Reference values for lead, cadmium and mercury in the blood of adults from the metropolitan area of Sao Paulo, Brazil.

Human biomonitoring is an important tool for the evaluation of environmental exposure to contaminants. The data that are obtained from these studies might be compared to appropriate reference values (RVs) in a specific population. The RVs were derived from the rounded values of the upper limit of the 95th confidence interval of the 95th percentile for lead (Pb), cadmium (Cd) and mercury (Hg) in blood from adults in the metropolitan area of Sao Paulo (MASP), Brazil to investigate the association between blood metals and sociodemographic and lifestyle factors. Blood samples from 653 nonsmoking blood donors without occupational exposure to the studied metals were collected in 2006. Our evaluations distinguished a younger group (18-39 years) and an older group (40-65 years). RVs in the younger group were 60 µgPb/L and 4 µgHg/L for men and 47 µgPb/L and 4 µgHg/L for women. RVs in the older group were 80 µgPb/L and 5 µgHg/L for men and 63 µgPb/L and 6 µgHg/L for women. The RV for Cd was 0.6 µg/L for adults aged 18-65 years. Pb and Cd levels demonstrated a significant association with sex and age. Male blood contained 50% more Pb, and the older group exhibited 23% more Pb. Fish consumption and amalgam fillings were primarily related to Hg levels. RVs for lead were similar to the Czech Republic and Germany but higher than the US population. The RV for Cd in Brazil was well below the RVs of these countries. The RVs for Hg in Brazil were similar to the US but higher than Germany and the Czech Republic.

[Concepts and determination of reference values for human biomonitoring of environmental contaminants]. / Conceitos e derivação de valores de referência para biomonitorização humana de contaminantes ambientais.

Human biomonitoring (HBM) of environmental contaminants plays an important role in estimating exposure and evaluating risk, and thus it has been increasingly applied in the environmental field. The results of HBM must be compared with reference values (RV). The term 'reference values' has always been related to the interpretation of clinical laboratory tests. For physicians, RV indicate 'normal values' or 'limits of normal'; in turn, toxicologists prefer the terms 'background values' or 'baseline values' to refer to the presence of contaminants in biological fluids. This discrepancy leads to the discussion concerning which should be the population selected to determine RV. Whereas clinical chemistry employs an altered health state as the main exclusion criterion to select a reference population (that is, a 'healthy' population would be selected), in environmental toxicology the exclusion criterion is the abnormal exposure to xenobiotics. Therefore, the choice of population to determine RV is based on the very purpose of the RV to be determined. The present paper discusses the concepts and methodology used to determine RV for biomarkers of chemical environmental contaminants.

Conceitos e derivação de valores de referência para biomonitorização humana de contaminantes ambientais / Concepts and determination of reference values for human biomonitoring of environmental contaminants

Human biomonitoring (HBM) of environmental contaminants plays an important role in estimating exposure and evaluating risk, and thus it has been increasingly applied in the environmental field. The results of HBM must be compared with reference values (RV). The term "reference values" has always been related to the interpretation of clinical laboratory tests. For physicians, RV indicate "normal values" or "limits of normal"; in turn, toxicologists prefer the terms "background values" or "baseline values" to refer to the presence of contaminants in biological fluids. This discrepancy leads to the discussion concerning which should be the population selected to determine RV. Whereas clinical chemistry employs an altered health state as the main exclusion criterion to select a reference population (that is, a "healthy" population would be selected), in environmental toxicology the exclusion criterion is the abnormal exposure to xenobiotics. Therefore, the choice of population to determine RV is based on the very purpose of the RV to be determined. The present paper discusses the concepts and methodology used to determine RV for biomarkers of chemical environmental contaminants.