الفهرس 
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Abstract
Aluminium is used widely throughout industry and in larger quantities than any other non ferrous metal. Aluminium is 100% recyclable without any loss of its natural qualities. Aluminium metal and its alloys are used mainly in transportation, building, construction and in electrical equipment with many forms of aluminium like aluminum oxides which are used as food additives and explosives while aluminium hydroxide is used widely in pharmaceuticals like antacids and in buffered analgesics (Soni et al., 2001).
Occupational exposure to aluminium occurs by inhalation of aluminium dusts and fumes during mining, processing, production and recovery of aluminum and its compounds (Nieboer et al., 1995).
Biological monitoring of exposure to aluminium has been conducted with urine which indicates recent exposure or serum which reflects long term exposure. However, neither is very good predictor of the aluminium body burden. Although the serum aluminium level increases with increased aluminium body burden, it doesn’t directly reflect the aluminium body burden for long term exposure. This is better measured by bone aluminium (Fernández-Martin et al., 2000).
The present study was concerned with neurological and psychiatric health hazards which occur due to exposure to multiple stressors like aluminium, copper, noise and heat in aluminium industry.
In this study, hundred subjects were included; fifty of them were normal controls, not occupationally exposed to aluminium while the remaining fifty subjects were occupationally exposed to aluminium in aluminium factory. The duration of work of the exposed group was ranged from 17.5 to 36 years.
Full history was taken which included personal history, occupational history and medical history entailing present, past and family history.
Clinical examination was performed with special emphasis on neurological examination and neuropsychological tests were performed.
Some laboratory investigations were done in the form of serum aluminium, serum copper and urinary aluminium.
Environmental measurement of aluminium, copper dusts, noise and heat were carried out in selected workplaces.
Aluminium concentrations ranged between (0.53- 3.45) mg/m3 which are within the permissible limits in Egypt (10 mg/m3) and according to NIOSH a recommended exposure limit (REL) for aluminium is 10 mg/m3 for total dust.
While copper concentrations ranged between (0.1- 0.8) mg/m3 which are within the permissible limits of OSHA which has set 1 mg/m3 for copper dust.
The measurements of noise ranged from 76.7- 89 dB which are within the permissible limits of Egyptian law and Occupational Safety and Health Administration is (90 dB for 8 hour workday).
While environmental measurement of heat at workplace ranged between 21.3- 31.50c using Wet Bulb Globe Temperature Index ( WBGT), the highest measured level were 31.50c and this level is higher than the recommended WBGT in case of moderate work condition according to the Egyptian law ( 28.8- 30.5 0c).
The results of the present study showed that there were no statistically significant differences between the exposed and the control group as regards age and smoking index.
Neurological symptoms in the form of headache, dizziness, fatigue and lack of concentration were significantly higher among workers compared to the control group.
The study showed that there was a statistically significant difference between exposed and control groups as regards serum and urinary aluminium.
There were a statistically significant difference between exposed and control groups as regards subtests of Wechsler memory scale test (information, orientation, logical memory and digit span).
The study also showed that there was statistically significant difference between exposed and control groups as regards results of mini-mental state examination, Eysnek personality test, Hamilton depression scale and Hamilton anxiety scale.
While the study showed that there was a statistically non significant difference between exposed and control groups as regards serum copper and one subtest of wechsler memory scale test (mental control).
The study showed that there were statistically significant positive correlations between serum, urinary aluminium and age, duration of employment.
Also there was a statistically significant positive correlation between serum aluminum and criminality (subtest of Eysnek personality test) and there was a statistically significant positive correlation between serum aluminium and Hamilton depression scale and Hamilton anxiety scale.
The study also showed that there was statistically negative correlation between serum and urinary aluminium and subtests of wechsler memory scale test (information, logical memory and digit span).
The study showed that there was a statistically negative correlation between serum and urinary aluminium and results of mini-mental state examination.
The study also showed that there was synergistic effect of both exposure and smoking on serum and urinary aluminium which was statistically significant.