Lead, Whole Blood (Capillary by ICP-MS)

Label Mnemonic:	LEADCAP
Epic code:	LAB9114
Downtime form:	Doctor/Provider Orders - Pathology Core and Specialty Care Nursery

Commercial Mailout Laboratory
6240-8 RCP
356-8593

Specimen(s):

Whole Blood

Specimen Instructions:

Invert specimen 10 times to prevent clot formation.

Collection Medium:

Lavender top tube 0.5 mL (EDTA)

Minimum:

Clean puncture site well with soap and water before collection procedure begins. Invert specimen 10 times to prevent clot formation.

Preferred Minimum: One FULL Lavender 0.5 mL (EDTA) top tube.

Absolute Minimum: 0.3 mL whole blood

Rejection Criteria:

Specimens collected in tubes other than Lavender Pediatric (EDTA). Specimens transported in tubes other than trace-element free transport tubes or Lavender Pediatric (EDTA) tubes. Heparin anticoagulant. Clotted specimens.

Turn Around Time:

1-3 days upon receipt at reference laboratory

Reference Range:

Concentration   Comment
5-9.9 μg/dL     Adverse health effects are possible, particularly
                in children under 6 years of age and pregnant women.
                Discuss health risks associated with continued lead 
                exposure. For children and women who are or may become
                pregnant, reduce lead exposure.
                All ages

10-19.9 μg/dL   Reduced lead exposure and increased biological
                monitoring are recommended.
                All ages

20-69.9 μg/dL   Removal from lead exposure and prompt medical
                evaluation are recommended. Consider chelation therapy 
                when concentrations exceed 50 μg/dL and symptoms 
                of lead toxicity are present.
                All ages

>44.9 μg/dL     Critical.  Immediate medical evaluation is
                recommended. Consider chelation therapy when symptoms 
                of lead toxicity are present.
                Less than 19 years of age

>69.9 μg/dL     Critical.  Immediate medical evaluation is
                recommended. Consider chelation therapy when symptoms 
                of lead toxicity are present.
                Greater than 19 years of age

Interpretive Data:

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified lead-free collection/transport tube. If contamination concerns exist due to elevated levels of blood lead, confirmation with a venous specimen collected in a certified lead-free tube is recommended.

Repeat testing is recommended prior to initiating chelation therapy or conducting environmental investigations of potential lead sources. Repeat testing collections should be performed using a venous specimen collected in a certified lead-free collection tube.

Information sources for reference intervals and interpretive comments include the "CDC Response to the 2012 Advisory Committee on Childhood Lead Poisoning Prevention Report" and the "Recommendations for Medical Management of Adult Lead Exposure, Environmental Health Perspectives, 2007." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.

This test was developed and its performance characteristics determined by reference laboratories. It has not been cleared or approved by the US Food and Drug Administration. This test was performed in a CLIA certified laboratory and is intended for clinical purposes.

Comments:

Recommended for routine testing for lead exposure in pediatric populations. Confirm elevated results with Lead, Venous Confirmation by ICP-MS.

Methodology:

Quantitative Inductively Coupled Plasma/Mass Spectrometry

CPT Code:

83655