The Canadian Health Measures Survey (CHMS), an ongoing national health survey conducted in two-year cycles, collects extensive biomonitoring data that is used to assess the exposure of Canadians to environmental chemicals of concern. Combining data from multiple cycles of the CHMS allows for the calculation of robust regional estimates of chemical concentrations in blood and urine. The objective of this work was to compare biomarkers of exposure to several environmental chemicals for the provinces of Quebec and Ontario, two major CHMS regions, as well as the entire CHMS (representing Canada) minus Quebec (CMQ), and the entire CHMS minus Ontario (CMO), and to interpret differences between regions. Geometric means and 95th percentiles of blood and/or urinary concentrations of 45 environmental chemicals or their metabolites for Ontario, Quebec, CMQ, and CMO were calculated by combining the two most recent cycles of data available for a chemical (cycles 1 and 2, or cycles 2 and 3) from the first three cycles of the CHMS (2007–2013). Weighted one-way ANOVA was used to test the differences between regional estimates. After applying a Bonferonni-Holm adjustment for multiple comparisons, the following measures were significantly higher in Quebec as compared to Ontario and CMQ: blood lead, urinary lead and the urinary polyaromatic hydrocarbon (PAH) metabolites, 9-hydroxyfluorene, 1-hydroxyphenanthrene, 2- hydroxyphenanthrene and 3-hydroxyphenanthrene. In Quebec compared to CMQ only, urinary 2-hydroxfluorene, 3-hydroxyfluorene, 2-hydroxynaphthalene, and 4-hydroxyphenanthrene were higher. The concentration of urinary fluoride was significantly higher in Ontario as compared to Quebec and CMO. Blood manganese and urinary fluoride were significantly lower in Quebec compared to CMQ, and blood and urinary selenium were significantly lower in Ontario compared to CMO. Regional differences in tobacco use, age of dwellings and drinking water fluoridation are among the possible contributing factors to some of the observed differences. In conclusion, this is the first study where biomonitoring data from multiple cycles of CHMS were combined in order to generate robust estimates for subsets of the Canadian population. Such assessments can contribute to a regional-level prioritization of control measures to reduce the exposure of Canadians to chemicals in their environment.

加拿大健康措施调查（CHMS）是一项持续两年的持续性国家健康调查，它收集了广泛的生物监测数据，用于评估加拿大人所关注的环境化学品的暴露程度。结合来自多个CHMS周期的数据，可以计算出血液和尿液中化学浓度的可靠区域估计值。这项工作的目的是比较魁北克和安大略省，两个主要的CHMS地区以及整个CHMS（代表加拿大）减去魁北克（CMQ）和整个CHMS减去安大略省的几种环境化学品的暴露生物标志物。 （CMO），并解释区域之间的差异。安大略省，魁北克省，CMQ，45种环境化学物质或其代谢物的血液和/或尿液浓度的几何平均值和95％百分数，通过将CHMS的前三个周期（2007-2013年）中可获得的两个最新数据周期（周期1和2，或周期2和3）相结合，计算出CMO和CMO。加权单向方差分析用于检验区域估计之间的差异。在应用Bonferonni-Holm校正进行多次比较后，魁北克的以下措施比安大略省和CMQ显着更高：血铅，尿铅和尿中多环芳烃（PAH）代谢物，9-羟基芴，1-羟基菲，2 -羟基菲和3-羟基菲。在魁北克，与仅CMQ相比，尿中的2-羟基芴，3-羟基芴，2-羟基萘和4-羟基菲更高。与魁北克和CMO相比，安大略省的氟尿素浓度明显更高。与CMQ相比，魁北克的血锰和氟尿素显着降低，安大略省的血和尿硒显着低于CMO。烟草使用，住所年龄和饮用水氟化的区域差异是造成某些观察到的差异的可能因素。总之，这是第一项研究，将来自多个CHMS周期的生物监测数据进行了合并，以便对加拿大人口的子集生成可靠的估计。此类评估可有助于在区域一级对控制措施进行优先排序，以减少加拿大人对其环境中化学品的接触。烟草使用，住所年龄和饮用水氟化的区域差异是造成某些观察到的差异的可能因素。总之，这是第一项研究，将来自多个CHMS周期的生物监测数据进行了合并，以便对加拿大人口的子集生成可靠的估计。此类评估可有助于在区域一级对控制措施进行优先排序，以减少加拿大人对其环境中化学品的接触。烟草使用，住所年龄和饮用水氟化的区域差异是造成某些观察到的差异的可能因素。总之，这是第一项研究，该研究将来自多个CHMS周期的生物监测数据进行了合并，以生成针对加拿大人口子集的可靠估计。此类评估可有助于在区域一级对控制措施进行优先排序，以减少加拿大人对其环境中化学品的接触。