RESUMEN
Gastrointestinal (GI) symptoms, the primary acute effect of the essential micronutrient copper, paradoxically occur at lower exposure levels than hepatotoxicity, the primary chronic effect. We developed a remedial action criterion (RAC) for copper to protect against GI symptoms, which primarily relate to the stomach copper concentration, and subside within an hour. Using Monte Carlo methods, we generated a distribution of RACs protective against GI symptoms for a 1 h exposure (hourly RACs) based on soil ingestion rate, volume of liquid and food in the stomach, and bioaccessibility. We then generated a distribution of daily RACs, selected as the minimum hourly RAC for each day over a year, constrained by total daily soil ingestion. Next, we identified a percentile of the distribution of daily RACs, and associated RAC, that would result in a high probability of having a minimal number of GI symptom episodes per year. Our analysis indicates that a copper concentration of 3600 mg/kg would result in a 95% probability of having fewer than five episodes of GI symptoms per year, for a child ingesting outdoor soil 180 days per year. Children residing near copper smelters are most likely to experience GI symptoms from ingestion of copper in soil.