Detecting clinically significant lead exposure due to occupational exposure
This test is not a substitute for blood lead screening.
Test Id | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
PBOU | Lead Occupational Exposure | No | No |
CRETR | Creatinine, Random, U | No | No |
PBOU: Triple Quadrupole Inductively Coupled Plasm Mass Spectrometry (ICP-MS/MS)
CRETR: Enzymatic Colorimetric Assay
Lead (Pb)
Pb (Lead)
Urine
The Centers for Disease Control and Prevention recommends venous blood collection for lead testing; see PBDV / Lead, Venous, with Demographics, Blood.
Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Supplies: Urine Tubes, 10 mL (T068)
Collection Container/Tube: Clean, plastic urine container with no metal cap or glued insert
Submission Container/Tube: Plastic vial or clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 3 mL
Collection Instructions:
1. Collect a random urine specimen.
2. See Metals Analysis Specimen Collection and Transport for complete instructions.
1.5 mL
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Urine | Refrigerated (preferred) | 28 days | |
Frozen | 28 days | ||
Ambient | 14 days |
Detecting clinically significant lead exposure due to occupational exposure
This test is not a substitute for blood lead screening.
Lead toxicity primarily affects the gastrointestinal, neurologic, and hematopoietic systems. Increased urine lead concentration per gram of creatinine indicates significant lead exposure. Measurement of urine lead concentration per gram of creatinine before and after chelation therapy has been used as an indicator of significant lead exposure. However, the American College of Medical Toxicology (ACMT 2010) position statement on post-chelator challenge urinary metal testing states that "post-challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may be harmful when applied in the assessment and treatment of patients in whom there is concern for metal poisoning.
Lead blood measurement is the best test for clinical correlation of toxicity. For more information see PBDV / Lead, Venous, with Demographics, Blood.
LEAD/CREATININE:
Biological Exposure Index (BEI): <150 mcg/g creatinine
CREATININE:
> or =18 years: 16-326 mg/dL
Reference values have not been established for patients who are younger than 18 years of age.
Measurements of urinary lead levels have been used to assess lead exposure. However, like blood lead, urinary lead excretion mainly reflects recent exposure and, thus, shares many of the same limitations for assessing lead body burden or long-term exposure.(1,2)
Urinary lead concentration increases exponentially with blood lead and can exhibit relatively high intra-individual variability, even at similar blood lead concentrations.(3,4)
No significant cautionary statements
1. Sakai T. Biomarkers of lead exposure. Ind Health. 2000;38(2):127-142
2. Skerfving S. Biological monitoring of exposure to inorganic lead. In: Clarkson TW, Friberg L, Nordberg GF, Sager PR, eds. Biological Monitoring of Toxic Metals. Rochester Series on Environmental Toxicity. Springer; 1988:169-197
3. Gulson BL, Jameson CW, Mahaffey KR, et al. Relationships of lead in breast milk to lead in blood, urine, and diet of the infant and mother. Environ Health Perspect. 1998;106(10):667-674
4. Skerfving S, Ahlgren L, Christoffersson JO. Metabolism of inorganic lead in man. Nutr Res. 1985;Suppl 1:601-607
5. Kosnett MJ, Wedeen RP, Rotherberg SJ, et al. Recommendations for medical management of adult lead exposure. Environ Health Perspect. 2007;115(3):463-471
6. De Burbane 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(4):584-590
7. Strathmann FG, Blum LM. Toxic elements. In: Rifai N, Chiu RWK, Young I, Burnham CD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 44
8. Hauptman M, Bruccoleri R, Woolf AD. An update on childhood lead poisoning. Clin Pediatr Emerg Med. 2017;18(3):181-192. doi:10.1016/j.cpem.2017.07.010
The metal of interest is analyzed by triple-quadrupole inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Monday through Friday
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.
83655
82570
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
PBUOE | Lead Occupat Exp, Random, U | 13466-8 |
Result Id | Test Result Name |
Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
|
---|---|---|
CRETR | Creatinine, Random, U | 2161-8 |
608894 | Lead Occupational Exposure | 13466-8 |