Detecting acute or very recent arsenic exposure
Monitoring the effectiveness of therapy
This test is not useful for evaluation of chronic arsenic exposure.
Triple Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)
As (Arsenic)
Arsenic (As)
Whole blood
The preferred method of screening for arsenic exposure is measurement of urinary arsenic concentration. Order either SPASU / Arsenic Speciation, 24 Hour, Urine or SPAS / Arsenic Speciation, Random, Urine.
Patient Preparation: High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based metal 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 Metals Analysis Specimen Collection and Transport for complete instructions.
2. Send whole blood specimen in original collection tube. Do not aliquot.
0.3 mL
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated (preferred) | 28 days | |
Ambient | 28 days | ||
Frozen | 28 days |
Detecting acute or very recent arsenic exposure
Monitoring the effectiveness of therapy
This test is not useful for evaluation of chronic arsenic exposure.
Arsenic (As) exists in a number of toxic and nontoxic forms. The toxic forms are the inorganic species As(5+), also denoted as As(V), the more toxic As(3+), also known as As(III), and their partially detoxified metabolites, monomethylarsonic acid (MMA) and dimethylarsinic acid (DMA). Detoxification occurs in the liver as As(3+) is oxidized to As(5+) and then methylated to MMA and DMA. As a result of these detoxification steps, As(3+) and As(5+) are found in the urine shortly after ingestion, whereas MMA and DMA are the species that predominate more than 24 hours after ingestion.
Blood concentrations of arsenic are elevated for a short time after exposure, after which arsenic rapidly disappears into tissues because of its affinity for tissue proteins. The body treats arsenic like phosphate, incorporating it wherever phosphate would be incorporated. Arsenic "disappears" into the normal body pool of phosphate and is excreted at the same rate as phosphate (excretion half-life of 12 days). The half-life of inorganic arsenic in blood is 4 to 6 hours, and the half-life of the methylated metabolites is 20 to 30 hours. Abnormal blood arsenic concentrations (>12 ng/mL) indicate significant exposure but will only be detected immediately after exposure. Arsenic is not likely to be detected in blood specimens drawn more than 2 days after exposure because it has become integrated into nonvascular tissues. Consequently, blood is not a good specimen to screen for arsenic, although periodic blood levels can be determined to follow the effectiveness of therapy. Urine is the preferred specimen for assessment of arsenic exposure.
A wide range of signs and symptoms may be seen in acute arsenic poisoning, including headache, nausea, vomiting, diarrhea, abdominal pain, hypotension, fever, hemolysis, seizures, and mental status changes. Symptoms of chronic poisoning, also called arseniasis, are mostly insidious and nonspecific. The gastrointestinal tract, skin, and central nervous system are usually involved. Nausea, epigastric pain, colic (abdominal pain), diarrhea, and paresthesias of the hands and feet can occur.
<13 ng/mL
Reference values apply to all ages.
Abnormal blood arsenic concentrations (>12 ng/mL) indicate significant exposure.
Absorbed arsenic is rapidly distributed into tissue storage sites with a blood half-life of less than 6 hours. Unless a blood specimen is drawn within 2 days of exposure, arsenic is not likely to be detected in a blood specimen.
No significant cautionary statements
1. 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
2. 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
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Monday through Saturday
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.
82175
Test Id | Test Order Name | Order LOINC Value |
---|---|---|
ASB | Arsenic, B | 5583-0 |
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.
|
---|---|---|
32190 | Arsenic, B | 5583-0 |