The measurement of trace elements in human nails and nail clippings using portable X-ray fluorescence: A review

A variety of biomarkers are available for the assessment of human exposure to, and absorption of, trace elements. The measurement of trace elements in nail or nail clippings offers some benefits relative to other body sites. Typically, concentrations of elements are assessed in clippings, using high precision methods such as inductively coupled plasma mass spectrometry or instrumental neutron activation analysis. Over the last decade, portable X-ray fluorescence (pXRF) has emerged as a novel method with potential advantages for the measurement of trace elements in nail and nail clippings. This review paper examines early developments and recent work in the use of pXRF to measure elements such as As, Se, Mn, Zn, Cr, Pb, and Hg in nails and nail clippings. While initial pXRF studies were limited to the use of nail phantoms and nail clipping phantoms, more recent work has applied the pXRF method with real nail clippings and nails. Results have been promising, but a number of issues have emerged requiring additional attention. These relate to the analysis of X-ray spectra, selection of X-ray beam for excitation, method validation and normalization, and practical aspects of study design. With consideration of these issues, pXRF offers significant potential to provide a straightforward, economical, and rapid measurement approach to help improve our understanding of trace element exposure and related health outcomes.