title: Reference values of urinary chromium in Italy.
abstract: OBJECTIVE
  The paper describes the results of a polycentric study for the assessment of reference values of urinary chromium (U-Cr) in the Italian population.
  
  
  METHODS
  A total of 890 subjects (58.3% males and 41.7% females) were selected on the basis of standardized criteria in eight different areas of Italy. Urinary chromium was determined on morning spot samples collected using standardized procedures. The U-Cr was determined independently by three laboratories using an Electrothermic atomization-Atomic Absorption Spectrometry (ETA-AAS) method with a detection limit of 0.05 microgram/l, adopting-for the statistical analysis-the median value of the results of the three laboratories. The between-laboratories within-subjects standard deviation was 0.049 microgram/l. Due to the high proportion (approx, 28%) of undetectable chromium levels, the geometric mean (GM) and geometric standard deviation (GSD) were estimated using a procedure of linear interpolation. The analysis of the effects of some variables (sex, age, center, residence, smoking and drinking habits) on the U-Cr values, was also performed, by multiple regression analysis after logarithmic transformation, using GM and SD.
  
  
  RESULTS
  The reference value of U-Cr was of 0.08 microgram/l as an estimated GM, whereas the expected distribution ranged from not detectable (nd) (95% CI = nd-0.06) to 0.24 microgram/l (95th percentile; 95% CI = 0.20-0.31). Among the variables studied, only geographical area and sex significantly influenced the U-Cr levels. In subjects selected in the provinces of Bari and Venice values of U-Cr were significantly lower than those determined in subjects residing in other areas.
  
  
  CONCLUSIONS
  From our investigation the reference values for U-Cr were lower than those obtained in previous investigations. In addition it confirms a further reduction in U-Cr levels following the previous decline reported in the 1970s and 1980s. In over 20 years U-Cr values in the general population dropped from values greater than 1 microgram/l to values between 0.5 and 0.2 microgram/l. The reasons of this progressive decline cannot be attributed in our opinion to a reduced intake of the metal, but mainly to the improvement in analytical instrumentation and methods. A further decrease may be ascribed to a more accurate definition of the reference groups and to a better control of pre-analytical factors. Considering that the reference values for U-Cr are much lower than those determined some decades ago, toxicological studies in order to verify the significance of biological limit values currently suggested for chromium seem to be necessary.
authors.affiliation: Cattedra di Medicina del Lavoro, Università di Brescia, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Apostoli
authors.forename: G
authors.initials: G
authors.lastname: Maranelli
authors.forename: P G
authors.initials: PG
authors.lastname: Duca
authors.forename: P
authors.initials: P
authors.lastname: Bavazzano
authors.forename: A
authors.initials: A
authors.lastname: Bortoli
authors.forename: A
authors.initials: A
authors.lastname: Cruciatti
authors.forename: G
authors.initials: G
authors.lastname: Elia
authors.forename: C
authors.initials: C
authors.lastname: Minoia
authors.forename: R
authors.initials: R
authors.lastname: Piccinini
authors.forename: E
authors.initials: E
authors.lastname: Sabbioni
authors.forename: G
authors.initials: G
authors.lastname: Sciarra
authors.forename: C
authors.initials: C
authors.lastname: Soave
mesh_terms: D000328:Adult; D000368:Aged; D002857:Chromium / Q000652:urine*; D005260:Female; D006801:Humans; D007558:Italy; D008297:Male; D008875:Middle Aged; D012016:Reference Values; D012044:Regression Analysis
chemical_list: D002857:Chromium