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Test Code PBUOE Lead Occupational Exposure, Random, Urine


Ordering Guidance


The Centers for Disease Control and Prevention recommends venous blood collection for lead testing; see PBDV / Lead, Venous, with Demographics, Blood.



Specimen Required


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.


Useful For

Detecting clinically significant lead exposure due to occupational exposure

 

This test is not a substitute for blood lead screening.

Profile Information

Test ID Reporting Name Available Separately Always Performed
PBOU Lead Occupational Exposure No No
CRETR Creatinine, Random, U No No

Method Name

PBOU: Triple Quadrupole Inductively Coupled Plasm Mass Spectrometry (ICP-MS/MS)

CRETR: Enzymatic Colorimetric Assay

Reporting Name

Lead Occupat Exp, Random, U

Specimen Type

Urine

Specimen Minimum Volume

1.5 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

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.

Reference Values

LEAD/CREATININE:

Biological Exposure Index (BEI): <150 mcg/g creatinine

 

CREATININE:

≥18 years: 16-326 mg/dL

Reference values have not been established for patients who are younger than 18 years of age.

Interpretation

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)

Cautions

No significant cautionary statements

Method Description

The metal of interest is analyzed by triple-quadrupole inductively coupled plasma mass spectrometry.(Unpublished Mayo method)

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

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.

CPT Code Information

83655

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
PBUOE Lead Occupat Exp, Random, U 13466-8

 

Result ID Test Result Name Result LOINC Value
CRETR Creatinine, Random, U 2161-8
608894 Lead Occupational Exposure 13466-8

Day(s) Performed

Monday through Friday

Report Available

2 to 4 days