications commonly administered to infants.…”

Low levels of aluminum can lead to behavioral and morphological changes associated with Alzheimer's disease and age-related neurodegeneration

“…These aluminum-based colors also have cosmetic applications. Infant formulae can have a significant aluminum content (Dabeka et al, 2011;Burrell and Exley, 2010). Concentrations as high as 1.8 mM Al can be reached in the fruit juice resulting when acidic fruit is boiled in aluminum cookware (Fimreite et al, 1997).…”