peer reviewed ; This report investigated the distribution of serum zinc and the factors determining serum zinc concentration in a large random population sample. The 197 participants (959 men and 1018 women), 20-80 years old, constituted a stratified random sample of the population of four Belgian districts, representing two areas with low and two with high environmental exposure to cadmium. For each exposure level, a rural and an urban area were selected. The serum concentration of zinc, frequently used as an index for zinc status in human subjects, was higher in men (13.1 µmole/L, range 6.5-23.0 µmole/L) than in women (12.6 µmoleL, range 6.3-23.2 µmole/L). In men, 20% of the variance of serum zinc was explained by age (linear and squared term, R=0.29), diurnal variation (r=0.29), and total cholesterol (r=0.16). After adjustment for these covariates, a negative relationship was observed between serum zinc and both blood (r= -0.10) and urinary cadmium (r= -0.14). In women, 11% of the variace could be explained by age (linear and squared term, R = 0.15), diurnal variation in serum zinc (r=0.27), creatinine clearance (r= -0.11), log y-glutamyltranspeptidase (r= 0.08), cholesterol (r= 0.07), contraceptive pill intake (r= -0.07), and log serum ferritin (r=0.06). Before and after adjustment for significant covariates, serum zinc was, on average, lowest in the two districts where the body burden of cadmium, as assessed by urinary cadmium excretion, was highest. These results were not altered when subjects exposed to heavy metals at work were excluded from analysis.