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Trace elements (TEs) are elements that are present in natural or working environments. They are present in smalt concentrations in human tissues and body fluids. Sorne of them play a biological rote, i.e. they are essential, others are non-essential. Taking into account all sources of exposure, human biomonitoring is used to evaluate the absorbed doses of various contaminants. When assessing natural or occupational levels of exposure, reference values are required to interpret values observed in an individual. So far, reference values determined in other countries have been used in Belgium. But since these values vary with exposure levels according to country or region, natural and working environments, lifestyle and diet, reference values that are appropriate for a given population have to be used for proper interpretation .The purpose of this study was to provide urinary reference values for 26 TEs (Al, Sb, As, Ba, Be, Bi,Cd, Cr, Co, Cu, ln, Pb, Li, Mn, Hg,Mo,Ni,Pd,Pl,Se, Te, Tl,Sn, U, V, and Zn) established within the general adult population of Belgium. To that effect, 1022 healthy participants were recruited by occupational physicians and toxicologists throughout Belgium. An anonymous questionnaire was completed with each participant, with a view to collecting information on factors likely to influence TEs status, and a non-fasting spot urine sample was collected. Due to lack of information or inadequate urine storage, 21 samples were discarded. Special care was taken to avoid sample contamination during collection, handling and analyses. A certified laboratory analyzed the samples by lnductively Coupled Plasma­ Mass Spectrometry {ICP-MS}. Following international recommendations, the urinary distributions were measured for all 26 TEs, and upper reference limits (URLs; the rounded value of the upper limit of the 90% Cl of P97.5) were determined, both in µg/L and µg/g creatinine. The cohort was partitioned into subgroups according to gender (541 females and 460 males), age {18-30 years old: 25.5%; 31-40 years old: 24.2%;41-50 years old: 28.4%;and > 50 years old: 22.2%} and smoking status (non-smokers: 61.9%; smokers: 24.1%; and ex­ smokers: 14%}.Overall, the general adult population of Belgium has low exposure levels to the investigated TEs. These levels are fairly similar to the ones determined in other national surveys (Canada, Germany, France and USA}. Compared to the reference values that were previously used, 15 newly established URLs are lower (Al, Sb, Ba, Be, Bi, Cd, Cr, Co, Cu, Pb, Mn, Hg,Tl, Sn, and Zn), and 5 URLs are higher (total As, Mo, Ni,Se, and V}. For 6 TEs {ln,Li, Pd,Pl,Te, and U}, as well as for total As when there was neither fish nor seafood consumption within the last 4 days, and for Cd in non-smokers, there were no available previous reference values.The reference values and URLs that have been determined through this study will be useful for biological monitoring and for future surveys in the population of Belgium.

Urinalasys