Test directory: Heavy Metals Panel 3, Blood

Note¹:

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified metal-free collection/transport tube. If contamination concerns exist due to elevated levels of blood arsenic, confirmation with a second specimen collected in a certified metal-free tube is recommended

Potentially toxic ranges for blood arsenic: Greater than or equal to 600 ug/L

Blood arsenic is for the detection of recent exposure poisoning only. Blood arsenic levels in healthy subjects vary considerably with exposure to arsenic in the diet and the environment. A 24- hour urine arsenic is useful for the detection of chronic exposure

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test
Was performed in a CLIA certified laboratory and is intended for clinical purposes
.

Note²:

Analysis performed by Inductively Coupled Plasma-Mass Spectrometry
(ICP-MS).
 
Elevated results may be due to skin or collection-related
contamination, including the use of a noncertified lead-free
tube. If contamination concerns exist due to elevated levels of
blood lead, confirmation with a second specimen collected in a
certified lead-free tube is recommended.
 
Information sources for blood lead reference intervals and
interpretive comments include the CDC's "Childhood Lead               
Poisoning Prevention: Recommended Actions Based on Blood
Lead Level" and the "Adult Blood Lead Epidemiology and
Surveillance: Reference Blood Lead Levels (BLLs) for Adults in
the U.S." Thresholds and time intervals for retesting, medical
evaluation, and response vary by state and regulatory body.
Contact your State Department of Health and/or applicable
regulatory agency for specific guidance on medical
management recommendations.
 
Group    Concentration    Comment
Children 3.5-19.9 ug/dL   Children under the age of 6
                          years are the most vulnerable
                          to the harmful effects of
                          lead exposure. Environmental
                          investigation and exposure
                          history to identify potential
                          sources of lead. Biological
                          and nutritional monitoring
                          are recommended. Follow-up
                          blood lead monitoring is
                          recommended.
 
         20-44.9 ug/dL    Lead hazard reduction and
                          prompt medical evaluation are
                          recommended. Contact a
                          Pediatric Environmental
                          Health Specialty Unit or
                          poison control center for
                          guidance.
  
         Greater than     Critical. Immediate medical
         44.9 ug/dL       evaluation, including
                          detailed neurological exam is
                          recommended. Consider
                          chelation therapy when
                          symptoms of lead toxicity are
                          present. Contact a Pediatric
                          Environmental Health
                          Specialty Unit or poison
                          control center for
                          assistance.
 
Adult    5-19.9 ug/dL     Medical removal is
                          recommended for pregnant
                          women or those who are trying
                          or may become pregnant.
                          Adverse health effects are
                          possible. Reduced lead
                          exposure and increased blood
                          lead monitoring are
                          recommended.
 
         20-69.9 ug/dL    Adverse health effects are
                          indicated. Medical removal
                          from lead exposure is
                          required by OSHA if blood
                          lead level exceeds 50 ug/dL.
                          Prompt medical evaluation is
                          recommended.
 
         Greater than     Critical. Immediate medical
         69.9 ug/dL       evaluation is recommended.
                          Consider chelation therapy
                          when symptoms of lead
                          toxicity are present.
 
This test was developed and its performance characteristics
determined by ARUP Laboratories. It has not been cleared or
approved by the U.S. Food and Drug Administration. This test
was performed in a CLIA-certified laboratory and is intended
for clinical purposes.
.

Note³:

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified metal-free collection/transport tube. If contamination concerns exist due to elevated levels of blood mercury, confirmation with a second specimen collected in a certified metal-free tube is recommended

Blood mercury levels predominantly reflect recent exposure and are most useful in the diagnosis of acute poisoning as blood mercury concentrations rise sharply and fall quickly over several days after ingestion. Blood concentrations in unexposed individuals rarely exceed 20 ug/L. The provided reference interval relates to inorganic mercury concentrations. Dietary and non-occupational exposure to organic mercury forms may contribute to an elevated total mercury result. Clinical presentation after toxic exposure to organic mercury may include dysarthria, ataxia and constricted vision fields with mercury blood concentrations from 20 to 50 ug/L

This test was developed and its performance characteristics determined by ARUP Laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes
.