ANNALS O F CLIN ICA L AND LABORATORY S C IEN C E, Vol. 8, No.

4
Copyright 1978, Institute for Clinical Science

The Excretion of Trace Metals

in Human Sweat
JAMES R. CO HN , M.S.*
and EDW ARD A. EM M ETT, M.B., B.S., M.S., F.R.A.C.P.

Department o f Environmental Health,

University o f Cincinnati College o f Medicine,
Cincinnati, OH 45267

ABSTRACT

The concentrations of zinc, copper, iron, nickel, cadmium, lead, m an

ganese, sodium and chloride in the sw eat of six males and three females were
determ ined after collections utilizing a total body washdow n technique.
From our results, sweat appears to be an im portant excretory pathw ay for
zinc and copper. The m ean concentrations of nickel and cadium in sweat
were higher than those reported for urine, that of lead was sim ilar to urine.
The loss of m anganese in sw eat is insignificant. Levels of zinc and iron
w ere lower in sw eat from fem ales, possibly reflecting com pensation for
m enstrual and other losses.
Collections w ere made in six subjects sim ultaneously utilizing a total body
washdown m ethod andcollections from one arm in an occlusive arm-bag. The
arm-bag collection m ethod gave higher and more variable results and is not
recom m ended as an indicator of loss from the entire skin surface.

Introduction depending on the trace m etal under study.

Hum an studies are particularly im portant
This study was undertaken in order to
as there is no good anim al m odel for total
determ ine the im portance of excretion in
body hum an eccrine sweating.
hum an sweat of certain trace metals. The
It is im portant to obtain a specim en
excretion of essential trace metals in sweat
which will be representative of the total
is of potential significance in nutrition and
loss in sweat o f the substance in question.
in the consideration of heat stress. The loss
To date investigators who have studied the
of non-essential or toxic trace m etals in
concentrations of trace elem en ts have
sw e a t c o u ld b e o f to x ico lo g ic a n d
usually collected the sw eat from the fore
therapeutic im portance. Balance studies
arm in an occlusive bag.7' 12,2fi27,28 It has been
to date have given little attention to the
shown for chloride,3,41 lactate,41 urea,3,41
am ount o f trace metal excreted via sweat
sodium ,3 potassium 3 and creatinine3 that
ing. As with other excretory pathways, the
collection in such a m anner leads to a m is
relative im portance of the sweat w ill differ
leadingly high estimate of total body sweat
* Present Address: Allied Chemical, P.O. Box concentrations. The difference has been
105 7R, Morristown, NJ 07960. attributed either to elevations in local skin
270
0091-7370/78/0700-0270 $00.90 Institute for Clinical Science, Inc.
 M E T A LS IN HUM A N SW E A T
tem perature or hum idity.41 It has been
shown that there are regional variations in
the concentration of such elem en ts as
sodium and chloride in body sweat.17Addi
tionally, arm-bag sweat is prim arily of ec-
crine gland origin w hile whole body sweat
is a variable m ixture of eccrine and apo
crine secretions. The eccrine8 contribution
rises sharply w ith vigorous m uscular activ
ity or w ith em otional factors such as anxi
ety or fear. T he two types of sw eat are
known to differ in composition.23,24,34
In this study, the concentrations were
