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HelpTest Code HMSDM Heavy Metals Screen with Demographics, Blood
Reporting Name
Heavy Metals Scrn with DemographicsUseful For
Detecting exposure to arsenic, lead, cadmium, and mercury
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
Whole bloodNecessary Information
If not ordering electronically, the Lead and Heavy Metals Reporting (T491) form is required. Send with specimen.
Specimen Required
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals 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 Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.
2. Send specimen in original collection tube.
Additional Information: If ordering the trace element blood collection tube from BD, order catalog #368381.
Specimen Minimum Volume
0.3 mL
Testing Algorithm
See Porphyria (Acute) Testing Algorithm in Special Instructions.
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Special Instructions
Reference Values
ARSENIC
Reference values apply to all ages.
LEAD
All ages: <5.0 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.
Day(s) and Time(s) Performed
Monday through Saturday; 2 p.m.
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the U.S. 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 |
Clinical Reference
1. Lee R, Middleton D, Calwell K, et al: A review of events that expose children to elemental mercury in the United States. Environ Health Perspect. 2009;117:871-878
2. Hall M, Chen Y, Ahsan H, et al: Blood arsenic as a biomarker of arsenic exposure: results from a prospective study. Toxicology. 2006;225(2-3):225-233
3. Centers for Disease Control and Prevention. National Report on Human Exposure to Environmental Chemicals. Updated January 2019. Accessed May 5, 2020. Available at www.cdc.gov/exposurereport
4. de Burbure C, Buchet J-P, Leroyer A, et al: Renal and neurologic effects of cadmium, lead, mercury, and arsenic in children: evidence of early effects and multiple interactions at environmental exposure levels. Environ Health Perspect. 2006;114:584-590
5. Kosnett MJ, Wedeen RP, Rothenberg SJ, et al: Recommendations for medical management of adult lead exposure. Environ Health Perspect. 2007;115:463-471
6. Jusko T, Henderson C, Lanphear B, Cory-Slechta DA, Parsons PJ, Canfield RL.: Blood lead concentrations <10 mcg/dL and child intelligence at 6 years of age. Environ Health Perspect. 2008;116:243-248
7. Moreau T, Lellouch J, Juguet B, Claude JR, Juguet B, Festy B: Blood cadmium levels in a general population with special reference to smoking. Arch Environ Health. 1983;38:163-167
8. Bjorkman L, Lundekvam B, Laegreid T, et al: Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study. Environ Health. 2007;6:30
9. deBurbure C, Buchet JP, Leroyer A, et al: Renal and neurologic effects of cadmium, lead, mercury, and arsenic in children: evidence of early effects and multiple interactions at environmental exposure levels. Environ Health Perspect. 2006;114:584-590
Method Description
Arsenic (As), cadmium (Cd), mercury (Hg), and lead (Pb) are analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) in kinetic energy discrimination (KED) mode using helium as a nonreactive gas to collide with polyatomic interferences such as argon chloride (ArCl). Internal standards used are gallium (Ga) for As, rhodium (Rh) for Cd, and lutetium (Lu) and iridium (Ir) summed for Hg and Pb. A salt matrix calibration is used.(Unpublished Mayo method)
Analytic Time
1 dayReject Due To
| Gross hemolysis | OK |
| Gross lipemia | OK |
| Gross icterus | OK |
Method Name
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Forms
Lead and Heavy Metals Reporting (T491) in Special Instructions
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 |