• Component Description
• Eligible Sample
• Description of Laboratory Methodology
• Data Processing and Editing
• Laboratory Quality Assurance and Monitoring
• Analytic Notes
• References
• Codebook
  • SEQN - Respondent sequence number
  • WTSHM2YR - Heavy Metal Subsample 2 Year Mec Weight
  • WTSHM4YR - Heavy Metal Subsample 4 Year Mec Weight
  • WTSHM01 - Heavy Metal Mec Weight Jack Knife Rep 01
  • WTSHM02 - Heavy Metal Mec Weight Jack Knife Rep 02
  • WTSHM03 - Heavy Metal Mec Weight Jack Knife Rep 03
  • WTSHM04 - Heavy Metal Mec Weight Jack Knife Rep 04
  • WTSHM05 - Heavy Metal Mec Weight Jack Knife Rep 05
  • WTSHM06 - Heavy Metal Mec Weight Jack Knife Rep 06
  • WTSHM07 - Heavy Metal Mec Weight Jack Knife Rep 07
  • WTSHM08 - Heavy Metal Mec Weight Jack Knife Rep 08
  • WTSHM09 - Heavy Metal Mec Weight Jack Knife Rep 09
  • WTSHM10 - Heavy Metal Mec Weight Jack Knife Rep 10
  • WTSHM11 - Heavy Metal Mec Weight Jack Knife Rep 11
  • WTSHM12 - Heavy Metal Mec Weight Jack Knife Rep 12
  • WTSHM13 - Heavy Metal Mec Weight Jack Knife Rep 13
  • WTSHM14 - Heavy Metal Mec Weight Jack Knife Rep 14
  • WTSHM15 - Heavy Metal Mec Weight Jack Knife Rep 15
  • WTSHM16 - Heavy Metal Mec Weight Jack Knife Rep 16
  • WTSHM17 - Heavy Metal Mec Weight Jack Knife Rep 17
  • WTSHM18 - Heavy Metal Mec Weight Jack Knife Rep 18
  • WTSHM19 - Heavy Metal Mec Weight Jack Knife Rep 19
  • WTSHM20 - Heavy Metal Mec Weight Jack Knife Rep 20
  • WTSHM21 - Heavy Metal Mec Weight Jack Knife Rep 21
  • WTSHM22 - Heavy Metal Mec Weight Jack Knife Rep 22
  • WTSHM23 - Heavy Metal Mec Weight Jack Knife Rep 23
  • WTSHM24 - Heavy Metal Mec Weight Jack Knife Rep 24
  • WTSHM25 - Heavy Metal Mec Weight Jack Knife Rep 25
  • WTSHM26 - Heavy Metal Mec Weight Jack Knife Rep 26
  • WTSHM27 - Heavy Metal Mec Weight Jack Knife Rep 27
  • WTSHM28 - Heavy Metal Mec Weight Jack Knife Rep 28
  • WTSHM29 - Heavy Metal Mec Weight Jack Knife Rep 29
  • WTSHM30 - Heavy Metal Mec Weight Jack Knife Rep 30
  • WTSHM31 - Heavy Metal Mec Weight Jack Knife Rep 31
  • WTSHM32 - Heavy Metal Mec Weight Jack Knife Rep 32
  • WTSHM33 - Heavy Metal Mec Weight Jack Knife Rep 33
  • WTSHM34 - Heavy Metal Mec Weight Jack Knife Rep 34
  • WTSHM35 - Heavy Metal Mec Weight Jack Knife Rep 35
  • WTSHM36 - Heavy Metal Mec Weight Jack Knife Rep 36
  • WTSHM37 - Heavy Metal Mec Weight Jack Knife Rep 37
  • WTSHM38 - Heavy Metal Mec Weight Jack Knife Rep 38
  • WTSHM39 - Heavy Metal Mec Weight Jack Knife Rep 39
  • WTSHM40 - Heavy Metal Mec Weight Jack Knife Rep 40
  • WTSHM41 - Heavy Metal Mec Weight Jack Knife Rep 41
  • WTSHM42 - Heavy Metal Mec Weight Jack Knife Rep 42
  • WTSHM43 - Heavy Metal Mec Weight Jack Knife Rep 43
  • WTSHM44 - Heavy Metal Mec Weight Jack Knife Rep 44
  • WTSHM45 - Heavy Metal Mec Weight Jack Knife Rep 45
  • WTSHM46 - Heavy Metal Mec Weight Jack Knife Rep 46
  • WTSHM47 - Heavy Metal Mec Weight Jack Knife Rep 47
  • WTSHM48 - Heavy Metal Mec Weight Jack Knife Rep 48
  • WTSHM49 - Heavy Metal Mec Weight Jack Knife Rep 49
  • WTSHM50 - Heavy Metal Mec Weight Jack Knife Rep 50
  • WTSHM51 - Heavy Metal Mec Weight Jack Knife Rep 51
  • WTSHM52 - Heavy Metal Mec Weight Jack Knife Rep 52
  • URXUCR - Creatinine, urine (mg/dL)
  • URXUBA - Barium, urine (ng/mL)
  • URXUBE - Beryllium, urine (ng/mL)
  • URDUCD - Cadmium, urine (ng/mL)
  • URDUCDLC - Urinary cadmium comment code
  • URXUCO - Cobalt, urine (ng/mL)
  • URXUCS - Cesium, urine (ng/mL)
  • URXUMO - Molybdenum, urine (ng/mL)
  • URXUPB - Lead, urine (ng/mL)
  • URXUPT - Platinum, urine (ng/mL)
  • URXUSB - Antimony, urine (ng/mL)
  • URXUTL - Thallium, urine (ng/mL)
  • URXUTU - Tungsten, urine (ng/mL)

