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Test Code 0202267 Heavy Metals Screen with Demographics, Blood

Additional Codes

 

Mayo Test ID
HMDB

 

Useful For

Detecting exposure to arsenic, lead, cadmium, and mercury

Profile Information

Test ID Reporting Name Available Separately Always Performed
ASB Arsenic, B Yes Yes
PBHMB Lead, B Yes, (Order PBDB) Yes
CDB Cadmium, B Yes Yes
HG Mercury, B Yes Yes
DEMO6 Patient Demographics No Yes

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Heavy Metals Scrn with Demographics

Specimen Type

Whole blood


Specimen Required


Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Container/Tube: Royal blue-top (EDTA) Vacutainer plastic trace element blood collection tube (T183)

Specimen Volume: Full tube

Collection Instructions:

1. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.

2. Send specimen in original collection tube.

Additional Information: If ordering the trace element blood collection tube from BD, order catalog #368381.


Specimen Stability Information

Specimen Type Temperature Time
Whole blood Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reject Due To

Hemolysis

Mild OK; Gross OK

Lipemia

Mild OK; Gross OK

Icterus

Mild OK; Gross OK

Other

Green-top (heparin) tube

Interpretation

Arsenic:

Abnormal blood arsenic concentrations (>12 ng/mL) indicate significant exposure.

 

Absorbed arsenic is rapidly distributed into tissue storage sites with a blood half-life of <6 hours. Unless a blood specimen is drawn within 2 days of exposure, arsenic is not likely to be detected in a blood specimen.

 

Lead:

The 95th percentile of the Gaussian distribution of whole blood lead concentration in a population of unexposed adults is <6.0 mcg/dL. For pediatric patients, there may be an association with blood lead values of 5.0 to 9.9 mcg/dL and adverse health effects. Follow-up testing in 3 to 6 months may be warranted. Chelation therapy is indicated when whole blood lead concentration is >25.0 mcg/dL in children or >45.0 mcg/dL in adults.

 

The Occupational Safety and Health Administration has published the following standards for employees working in industry:

-Employees with a single whole blood lead result >60.0 mcg/dL must be removed from workplace exposure.

-Employees with whole blood lead levels >50.0 mcg/dL averaged over 3 blood samplings must be removed from workplace exposure.

-An employee may not return to work in a lead exposure environment until their whole blood lead level is <40 mcg/dL.

 

New York State has mandated inclusion of the following statement in reports for children under the age of 6 with blood lead in the range of 5.0 to 9.9 mcg/dL: "Blood lead levels in the range of 5.0-9.9 mcg/dL have been associated with adverse health effects in children aged 6 years and younger."

 

Cadmium:

Normal blood cadmium is <5.0 ng/mL, with most results in the range of 0.5 to 2.0 ng/mL.

 

Acute toxicity will be observed when the blood level exceeds 50 ng/mL.

 

Mercury:

The quantity of mercury (Hg) found in blood and urine correlates with degree of toxicity. Hair analysis can be used to document the time of peak exposure if the event was in the past.

 

Normal whole blood mercury is usually <10 ng/mL.

 

Individuals who have mild exposure during work, such as dentists, may routinely have whole blood mercury levels up to 15 ng/mL.

 

Significant exposure is indicated when the whole blood mercury is >50 ng/mL if exposure is due to alkyl Hg, or >200 ng/mL if exposure is due to Hg(+2).

Day(s) and Time(s) Performed

Monday through Saturday; 2 p.m.

Analytic Time

1 day

Specimen Retention Time

7 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

See Individual Test IDs

CPT Code Information

82175-Arsenic

82300-Cadmium

83655-Lead

83825-Mercury

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HMDB Heavy Metals Scrn with Demographics 29588-1

 

Result ID Test Result Name Result LOINC Value
32190 Arsenic, B 5583-0
8682 Cadmium, B 5609-3
8618 Mercury, B 5685-3
2588 Lead, B 77307-7
VECP6 Venous/Capillary 31208-2
PTAD6 Patient Street Address 56799-0
PTCI6 Patient City 68997-6
PTST6 Patient State 46499-0
PTZI6 Patient Zip Code 45401-7
PTCN6 Patient County 87721-7
PTPH6 Patient Home Phone 42077-8
PTRA6 Patient Race 32624-9
PTET6 Patient Ethnicity 69490-1
PTOC6 Patient Occupation 11341-5
PTEM6 Patient Employer 80427-8
GDFN6 Guardian First Name 79183-0
GDLN6 Guardian Last Name 79184-8
MDOR6 Health Care Provider Name 52526-1
MDAD6 Health Care Provider Street Address 74221-3
MDCI6 Health Care Provider City 52531-1
MDST6 Health Care Provider State 52532-9
MDZI6 Health Care Provider Zip Code 87720-9
MDPH6 Health Care Provider Phone 68340-9
LABP6 Submitting Laboratory Phone 65651-2

Specimen Minimum Volume

0.3 mL

Reference Values

ARSENIC

0-12 ng/mL

Reference values apply to all ages.

 

LEAD

All ages: 0.0-4.9 mcg/dL

Critical values

Pediatrics (≤15 years): ≥20.0 mcg/dL

Adults (≥16 years): ≥70.0 mcg/dL

 

CADMIUM

0.0-4.9 ng/mL

Reference values apply to all ages.

 

MERCURY

0-9 ng/mL

Reference values apply to all ages.

Forms

Lead/Heavy Metals Reporting Form (T491) in Special Instructions

Testing Algorithm

See Porphyria (Acute) Testing Algorithm in Special Instructions.