Heavy Metals Panel, Blood (Arsenic, Lead, Mercury)


Sunquest Code:HMET  
Epic Code:LAB832Epic Name:Blood Metal Panel
Methodology:Inductively coupled plasma/mass spectrometry
CPT Code:----------CPTCODES HERE----------
Test Includes:Arsenic, lead and mercury
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported in 1-4 days.
Special Instructions:Lead requisition may be required. Notification will be given if required.
Compliance:

This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.



Collection Instructions

Specimen:Blood
Optimal Volume:7 mL
Minimum\Peds Volume:1.5 mL
Patient Preparation:Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician), and avoid shellfish and seafood for 48 to 72 hours.
Causes for Rejection:Specimens collected in tubes other than Royal Blue (EDTA). Specimens transported in containers other than Royal Blue (EDTA) or Trace Element-Free Transport tube. Heparin anticoagulant. Clotted specimens.


Processing and Shipping

Specimen Processing:Whole blood. Do not centrifuge. Send sample in the original collection tube. Store at room temperature.
Shipping Instructions:Ship at room temperature.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:99470


Interpretive

Reference Range:
Arsenic, Blood 0.0-12.0 μg/L
Mercury, Blood 0-10 μg/dL
Lead, Blood 0-4.9 μg/dL
 Mercury is volatile; concentration may decrease over time. If the specimens is drawn and stored in the appropriate container, the arsenic and lead values do not change with time.
 
Blood Lead in Adults:
Result (μg/dL) Comment
Less than or equal to 4.9 No action required.
5.0-9.9 Blood lead concentrations between 5-9.9 μg/dL have been associated with adverse health effects in children under 6 years of age and pregnant women. Thresholds and time intervals for retesting and response vary by state. Contact your State Department of Health for specific guidance on medical management recommendations
10.0-24.9 Identify and minimize exposure.
25.0-49.9 Remove from exposure if symptomatic.
50.0-79.9 Remove from lead exposure. Immediate medical evaluation. Excessive chelation therapy is discouraged.
80.0 or greater Chelation may be indicated if symptomatic. See consultation.
Blood lead in adults, occupationally exposed: Refer to OSHA and/or industrial standards.
 
Blood Lead in Children According to CDC Screening Young Children for Lead Poisoning Program, 1997*
Result (μg/dL) Comment
Less than or equal to 4.9 No action required.
0.0-9.9 Blood lead concentrations between 5-9.9 μg/dL have been associated with adverse health effects in children under 6 years of age and pregnant women. Thresholds and time intervals for retesting and response vary by state. Contact your State Department of Health for specific guidance on medical management recommendations
10.0-14.9 Provide family lead education. Provide at least one follow-up test within 3 months. Refer for social services, if necessary.
15.0-19.9 Provide family lead education. Provide one follow-up test within 2 months. Refer for social services if necessary. If blood levels (BLLs) persist (i.e. two BLLs in this range at least 3 months apart) or increase, proceed according to actions for BLLs 20.0-44.9 μg/dL.
20.0-44.9 Provide coordination of care (case management). Provide clinical management. Provide environment investigation. Provide lead-hazard control.
45.0-69.9 Within 48 hours, begin coordination of care (case management), clinical management, environmental investigation, and lead hazard control.
70.0 or greater This is a critical concentration. A second venous test, hospitalization, appropriate chelation therapy and removal from lead exposure are urgently recommended.
Elevated results from tubes not certified lead-free tubes may be due to contamination. Elevated levels of blood lead should be confirmed with a second specimen collected in a metal-free tube (royal blue, Na2, EDTA or tan K2EDTA)
   


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