National Health and Nutrition Examination Survey

1999-2000 Data Documentation, Codebook, and Frequencies

Metals - Urine (LAB06HM)

Data File: LAB06HM.xpt

First Published: March 2005

Last Revised: September 2023

Component Description

Urinary Barium, Beryllium, Cadmium, Cobalt, Cesium, Molybdenum, Lead, Platinum, Antimony, Thallium, and Tungsten

Trace metals have been associated with adverse health effects in occupational studies or laboratory studies, but have not been monitored in general population groups.

Information on levels of exposure to these compounds is essential to determine the need for regulatory mechanisms to reduce the levels of hazardous pollutants to which the general population is exposed and to establish population-based reference intervals for several potentially toxic metals.

Eligible Sample

Participants aged 6 years and older who met the subsample requirements and who did not meet any of the exclusion criteria composed the eligible sample.

Description of Laboratory Methodology

Urinary Barium, Beryllium, Cobalt, Cesium, Molybdenum, Lead, Platinum, Antimony, Thallium, and Tungsten

Inductively coupled plasma-mass spectrometry (ICP-MS) is a multi-element analytical technique.¹ Liquid samples are introduced into the ICP through a nebulizer and spray chamber carried by a flowing argon stream. By coupling radio frequency power into flowing argon, a plasma is created in which the predominant species are positive argon ions and electrons. The sample passes through a region of the plasma with a temperature of 6000–8000 K. The thermal energy atomizes the sample and then ionizes the atoms. The ions, along with the argon, enter the mass spectrometer through the interface that separates the ICP, which operates at atmospheric pressure, from the mass spectrometer, which operates at a pressure of 10^–6 torr. The mass spectrometer permits detection of ions at each mass in rapid sequence, allowing individual isotopes of an element to be determined. Electrical signals resulting from the detection of the ions are processed into digital information that is used to indicate the intensity of the ions and subsequently the concentration of the element. A total of 15 elements, including Be, Mn, Co, Ni, Mo, Sn, Sb, Cs, Ba, W, Pt, Tl, and Pb, are measured in urine by ICP-MS based on the method by Kevin J. Mulligan et al.² Urine samples are diluted 1+9 with 2% v/v double-distilled concentrated nitric acid (GFS Chemicals Inc., Columbus, OH) containing both iridium and rhodium for multi-internal standardization. This procedure may be used for all 15 elements or subsets of the 15 elements.

This method is used to achieve rapid and accurate quantification of multiple elements of toxicological and nutritional interest. The method is sensitive enough to be used to rapidly screen urine specimens from subjects suspected of exposure to a number of important toxic elements or to evaluate environmental or other non-occupational exposure to these same elements.

6.2 ***Special Note Regarding Urine Cadmium***

Urine cadmium levels are corrected for interference from molybdenum oxide. The variable name for the corrected cadmium levels is URDUCD. The formula for the correction is:

URDUCD = URXUCD – [(0.00175* URXUMO) – 0.0136]

where URXUCD is the original value for the cadmium result.

Corrected values that are less than zero are recoded to equal zero. If the result for urine molybdenum is missing, then the result for the corrected cadmium result is also missing.

The corrected data set also includes a variable URDUCDLC to indicate which results were below the limit of detection. For results below the limit of detection, the corrected value was calculated using the detection limit for urinary cadmium divided by the square root of two (value = 0.04).

See below for further explanation of this correction:

6.3 Effect of Molybdenum Oxide on Urine Cadmium Results

The ICP-MS method for the determination of urine cadmium has not been corrected for a possible interference from molybdenum oxide, MoO. Because the historical Proficiency Testing (PT) results for urine Cd were well within expected ranges and no consistent bias was observed with these PT samples, including several years of challenges, it was thought that, at typical biological molybdenum levels and typical instrumental oxide levels, the interference would not be significant. Upon investigation with over 6000 NHANES samples analyzed, we were able to see a possible effect on the urine Cd results when the results for the urine Cd versus Mo concentration were plotted. This effect cannot be easily seen with a few hundred sample results. Upon further investigation, we determined that the historical NHANES urine Cd results were biased high. For example, a 1st order approximation of the effect of this interference was determined to be 0.33 µg/L (at the 50th percentile) for urine Cd without correcting for the MoO interference versus 0.19 µg/L with the correction. Therefore, we investigated how best to implement a revised analytical method to eliminate this interference. In addition, until DLS had received and implemented some new ICP-MS technology, we could not eliminate this interference using the traditional ICP-MS technologies. We have recently implemented this new technology (Dynamic Reaction Cell technology [DRC]) and have been able to develop a revised analytical method that allows for correction of this MoO interference.

