Order Code PBPFD Lead Profile Occupational Exposure, Blood
Ordering Guidance
This test is only for assessment of occupational exposure to lead. The preferred test for lead toxicity in children is blood lead. For more information see:
-PBDV / Lead, Venous, with Demographics, Blood
-PBDC / Lead, Capillary, with Demographics, Blood
The preferred screening test for suspicion of a hepatic porphyria is urine porphyrins. For more information see PQNRU / Porphyrins, Quantitative, Random, Urine.
Necessary Information
Include a list of medications the patient is currently taking.
Specimen Required
Both EDTA whole blood and heparin whole blood specimens are required.
Patient Preparation:
1. High concentrations of gadolinium and iodine are known to interfere with most inductively couple 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.
2. Patient should abstain from alcohol for 24 hours prior to specimen collection.
Specimen Type: Whole blood
Supplies:
-Metal Free B-D Tube (EDTA), 6 mL (T183)
-Metal Free B-D Tube (EDTA), 3 mL (T989)
-Microtainer (EDTA) Tube, 0.5 mL (T174)
Container/Tube:
Preferred: Royal blue-top BD Vacutainer Plus with EDTA blood collection tube (6 mL) (BD catalog no. 368381)
Acceptable: Royal blue-top BD vacutainer with EDTA blood collection tube (3 mL), BD Microtainer with EDTA, or royal blue-top Monoject trace element blood collection tube
Specimen Volume: 2 mL
Collection Instructions:
1. See Metal Analysis Specimen Collection and Transport for complete instructions.
2. Send whole blood specimen in original tube. Do not aliquot.
3. Refrigerate specimen as soon as possible.
Specimen Type: Whole blood
Container/Tube:
Preferred: Green top (sodium heparin)
Acceptable: Dark blue top (metal free heparin), green top (lithium heparin), or lavender top (EDTA)
Specimen Volume: 4 mL
Collection Instructions: Refrigerate specimen as soon as possible after collection.
Forms
Useful For
Detecting lead toxicity due to occupational exposure
Profile Information
Test ID | Reporting Name | Available Separately | Always Performed |
---|---|---|---|
PBB | Lead, B | Yes, (order PBDV) | Yes |
PPFE | Protoporphyrins, Fractionation, WB | Yes | Yes |
DEMO5 | Patient Demographics | No | Yes |
Special Instructions
Method Name
PBB: Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
PPFE: High-Performance Liquid Chromatography (HPLC) with Fluorescence Detection
Reporting Name
Lead Profile Occ Exposure, BSpecimen Type
Whole bloodSpecimen Minimum Volume
See Specimen Required
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated | 7 days |
Reject Due To
Gross hemolysis | Reject |
Gross lipemia | Reject |
Clotted blood | Reject |
Reference Values
LEAD: <3.5 mcg/dL
The Occupational Safety and Health Administration (OSHA) recommended limit for blood lead level is 40 mcg/dL (OSHA 1978).
The biological exposure index (BEI) for Pb in blood of exposed workers is 20 mcg/dL (ACGIH 2018).
Critical Values:
Pediatrics (≤15 years): ≥20.0 mcg/dL
Adults (≥16 years): ≥70.0 mcg/dL
PROTOPORPHYRINS, FRACTIONATION
Free Protoporphyrin: <20 mcg/dL
Zinc-Complexed Protoporphyrin: <60 mcg/dL
Method Description
Lead
The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)
Protoporphyrins, Fractionation
Extraction followed by fractionation by high-performance liquid chromatography. Zinc protoporphyrin and free protoporphyrin are separately quantitated.(Smith RM, Doran D, Mazur M, Bush B. High-performance liquid chromatographic determination of protoporphyrin and zinc protoporphyrin in blood. J Chromatogr.1980;181[3-4]:319-327; Gou EE, Balwani M, Bissell DM, et al. Pitfalls in erythrocyte protoporphyrin measurement for diagnosis and monitoring of protoporphyrias. Clin Chem. 2015;61[12]:1453-1456. doi:10.1373/clinchem.2015.245456)
Day(s) Performed
Monday, Wednesday, Friday
Performing Laboratory
Mayo Clinic Laboratories in RochesterCPT Code Information
83655
82542