d eterm in ed of sodium , chloride, zinc,
cadmium, lead, iron, copper, nickel and
m anganese in male and fem ale sweat by a
total body washdown m ethod.17 The re
sults obtained by the sim ultaneous use of
the standard total body w ashdown m ethod
of sweat collection w ere also compared
with those obtained by collecting sweat in
an occlusive arm-bag.
M aterials and M ethods
W h o l e B o d y Sw e a t C o l l e c t io n
Sweat was collected from six males and
three fem ale healthy, adult volunteers,
aged betw een 23 and 33 years, using a
modification of the m ethod described by
Kuno.17 None of the subjects was taking
drugs or m edications, including oral con
traceptives. Inform ed consent was ob
tained after the nature of the procedure
had been fully explained.
Sweat collections took place in a con
trolled temperature chamber at 37.8C and
35 percent relative hum idity, conditions
under which the sw eatrapidly evaporated.
Prior to entering the cham ber each patient
sh o w e re d a n d rin s e d w ith d is tille d ,
deionized water. Analysis of the water
used for rinsing show ed no significant de
tectable trace metals. Polyethylene film
was used to prevent contact betw een the
subjects skin and garments. After entering
the cham ber the polyethylene film and
garments w ere rem oved and the subject
w e ig h e d on a p o ly e th y le n e c o v e re d
271
counter-beam scale (accuracy lOg). For
a 90 m inute period, subjects exercised on
a bicycle ergometer* w ith alternating 10
m inute exercise and rest periods. The er
gom eter work load was 600 kgm per m in
ute for males and 400 kgm per m inute
for females. Pedals, handles and seat of
the ergom eter w ere covered w ith poly
e th y le n e film to p re v e n t c o n ta m in a
tion. T he m inim al am ount o f d rip p e d
sw eat w as c o lle c te d on p o ly e th y le n e
sheeting. Rectal tem perature was m oni
tored continuously and pulse taken every
10 m inutes. Tap water at the same tem per
ature as the cham ber was provided for
drinking ad lib.
At the end of the period, the subject
was rinsed down from the hairline of the
forehead w ith distilled, deionized water
into a large, acid-washed, plastic basin.
After drying, the subject was rew eighed.
The volume of sweat was assum ed to be
the difference betw een the w eight of the
subject before and after the experimental
p erio d , a fter a llo w in g for w ater con
sum ed or urine passed. T he relatively
considerably sm aller am ount of w ater
loss through the lungs was ignored.
The volume of the washings was re
corded before transfer to acid-washed glass
bottles and storage at 4C until analysis.
After filtration to separate the liquid from
the derm al detritus, a 300 ml aliquot was
analyzed for zinc, iron, lead, nickel, cop
per, m anganese, cadmium, sodium and
chloride using atomic absorption spec
troscopy by the m ethods of Slavin.37
A r m -b a g S w e a t C o l l e c t i o n
Six su b jects, th re e m ale an d th re e
female, sim ultaneously wore polyethy
le n e bags over one forearm in o rd e r
to com pare lev e ls o f trace m etals in
w hole-body sweat and sweat collected in
an occlusive arm-bag. T hese specim ens
w ere h an d led as described previously
* Quinton Instrument Corp., Uniwork Ergometer
Model 844.
272 COHN AND EMMETT

