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Evaluation of physiological measures for correcting variation in urinary output: Implications for assessing environmental chemical exposure in children

Journal of Exposure Science & Environmental Epidemiology volume 19, pages 336–342 (2009)Cite this article

Abstract

Urinary contaminant concentrations are commonly adjusted by creatinine to account for the variability in urinary output. This approach may not be optimal among children due to developmental growth of muscle mass and the associated increase in creatinine formation. An alternative approach is to measure the specific gravity of the urine sample, which reflects the solute concentration of the urine. We compare the appropriateness of urinary creatinine and urinary-specific gravity as factors for correcting morning and evening spot urine samples collected from 23 children (3–11 years) for a total of 41 days in four different seasons. Two linear mixed-effects models were fit using age, sex, season, and sample collection time (morning/evening) as predictors with specific gravity and creatinine as dependent variables. Specific gravity was significantly associated with the sample collection time (P<0.001) with morning samples higher than evening samples. Creatinine was significantly associated with season (P<0.05), sample collection time (P<0.0001), and age (P<0.0001). Creatinine levels were higher during the summer compared to the other seasons, higher in the morning compared to the evening, and higher with increases in children's age. Normalizing the children's spot urine samples using creatinine would introduce bias to the data analysis. Whereas using specific gravity to correct for variable urinary output would be more robust. In addition, measuring specific gravity is relatively easy, does not require the use of chemicals, and the results are available instantaneously.

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Acknowledgements

This publication was developed under the support of the Science to Achieve Results (STAR) research assistance program (nos. R-828606 and 829364), awarded by the US Environmental Protection Agency (US EPA). The content of this publication has not been formally reviewed by the US EPA, and the views expressed in this document are solely the authors'. US EPA does not endorse any products or commercial services mentioned in this publication. We thank Rene Irish, Kathryn Toepel, and Patrick Sande at the University of Washington and Marjory Givens, Christina Holbrook, Hui-Mien Hsiao, Margarete Holubar, Daniel Gregory, and Mudresh Mehta at Emory University for their work in the Children Pesticide Exposure Study, including the measurements of specific gravity.

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Authors and Affiliations

  1. Department of Environmental and Occupational Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA

    Melanie A Pearson, Chensheng Lu & Anne M Riederer

  2. Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA

    Brian J Schmotzer & Lance A Waller

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  1. Melanie A Pearson
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  2. Chensheng Lu
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Correspondence to Chensheng Lu.

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Pearson, M., Lu, C., Schmotzer, B. et al. Evaluation of physiological measures for correcting variation in urinary output: Implications for assessing environmental chemical exposure in children. J Expo Sci Environ Epidemiol 19, 336–342 (2009). https://doi.org/10.1038/jes.2008.48

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