ArticleJournal of exposure science & environmental epidemiology2023
Reliability of low mass toenail samples as biomarkers of chronic metal exposure.
Article in Journal of exposure science & environmental epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 7 citations in OpenAlex.
- A Pilot Study to Explore the Application of Silicone Wristband-Based Chemical Exposure Assessment to Kidney Disease Epidemiology in Agricultural Workers.Environmental health perspectives · 2026Article
- Interpreting Postdiagnosis Toenail Metal Measurements in Childhood Nephrotic Syndrome.Kidney international reports · 2026Article
- Toenail metal concentrations and kidney health among young people at risk of chronic kidney disease of uncertain etiology.Environmental epidemiology (Philadelphia, Pa.) · 2026Article
- Impact of sample mass on the reliability of toenail fluoride for exposure assessment.Toxicology and environmental health sciences · 2026Article
- Residential Proximity to Metal-Emitting Industries and Toenail Metal Concentration in the US Gulf States.Exposure and health · 2024Article
- Associations of a toenail metal mixture with attention and memory in the Gulf long-term follow-up (GuLF) study.The Science of the total environment · 2024Article
- What does scientometry tell us about mercury toxicology and its biological impairments?Heliyon · 2024Article
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Authors and funding
12 authors at 4 institutions in 1 country.
Funding
Abstract
backgroundToenails are a promising matrix for chronic metal exposure assessment, but there are currently no standard methods for collection and analysis. Questions remain about sample mass requirements and the extent to which metals measured in this matrix are representative of chronic body burden.
objectiveThis study proposes a method to maximize sample conservation for toenail metals analysis using inductively coupled plasma mass spectrometry (ICP-MS). We demonstrate the reliability of an ~25 mg toenail sample (typically 1-2 clippings) for metals analysis and evaluate the intra-individual variability of multiple metals in this matrix over time in men from the Gulf Long-term Follow-up (GuLF) Study.
methodsToenail samples from 123 GuLF Study participants were collected at two visits 3 years apart and analyzed for 18 elements using ICP-MS. Participants with samples exceeding 200 mg at the first visit (n = 29) were selected for triplicate sub-sample analysis. Kendall's coefficient of concordance (W) was used to assess sub-sample reliability and Spearman's correlation coefficients (ρ) were used to evaluate fluctuations in elemental concentrations over time.
resultsResults were not reported for Cd, Co, Mo, Sb, and V (detected in <60% of the samples). There was strong agreement among triplicate samples (Kendall's W: 0.72 (Cu)-0.90 (Cu)) across all elements evaluated, moderate correlations of elemental concentrations (Spearman's ρ: 0.21-0.42) over 3 years for As, Ca, Cr, Fe, Pb, Mn, and Zn, and strong correlations (>0.50) for Se, Cu, and Hg. IMPACT STATEMENT: This toenail reliability study found that a low-mass (~25 mg) toenail sample (1-2 clippings) is suitable for the determination of most elements using ICP-MS and helps to increase the analytical capacity of limited toenail biospecimens collected in cohort studies. The results highlight differences in the suitability of toenails for chronic metal exposure assessment by element and underscore the need to consider intra-person variability, especially when comparing results across studies. We also provide recommendations for analytical standardization and the partitioning of the total collected toenail sample into multiple analytic sub-samples for future studies using toenail biospecimen for multiple assays.
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