with the exception th at the entire speci concentration in females was affected by
m en was filtered and used for analysis. one very high value (230 ng per 1), which
Students t test was used to determ ine was rejected for the purpose of determ in
the statistical significance of differences ing the mean.
in results. Com parative results for the sweat col
lec ted sim u ltaneously by w hole body
Results w ashing and by occlusive arm-bag collec
The m ean sweat loss over a 90 m inute tion are given in table II. Significant dif
period was 899 ml (range 620 to 1090 ml) ferences w ere found betw een values ob
for males and 847 ml (range 775 to 915 ml) tain ed by the two d ifferent collection
m ethods (p < 0.05) in all cases. T he con
for females. Arise in the rectal tem perature
occurred in all subjects shortly after com centrations in arm-bag sw eat were from 1.4
m encing the first p eriod of ergom eter to 5.3 tim es higher than the concentrations
work and reached a plateau (99 to 100.8 F) in sweat collected by whole body w ashing
after eith er the third or fourth exercise d e p e n d in g on th e p a rtic u la r m eta l
period. A rise in pulse rate to betw een 114 analyzed. In addition, arm-bag sweat con
and 156 beats per m inute accom panied the centrations w ere more variable from sub
je c t to su b ject than w ere the c o n cen
rise in tem perature. Only one male experi
enced any obvious discomfort during the tratio n s o b ta in e d by th e w hole body
experim ent and required an additional 20 w ashdow n m ethod.
m inute rest betw een the first and second No correlation betw een the co ncen
work periods. H e recovered and com trations of sodium and chloride and that of
pleted the experim ent w ithout ill-effects. any trace m etal was found in the lim ited
The concentrations o f m etals obtained num ber of subjects studied, nor could any
for total body sweat are given in table I. correlation be made betw een the concen
U nder the study conditions, the concen trations of one trace metal and another.
trations of sodium and c h lo rid e w ere The inverse relationship betw een sweat
so m e w h at h ig h e r in sw e a t from th e volume and trace metal concentrations re
females. Concentrations of other elem ents ported by H ohnadel12 was not seen over
were sim ilar in both sexes, except for zinc the lim ited range o f sw eat volumes ob
and iron w hich w ere lower in females served in this study.
perhaps because of reduced body stores as
a result of losses in m enstruation, preg
Discussion
nancy and lactation. The m ean cadmium
Any study addressing the loss of solutes
in hum an sweat is made difficult by the
TABLE I
m arked variations in rates of excretion and
Concentrations of Trace Metals, in solute concentrations under different
Sodium and Chloride in Human Sweat
co n d itio n s. M any of th e v ariables for
6 M ales 3 F em ales
sodium and chloride excretion have been
Mean + S .D . Mean & Range studied. T hese include the region of the
body, rate and duration o f sweating and
Sweat--volume (ml) 899 + 182 847 (775-915)
+ 425 507 (400-680)
degree of acclimatization.21 The latter two
Zn (yg/L) 960
Cd (ug/L) 24 + 16 20 (2 0 -2 3 0 ) factors are intim ately related, the rate of
Pb (yg/L) 62 + 40 53 (40-60)
Fe (yg/L) 630 + 587 163 (130-180) sw eating being inversely proportional to
(yg/L) 1427 + 505 1533 (1400-1600)
Cu
26 57 (40-80)
the degree of acclimatization. The concen
Ni (yg/L) 57
Mn (yg/L) 23 + 14 17 (10-20) tration of NaCl in sweat falls with acclim a
Na (mEq/L) 11.5 + 1.6 21.08 (15.3-28.6)
Cl (mEq/L) 7.6 + 3.5 19.20 (14.3-26.3) tization10, 17 and has b een reported as low as
5 Eq per L2,8' 11,19,33 or as high as 148 E q p e r
 M E T A LS IN HUM A N SW EA T 273

