Sign in →

Test Code HMNA Heavy Metals, Nails

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Useful For

Detection of nonacute arsenic, mercury, and lead exposure

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Heavy Metals, Nails

Specimen Type

Nail


Specimen Required


Supplies: Hair and Nails Collection Kit (T565)

Specimen Volume: 0.2 g

Collection Instructions:

1. Prepare and transport specimen per the instructions in the kit or see Collecting Hair and Nails for Metals Testing in Special Instructions.

2. Clippings should be taken from all 10 fingernails or toenails.

Additional Information: If known, indicate source of nails (fingernails or toenails).


Specimen Minimum Volume

0.05 g

Specimen Stability Information

Specimen Type Temperature Time
Nail Ambient (preferred)
  Frozen 
  Refrigerated 

Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Reference Values

ARSENIC

0-15 years: not established

≥16 years: 0.0-0.9 mcg/g of nails

 

LEAD

0.0-3.9 mcg/g of nails

Reference values apply to all ages.

 

MERCURY

0-15 years: not established

≥16 years: 0.0-0.9 mcg/g of nails

Interpretation

Nails grow at a rate of approximately 0.1 inch/month. Nail keratin synthesized today will grow to the distal end in approximately 6 months. Thus, a nail specimen collected at the distal end represents exposure of 6 months ago.

 

ARSENIC

Nail arsenic above 1.0 mcg/g dry weight indicates excessive exposure. It is normal for some arsenic to be present in nails, as everybody is exposed to trace amounts of arsenic from the normal diet.

 

The highest hair or nail arsenic observed at Mayo Clinic was 210 mcg/g dry weight in a case of chronic exposure that was the cause of death.

 

MERCURY

Normally, nails contain less than 1 mcg/g of mercury; any amount above this indicates that exposure to more than normal amounts of mercury has occurred.

 

LEAD-

Normally, the nail lead content is below 4.0 mcg/g. Nail lead content above 10.0 mcg/g indicates significant lead exposure.

Day(s) and Time(s) Performed

Tuesday; 3 p.m.

Analytic Time

2 days

Specimen Retention Time

14 days

Test Classification

See Individual Test IDs

CPT Code Information

82175-Arsenic

83655-Lead

83825-Mercury

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HMNA Heavy Metals, Nails In Process

 

Result ID Test Result Name Result LOINC Value
2535 Arsenic, Nails 8157-0
2509 Mercury, Nails 8204-0
2506 Lead, Nails 8202-4
PBNSC Specimen Source 31208-2
HGNSC Specimen Source 31208-2
ASNSC Specimen Source 31208-2

Profile Information

Test ID Reporting Name Available Separately Always Performed
ASNA Arsenic, Nails Yes Yes
PBNA Lead, Nails Yes Yes
HGNA Mercury, Nails Yes Yes