Variability and exposure classification of urinary levels of non-essential metals aluminum, antimony, barium, thallium, tungsten and uranium in healthy adult men.

Arsenic, cadmium and lead are well-known toxic metals, and there are substantial studies on variability of these metals in urine to optimize design of exposure assessment. For urinary levels of other nonessential metals such as aluminum (Al), antimony (Sb), barium (Ba), thallium (Tl), tungsten (W) and uranium (U), however, their within-individual and between-individual variability are unclear. Therefore, we collected 529 samples from 11 healthy adult men on 8 days during a 3-month period. We measured urinary metals and creatinine (Cr) levels, assessed the reproducibility using intraclass correlation coefficients (ICCs), and performed sensitivity and specificity analyses to assess how well 1, 2 or 3 specimens could classify exposure. Al, Sb, Ba, W and U levels measured from spot samples varied greatly over days and months (Cr-adjusted ICCs = 0.01-0.14). Serial measures of Tl levels measured from spot samples had fair-to-good reproducibility over 5 consecutive days (Cr-adjusted ICC = 0.40), but worsened when the specimens were collected months apart (Cr-adjusted ICC = 0.16). To identify men who were highly exposed (top 33%) based on their 3-month averages, tests of single spot samples and tests of first-morning voids had high specificities (0.73-0.85) but relatively low sensitivities (0.27-0.60). Collection of repeated urine specimens from each individual improved the classification.