Lead
Label Mnemonic: BLPB
Epic Lab Code: LAB98
Downtime Form: A-1a Doctor/Provider Orders - Pathology Core and Specialty Care Nursery
Chemistry
6240 RCP
356-3527
Specimen(s):
Whole Blood, (By LeadCare)
Collection Medium:
or
Lavender top tube 0.5 mL (EDTA) Lavender top tube 0.6 mL (EDTA)
Alternate Collection Media:
Call laboratory for additional acceptable specimen collection containers.
Minimum:
ONE lavender top (EDTA) microtainer or EDTA MAP tube for pediatric patients. It is recommended that patients at high risk for having elevated lead concentrations have a venous (as opposed to capillary) sample drawn to facilitate confirmatory testing if blood lead concentration exceeds 10 μg/dL.
Testing Schedule:
24 hrs/day, 7 days a week, including holidays.
Turn Around Time:
5 hours (upon receipt in laboratory)
Reference Range:
Children: <10 μg/dL Adults: <10 μg/dL
Comments:
An FDA warning issued May 17, 2017 advises against use of the LeadCare system for analysis of venous specimens due to reports of inaccurate results. This issue does not impact capillary specimens.

Until this issue is resolved, all venous specimens should be ordered using the order "LEAD, VENOUS CONFIRMATION BY ICP-MS" (Epic LAB7479). For urgent management of suspected lead poisoning, it is recommended that capillary collection be used for rapid turnaround time but with a concurrent venous specimen (using the LAB7479 order) also sent for confirmation. Please contact the Pathology Resident on-call (pager 3724) with questions.

By state of Iowa requirements, all lead concentrations of 10 μg/dL or greater by the LeadCare instrument must be confirmed with a venous sample analyzed by a reference method such as atomic absorption or inductively-coupled plasma mass spectrometry (ICP-MS). This requirement is fulfilled by having the test "LEAD, VENOUS CONFIRMATION BY ICP-MS" (Epic LAB7479) available. For the confirmatory test, only a venous specimen is acceptable (i.e., no capillary sample allowable). Venous lead concentrations are currently measured by confirmatory method (ICP-MS). Expected turn- around time is 2-4 days.

The LeadCare Plus assay quantitates blood lead concentrations between 1.9 and 65 μg/dL. Blood lead concentrations below 1.9 μg/dL are reported as <1.9, while lead concentrations greater than 65 μg/dL are reported as >65.

Methodology switched to LeadCare Plus on March 27, 2018.
Methodology:
Electrochemical
CPT Code:
83655
 
See also:
Lead, Confirmation by ICP-MS, Blood (Venous)