TABLE I I

C o m p a r i s o n o f Sweat V o l u m e s and C o n c e n t r a t i o n s of Tra c e Metals, Sodi u m and Chloride B etween Sweat

Co l l e c t e d b y Wh o l e Body W a s h d o w n M e t h o d and Sweat C o l l ected S i m ultaneously in an O c c l usive A rm-bag

W h ole B o d y S w e a t A r m -b a g S w e a t
S .D . R ange Mean S .D . R ange

S w e a t-v o l u m e (ml) 919 142 775-1090 11.5 9 2-5

Zn (pg/L) 773 332 400-1200 2185 1355 510-4640
Pb (yg/L) 60 33 40- 1 2 0 83 86 20-250
Fe (pg/L) 258 203 40- 5 5 0 922 582 300-1680
Cu (yg/L) 1360 314 8 6 0 -1600 2508 2090 660-6400
Ni (yg/L) 55 16 40-80 293 194 80-550
Mn (yg/L) 20 9 10-30 72 48 20-150
Na (mEq/L) 17 6 10 . 6-28.6 54 24 32.0-70.8
Cl (mEq/L) 15 7 8.5-26.31 32 15 14.7-59.8

L6, i3, is,20 ,4 2 jn supposedly normal subjects.
Women on the average have a higher tem
perature threshold for sweating than men.
In this study, carried out in summ er, it was
likely that all subjects w ere at least par
tially acclim atized w hich w ould account
for the com paratively low sodium values.
T he excretions in sweat of copper, zinc,
lead, cadm ium , nickel and m anganese
have not previously b e e n d e te rm in e d
using a total body washdown m ethod. The
results of previous studies of trace metal
concentrations in sw eat u sin g lim ited
sweat collection10,22,36 including occlusive
bag collection have resulted in highly vari
able results. For example, m ean sweat
copper concentrations have b een reported
to be as high as 4.9 mg per L36 or as negligi
ble.26 The levels of sweat copper excretion
(1.3 0.3 mg per L) found in this study
appear nutritionally significant in terms of
the estim ated daily dietary intake of two to
five mg4,5 and urinary excretion of five to
25 fig per day.27 These findings suggest
that im portant excretion of copper may
take place in sw eat as w ell as in bile.4,43
The sweat zinc excretion observed was
significantly h ig h er th an the rep o rted
m ean daily urinary zinc excretion of643 fig
per L.29 O ur results are consistent w ith the
contention of Prasad that zinc excretion in
sw eat may have played a major role in the
developm ent of hypogonadic dwarfism in
certain areas of Egypt and Iran.26,27,30,31 A
higher mean concentration of copper than
zinc was observed by us in the sw eat of
both males and females. This does not
support the postulate that the low er risk of
coronary heart disease in m en who exer
cise regularly may be due to the greater
loss of zinc over copper in sweat.16,22,32
After several hours of maximal sweating,
the sweat rate will fall and profuse sweat
ing day after day norm ally resu lts in
acclimatization with decreased sw eatrates
and solute concentrations. T he influence
of acclimatization and of continued heavy
sw eating on copper and zinc c o n c en
trations has not y et b e e n d e te rm in e d .
How ever, extrapolating from the results
obtained by us in the first 90 m inutes of
exercise to a total sweat excretion of from
three to six liters per day sweat losses of4.5
to 9 mg ofcopper and three to six mg ofzinc
appear possible. It is even possible that
zinc, copper and perhaps other losses in
sweat are im portant in the pathogenesis
of heat stroke.
O ur results for sweat iron excretion are
considerably lower than those reported for
four adult males by M itchell e t al22 o f 1.91
mg per L at sweat rates of less than 200 ml
per hour and 1.64 mg per L at sweat rates of
from 200 to 900 m l per hour. However,
these authors studied whole sweat rather
than cell-free sweat. Cell-rich sw eat is rich
in desquam ated cells w hich contain rela
tively large amounts of iron.1,9,39
274 COHN AND EMMETT

TABLE III 5. C a r t w r i g h t , G. E. and W i n t r o b e , M. M.:The

Comparison o f Mean Concentrations of Trace Metals
in Sweat with Published Figures of Usual Daily
Dietary Intakes and Urinary Concentrations
T race U su a l D a i l y Mean U r i n a r y
M e ta l D ie ta r y I n ta k e C o n c e n tr a ti o n
Pb 150-350 pg (38) 30-80 pg/L (39)
Cd 200-500 pg (40) 12.7 pg/L (41)
Ni 300-600 pg (42) 18 pg/L (43)
Mn 2.3-7.5 yg (42) <30 pg/L (41)
In table III the m ean concentrations o f
lead, cadm ium , nickel and m anganese
found by us in sw eat are com pared w ith
published values for the usual adult d iet
ary intake average and urinary concen
trations. In the case of lead, urinary and
sw e a t c o n c e n tra tio n s a p p e a r sim ila r.
Sw eat concentrations of cadm ium and
m agnesium appear higher than those in
urine w hereas in the case of m anganese
both urinary and sweat excretion appear
physiologically insignificant.
Our results indicate that the collection of
sweat in an occlusive arm-bag, as practiced
in a num ber of previous investigations,
can lead to high and quite variable results
for trace metal concentrations w hen com
pared w ith results obtained using the body
washdow n technique. This is unfortunate
as the former is a more convenient m ethod
of sample collection. On the basis of our
findings, it is our recom m endation that the
w ashdow n m ethod is generally prefer
able.
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