Specimen Requirements

Alternate Specimen Requirements

Minimum Specimen Requirements

Stability

Days Performed

Sun - Sat

Turnaround Time

2 - 6 days

Methodology

Reference Range

Special Info

HEAVY METALS FORM REQUIRED to meet State Health Department requirements. Patient Prep: High concentrations of iodine may interfere with testing. Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, non-essential over-the-counter medications (upon the advice of their physician) and avoid seafood for 48 hours. Avoid iodinated or gadolinium-based contrast media for at least 72 hours or 14 days for patients with impaired kidney function. Collection: Collect in a plastic container, mix well and aliquot into a trace metal free transport tube (ARUP #43116). Record total volume and collection time interval on specimen. Urine transported in a non-trace element-free tube or contaminated with iodine, gadolinium, blood, fecal material or acid preservative will be rejected. This test is New York DOH approved.

Clinical Info

This test may be useful in the assessment of acute and chronic exposure to arsenic, cadmium, mercury, and lead. Urine cadmium levels can be used to assess cadmium body burden. In chronic exposures, the kidneys are the primary target organ. Symptoms associated with cadmium toxicity vary based upon route of exposure and may include tubular proteinuria, fever, headache, dyspnea, chest pain, conjunctivitis, rhinitis, sore throat and cough. Ingestion of cadmium in high concentration may cause vomiting, diarrhea, salivation, cramps, and abdominal pain. Quantification of urine excretion rates before or after chelation therapy has been used as an indicator of lead exposure. Urinary excretion of >125 mg of lead per 24 hours is usually associated with related evidence of lead toxicity. Urinary mercury levels predominantly reflect acute or chronic elemental or inorganic mercury exposure. Urine concentrations in unexposed individuals are typically less than 10 µg/L. 24 hour urine concentrations of 30 to 100 µg/L may be associated with subclinical neuropsychiatric symptoms and tremor while concentrations greater than 100 µg/L can be associated with overt neuropsychiatric disturbances and tremors. Urine mercury levels may be useful in monitoring chelation therapy. The ACGIH Biological Exposure Index (BEI) for arsenic in urine is 35 µg/L. The ACGIH BEI is based on the sum of inorganic and methylated species. For specimens with elevated total arsenic results, fractionation is automatically performed at additional cost to determine the proportions of inorganic, methylated and organic species.

Patient Info Sheet

• Heavy Metals Form