Determining antimony toxicity
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Sb (Antimony)
Whole 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: Greiner Bio-One VACUETTE TUBE 6 mL NH Trace Elements Sodium Heparin tube (T819)
Container/Tube: Required: Greiner Bio-One Vacuette Tube 6 mL NH Trace Elements Sodium Heparin tube (Becton-Dickinson (BD) royal blue-top tubes are not acceptable.)
Specimen Volume: 0.8 mL
Collection Instructions:
1. See Metals Analysis Specimen Collection and Transport for complete instructions.
2. Send whole blood specimen in original tube. Do not aliquot.
0.25 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated | 7 days |
Determining antimony toxicity
Antimony is a silvery white metal that is used in alloys for lead batteries, solder, sheet metal, bearings, castings, ammunition, and pewter. It is also used for pigments, abrasives, flame-proofing fabrics, and in medications (ie, sodium stibogluconate [Pentostam], which is used to treat cutaneous leishmaniasis).(1) Antimony typically enters the environment during mining, processing of ores, emissions from coal-burning power plants, and production of alloys. Exposure to antimony can occur through inhalation, ingestion, or dermal contact with soil, water, foods, or certain medications. In the workplace, exposure is usually via inhalation. The Occupational Safety and Health Administration has set a limit of 0.5 mg/m(3) of antimony in workroom air to protect workers during an 8-hour work shift (40-hour workweek).(2)
Absorption of antimony through the lungs may take days to weeks. Absorption of antimony from ingestion typically enters the blood within a few hours.(2) The amount and form of the antimony affects how much is absorbed. Once in the blood, antimony is distributed to the liver, lungs, intestines, and spleen. Elimination is primarily through the urine, occurring over several weeks. The half-life varies depending on the chemical form. Trivalent antimony is primarily bound to erythrocytes, while pentavalent antimony is primarily found in plasma, which makes whole blood the preferred specimen to analyze for acute intoxication. Whole blood concentrations in healthy subjects not exposed to antimony averaged 0.7 mcg/L and usually do not exceed 2 mcg/L.(3) In battery plant workers, median blood antimony concentrations of 2.6 mcg/L were found in metal casters and 10 mcg/L in metal form workers.(4)
The effects of acute or chronic antimony poisoning are similar to arsenic poisoning and include abdominal pain, dyspnea, nausea, vomiting, dermatitis, and visual disturbances.(1) Additionally, toxicity can include pneumoconiosis and altered electrocardiograms.(2)
<3 ng/mL (unexposed)
3-10 ng/mL (exposed)
Normal blood concentrations are 0.7 to 2 ng/mL in the unexposed population and 2.6 to 10 ng/mL in exposed workers.(3)
No significant cautionary statements
1. Baselt R. Disposition of Toxic Drugs and Chemicals In Man. 10th ed. Biomedical Publications; 2014
2. Agency for Toxic Substances and Disease Registry: Toxicological profile for antimony and compounds. US Department of Health and Human Services; October 2019. Accessed May 18, 2020. Available at www.atsdr.cdc.gov/toxprofiles/tp23.pdf
3. Gebel T, Claussen K, Dunkelberg H. Human biomonitoring of antimony. Int Arch Occup Environ Health. 1998;71(3):221-224
4. Kentner M, Leinemann M, Schaller KH, Weltle D, Lehnert G. External and internal antimony exposure in starter battery production. Int Arch Occup Environ Health. 1995;67(2):119-123
5. Sodi R. Vitamins and trace elements. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 39
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Wednesday
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.
83018
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
SBWB | Antimony, B | 5578-0 |
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.
|
---|---|---|
64273 | Antimony, B | 5578-0 |