A method comparison was performed using 208 samples that included the typical range of Cd and Mo concentrations in urine. The results are shown in Figure 1, where (Cd_{Std Method} – Cd_{Corrected Method}) is plotted versus the urine molybdenum concentration. CdStd Method is the non-DRC method and Cd_{Corrected Method} is the DRC method. The best fit regression line had an r² = 0.81 and is given by Equation (1):

 (Cd_{Std Method} - Cd_{Corrected Method}) = 0.00175 (Mo) – 0.01360 (1)

Equation (2) is the adjustment equation used to correct the Standard Method results to the new Corrected method (the new DRC method).

Cd_{Corrected Method} = Cd_{Std Method} – (0.00175 * (Mo) + 0.01360 UCD_{Corrected Method}
= UCd_{Std Method} – (0.00175 * (UMO) + 0.01360 (2)

Data Processing and Editing

Automated data collection procedures for the survey were introduced in NHANES 1999. In the mobile examination centers (MECs) and analytical laboratories, data for the laboratory component is recorded directly onto a computerized data collection form. The system is centrally integrated and it allows for ongoing monitoring of much of the data. While the complete blood count and pregnancy analyses are performed in the MEC laboratory, most analyses are conducted elsewhere by approximately 21 laboratories across the United States.

Guidelines have been developed that provide standards for naming variables, filling missing values, and handling missing records. NCHS staff, assisted by contract staff, have developed data-editing specifications that check data sets for valid codes, ranges, and skip pattern consistencies and examine the consistency of values between interrelated variables. Comments have been reviewed and recoded. NCHS staff verifies extremely high and low values whenever possible, and numerous consistency checks are performed. Nonetheless, users should examine the range and frequency of values before analyzing data.

For laboratory tests with a lower detection limit, results below the lower detection limit are replaced with a value equal to the detection limit divided by the square root of two. This value has been created to help the user distinguish a nondetectable laboratory test result from a measured laboratory test result.

Laboratory Quality Assurance and Monitoring

Urine specimens are processed, stored, and shipped to the Division of Environmental Health Laboratory Sciences, National Center for Environmental Health, Centers for Disease Control and Prevention for analysis.

Detailed specimen collection and processing instructions are discussed in the NHANES Laboratory/Medical Technologists Procedures Manual (LPM). Vials are stored under appropriate frozen (–20°C) conditions until they are shipped to National Center for Environmental Health for testing.

Analytic Notes

10.1 Urinary Barium, Beryllium, Cadmium, Cobalt, Cesium, Molybdenum, Lead, Platinum, Antimony, Thallium, and Tungsten

Measures of this urinary multi-analyte profile are assessed in participants aged 6 years and over on a randomly selected 1/3 subsample. Specific sample weights for this subsample are included in this data file and should be used when analyzing these data. Read the Special Sample Weights for this Dataset section below before beginning analysis.

The dataset includes 2-year and 4-year subsample weights. The 4-year weights should be used if these 2001–2002 data are combined with 1999–2000 data. The 1999–2000 data files have been updated to include the subsample 4-year weights. The recommended procedure for variance estimation requires use of stratum and PSU variables (SDMVSTRA and SDMVPSU, respectively), which are included in the demographic data file for each data release. For further information, see the NHANES Analytic Guidelines, June 2004 version at: https://wwwn.cdc.gov/nchs/data/nhanes/nhanes_general_guidelines_june_04.pdf .

References

• Barnes S, Coward L, Kirk M, Sfakianos J. HPLC-mass spectrometry analysis of isoflavones. Proc Soc Exp Biol Med. 1998;217:254–262.
• Date AR, Gray AL. Applications of Inductively Coupled Plasma Mass Spectrometry. NY: Chapman and Hall; 1989.
• Franke AA, Custer LJ. High-performance liquid chromatographic assay of isoflavonoids and coumestrol from human urine. J Chromatogr B Biomed Appl. 1994;662:47–60.
• Gamache PH, Acworth IN. Analysis of phytoestrogens and polyphenols in plasma, tissue, and urine using HPLC with coulometric array detection. Proc Soc Exp Biol Med. 1998;217:274–280.
• Joannou GE, Kelly GE, Reeder AY, Waring M, Nelson C. A urinary profile study of dietary phytoestrogens. J Steroid Biochem Mol Biol. 1995;54:167–184.
• Messina M, Barnes S, Setchell KD. Phyto-oestrogens and breast cancer. Lancet. 1997;350:971–972.

Codebook and Frequencies