Hair Metal Concentrations in Adults Living in Campania, Italy: A Cross-Sectional Biomonitoring Study in a Mixed Geogenic-Anthropogenic Exposure Setting.

Human biomonitoring in environmentally complex regions requires not only matrices that are easy to collect but also careful consideration of external contamination, non-detects, and analytical uncertainty. Inductively coupled plasma mass spectrometry (ICP-MS) was used to measure the concentrations of 24 elements in occipital scalp-hair samples from 134 adults living in Campania, southern Italy (67 women and 67 men; age range: 20-72 yr). Continuous models were restricted to elements detected in at least 70% of adults and were fitted using HC3 heteroskedasticity-consistent standard errors, with Benjamini-Hochberg correction for the false discovery rate (FDR). Ca, Zn, Mg, K and Cu were the most abundant elements in the hair profile. The most consistent adjusted association was lower concentrations of Ca, Mg, Cu, Cr and Zn in men. Pb showed a strongly right-skewed distribution, whereas Cd was detected in only 22.4% of adults; this low detection frequency did not support a population-level elevation claim. Spatial summaries and clustering were retained for exploratory purposes: Kruskal-Wallis tests indicated a zone-level difference only for Zn, whereas patterns in Pb, Cr, As, Cd, and V were interpreted as priorities for confirmatory sampling rather than as evidence of territorial risk. Sensitivity analyses based on the limit of detection (LOD) supported retaining As and Cd as descriptive outcomes; V associations were not promoted to primary findings because the V detection frequency was below the pre-specified threshold. These findings support the use of hair biomonitoring as a non-invasive screening approach in mixed geogenic-anthropogenic settings, provided that sex, sample mass, non-detects, outliers, and external contamination are considered explicitly and that confirmatory matrices are used where appropriate.