Lead, Industrial Exposure Panel, Adults


Sunquest Code:PBOCC  
Epic Code:LAB5329Epic Name:Lead, Industrial Exposure Panel Adults
Synonyms:Lead, Occupational Exposure
Methodology:Inductively coupled plasma/ Mass spectrometry/Hematofluorometry
CPT Code:84202, 83655
Turnaround Time:Specimens are sent to reference laboratory Mon-Sat; results are reported within 1-5 days.
Special Instructions:Not available for children under 16 years. Lead requisition form required (ARUP Form #32990).
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:2 mL
Causes for Rejection:Frozen, hemolyzed or clotted specimens; heparin anticoagulant, serum.


Processing and Shipping

Specimen Processing:7 mL, 2 mL minimum, whole blood. Store in refrigerator.
Shipping Instructions:Ship at refrigerated temperature.
Test Performed at or Referral Lab Lab Sendouts  (ARUP)
Referral Lab number:25016 (LEAD-IND)


Interpretive

Reference Range:

Components

Reference Interval

16 y and older

Lead, Blood

0-4.9 mg/dL

Zinc Protoporphyrin (ZPP), Whole Blood

0-40 mg/dL

Zinc Protoporphyrin (ZPP),
to Heme Ratio

0-69 mmol ZPP/mol heme

Elevated results may be due to skin or collection-related contamination, including use of a noncertified lead-free tube. Elevated levels of blood lead should be confirmed with a second specimen collected in a lead-free tube.

 

Reference interval and interpretive comments are based on the Recommendations for Medical Management of Adult Lead Exposure, Environmental Health Perspectives, 2007. Thresholds and time intervals for retesting, medical evaluation and response vary by state and regulatory body. Actions described by OSHA in 1978 are shown below. Contact your state Department of Health and/or applicable regulatory Agency for specific guidance on medical management recommendations.

 

Ages

Concentration

Comment

All ages

5-9.9 mg/dL

Adverse health effects are possible, particularly in pregnant women. Discuss health risks associated with continued lead exposure. For women who are or may become pregnant, reduce lead exposure.

All ages

10-19.9 mg/dL

Reduced lead exposure and increased biological monitoring are recommended.

All ages

20-69.9 mg/dL

Removal from lead exposure and prompt medical evaluation are recommended. Consider chelation therapy when concentrations exceed 50 mg/dL and symptoms of lead toxicity are present.

Less than 19 years of age

Greater than
44.9
mg/dL

Critical: Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present

Greater than 19 years of age

Greater than
69.9
mg/dL

Critical. Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.

 

Action required for workers with elevated lead values OSHA;
Occupational Exposure to Lead, 1978

# of Tests

mg/dL

Action required

1

Greater than or equal to 40.0

Notification of workers in writing; medical examination of worker and consultation.

3

(average)

Greater than or equal to 50.0

Removal of worker from job with potential lead exposure.

1

Greater than or equal to 60.0

Removal of worker from job with potential lead exposure.

2

Less than 40.0

Reinstatement of worker in job with potential lead exposure is based upon symptoms and medical evaluation.

OSHA requirements in effect since 1978 call for the measurement of whole blood lead and zinc protoporphyrins (ZPP) (NCCLS document C42-A, Nov. 1996) to evaluate occupational exposure to lead. OSHA requires ZPP whole blood testing reported in units of mg/dL. For adults, conversion of ZPP units of mg/dL whole blood assumes a hematocrit of 45 percent.
Conversion factor: Umol/mol heme x 0.584 =
mg/dL

 

 

Use:Test not available for children under 16.


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