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Test Code HMSDM Heavy Metals Screen with Demographics, Blood

Reporting Name

Heavy Metals Scrn with Demographics

Useful For

Detecting exposure to arsenic, lead, cadmium, and mercury

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type

Whole blood


Necessary 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

Reference Values

ARSENIC

<13 ng/mL

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 day

Reject 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

Secondary ID

39183