Toxic metal contamination in food products and the environment is a public health concern. Therefore, understanding human exposure to cadmium (Cd), lead (Pb), cobalt (Co), and copper (Cu) levels in the general population of Taiwan is necessary and urgent. We aimed to establish the human biomonitoring data of urine toxic metals, exposure profile changes, and factors associated with metal levels in the general population of Taiwan. We randomly selected 1601 participants older than 7 years of age (36.9 ± 18.7 years (7–84 years)) from the Nutrition and Health Survey in Taiwan (NAHSIT) conducted during 1993–1996 (93–96) and 2005–2008 (05–08) periods and measured the levels of four metals in the participants’ urine samples using inductively coupled plasma-mass spectrometry. The median (range) levels of urinary Cd, Pb, Co, and Cu in participants from the NAHSIT 93–96 (N = 821)/05–08 (N = 780) were 0.60 (ND–13.90)/0.72 (ND–7.44), 2.28 (ND–63.60)/1.09 (0.04–48.88), 0.91 (0.08–17.30)/1.05 (0.05–22.43), and 16.87 (2.62–158.28)/13.66 (1.67–189.70) μg/L, respectively. We found that the urinary median levels of Pb and Cu in our participants were significantly lower in the NAHSIT 05–08 (Pb 1.09 μg/L, Cu 13.66 μg/L) than in the NAHSIT 93–96 (Pb 2.28 μg/L, Cu 16.87 μg/L; P < 0.01), whereas those of Cd and Co were significantly higher in the NAHSIT 05–08 (Cd 0.72 μg/L, Co 1.05 μg/L; P < 0.01). Youths had higher exposure levels of Pb, Co, and Cu than adults. Participants with alcohol consumption, betel quid chewing, or cigarette smoking had significantly higher median levels of urinary Pb or Cu (P < 0.01) than those without. Principal components and cluster analysis revealed that sex had different exposure profiles of metals. We concluded that levels of urinary Cd, Pb, Co, and Cu exposure in the general Taiwanese varied by age, sex, and lifestyles.
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