Specimen Requirements

Minimum Specimen Requirements

Stability

Days Performed

Mon - Fri

Turnaround Time

2 - 6 days

Methodology

Reference Range

Special Info

Patient demographics (Heavy Metals) form is required to meet State Health Department requirements. Both blood and urine must be submitted for testing. Patient Preparation: To avoid contamination, please collect specimens at the beginning of work shift. Urine: Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications upon the advice of their physician. High concentrations of iodine may interfere with elemental testing. Collection of urine specimens from patients receiving iodinated or gadolinium-based contrast media should be avoided for a minimum of 72 hours post-exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days post contrast media exposure. Blood and urine should be collected the same day. Blood: Specimens collected in tubes other than royal blue (EDTA), or specimens transported in containers other than royal blue (EDTA) tubes or trace element-free transport tubes will be rejected. Heparin anticoagulant and clotted specimens are unacceptable. Urine: Specimens collected within 72 hours after administration of iodinated or gadolinium-based contrast media are unacceptable. Specimens transported in non-trace element-free transport tubes (with the exception of the original device) are unacceptable. Specimens containing blood or fecal materials will be rejected. This test is New York DOH approved.

Clinical Info

Interpretations: Blood cadmium levels can be used to monitor acute toxicity and in combination with cadmium urine and B-2 microglobulin is the preferred method for monitoring occupational exposure. 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. 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. Urine B2-Microglobulin is an early marker of irreversible kidney damage and disease. Urine creatinine values less than 20 mg/dL represent very dilute urine and collections should be repeated. OSHA Action Levels: Cadmium, Urine (ug/g crt) : level A: 0-3 ; level B: 3.1-7.0; level C: 7.1 or greater; Cadmium, Blood (ug/L): level A : 0-5; level B: 5.1-10.0; level C: 10.1 or greater; B-2-Microglobulin, Urine (ug/g crt) : level A: 0-300; level B: 301-750; level C: 751 or greater; MONITOR: level A: Annual ; level B: Semiannual ; level C: Quarterly; MEDICAL EXAM: level A: Biennial; level B: Annual; level C: Semiannual; Reassess cadmium exposure in less than two weeks: level A: not applicable; level B: Discretionary removal; level C: Mandatory removal *If an employee's B-2 Microglobulin level is above 750 ug/g CRT, in order for mandatory medical removal to be required, either the employee's CdU level must also be >3 ug/g CRT or CdB level must also be >5 ug/L. *The determination of discretionary or mandatory removal is made by the examining physician consistent with the medical surveillance specifications in the Federal Register 42456 to 42463.

Patient Info Sheet

• Heavy Metals Form