INCE APRIL 17, 2009, WHEN THE first 2 cases of pandemic influenza A(H1N1) virus infection were reported in California, the virus has rapidly spread throughout the world. 1 On June 11, 2009, the World Health Organization raised the pandemic alert level to phase 6, indicating that a global pandemic had begun. 2 Although initial reports suggested that illness associated with pandemic 2009 influenza A(H1N1) infection may be mild compared with the 1918 influenza pandemic, data on the clinical features and populations at risk of complications from pandemic 2009 influenza A(H1N1) infection are still emerging. In the United

This paper reviews the process of elimination of creatinine (CRE), and the limitations presented when using it to express urine concentrations. This literature review leads to three conclusions: (1) CRE excretion is subject to wide fluctuations due to specific internal and external factors; (2) the use of CRE to correct chemical concentrations in urine will not necessarily improve the correlation to the exposure dose for all chemicals (it may, in fact, worsen the result); and (3) other means of expressing urine concentration may offer greater accuracy towards estimating individually absorbed dose.

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