**5. Conclusions**

The analysis of the temporal trends of the concentrations of a number of trace elements in five autopsy tissues indicates that there have been fluctuations through time, when comparing the results of the campaign performed in 2019 with those corresponding to the baseline survey (1998). Furthermore, no significant changes were noted between 2013 and 2018 for most elements. A general increasing or decreasing tendency was not found, with the only exceptions of Pb and Cr. On one hand, the mean blood levels of Pb were significantly reduced compared to the baseline (1998) study, mainly due to the e ffect of banning Pb as a gasoline additive, introduced in the early 2000's. On the other hand, the average Cr concentration in most tissues is still higher than that found in the baseline study, although the di fference was only significant in kidney and bone. In contrast, the 5 analyzed autopsy tissues showed significantly lower concentrations than the levels found in the previous campaign (2013), when a generalized increase, not only in autopsy tissues, but also in some environmental samples, was noticed. That rise was also supported by the increase in the dietary intake of Cr estimated for the adult population living near the HWI.

In any case, the levels of trace elements obtained in the present study are similar to those reported recently in various studies of di fferent countries. The global analysis of the data clearly indicates that air emissions of the HWI have not a significant exposure or accumulation of these elements in individuals living in the area near the facility. Moreover, the temporal changes may be more directly related to di fferences in the dietary exposure of the population.

**Author Contributions:** Conceptualization, J.L.D. and M.N.; methodology, F.G., E.B., P.T., I.L., C.L., M.N.; software, M.M., M.N.; validation, F.G., J.L.D.; formal analysis, F.G., E.B., P.T., M.M.; investigation, F.G., I.L., C.L.; resources, F.G., J.L.D.; data curation, F.G., M.N.; writing—original draft preparation, M.M., M.N.; writing—review and editing, M.M., J.L.D.; visualization, F.G., J.L.D.; supervision, F.G., M.N.; project administration, M.N.; funding acquisition, J.L.D. All authors have read and agreed to the published version of the manuscript.

**Funding:** This study was funded by Sarpi Constantí SL, Catalonia, Spain.

**Acknowledgments:** The authors appreciate the technical assistance of Jordi Sierra and Anabel Díez for the analytical treatment, as well all the relatives of the individuals who provided the autopsy tissue samples.

**Conflicts of Interest:** The authors declare no conflict of interest.
