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Test Code LAB0202267 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 PBDV) Yes
CDB Cadmium, B Yes Yes
HG Mercury, B Yes Yes
DEMO6 Patient Demographics No Yes

Method Name

Triple Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)

Reporting Name

Heavy Metals Scrn with Demographics

Specimen Type

Whole blood


Necessary Information


If not ordering electronically, the Lead and Heavy Metals Reporting (T491) is required. Send with specimen.



Specimen Required


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

Supplies: Metal Free B-D Tube (EDTA), 6 mL (T183)

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

Specimen Volume: Full tube

Collection Instructions:

1. See Metals Analysis Specimen Collection and Transport for complete instructions.

2. Send whole blood specimen in original collection tube. Do not aliquot.


Specimen Stability Information

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

Reject Due To

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK

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 less than 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:

For pediatric patients, there may be an association with blood lead values of 5.0 to 9.9 mcg/dL and adverse health effects. The current reference level at which the Centers of Disease Control and Prevention recommends public health actions be initiated is 3.5 mcg/dL in patients 0 to 5 years old and 5 mcg/dL for patients 6 years and older. The most recent National Health and Nutrition Examination Survey (NHANES) data shows that 97.5 percentile for blood lead levels in US adults age 16 years and older is 3.46 mcg/dL. In concurrence with the reference value concept that there is no safe level of lead in blood, the Council of State and Territorial Epidemiologists Occupational Health Subcommittee approved lowering the blood lead threshold from 5 to 3.5 mcg/dL for adults. Follow-up testing after 3 to 6 months may be warranted.

 

Chelation therapy is indicated when whole blood lead concentration is greater than 25.0 mcg/dL in children or greater than 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 greater than 60.0 mcg/dL must be removed from workplace exposure.

-Employees with whole blood lead levels greater than 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 less than 40 mcg/dL.

 

New York State has mandated inclusion of the following statement in reports for children under the age of 6 years 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 concentration is less than 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 concentration is usually less than 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 concentration is greater than 50 ng/mL if exposure is due to alkyl Hg, or greater than 200 ng/mL if exposure is due to Hg(2+).

Day(s) Performed

Monday through Saturday

Report Available

1 to 2 days

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

82175

82300

83655

83825

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

<13 ng/mL

Reference values apply to all ages.

 

LEAD

<3.5 mcg/dL

Critical values

Pediatrics (≤15 years): ≥20.0 mcg/dL

Adults (≥16 years): ≥70.0 mcg/dL

 

CADMIUM

<5.0 ng/mL

Reference values apply to all ages.

 

MERCURY

<10 ng/mL

Reference values apply to all ages.

Testing Algorithm

For more information see Porphyria (Acute) Testing Algorithm