Useful in the assessment of acute and chronic exposure to arsenic, mercury, and lead. The preferred test for the assessment of lead exposure is Lead, Blood (Venous) (0020098). For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016) and/or Cadmium Exposure Panel - OSHA (0025013).
- Patient Preparation
- 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 shellfish and seafood for 48 to 72 hours. 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.
- Random urine.
- Specimen Preparation
- Transfer an 8 mL aliquot from a well-mixed collection to ARUP Trace Element-Free Transport Tubes (ARUP supply #43116), available online through eSupply using ARUP Connect or contact ARUP Client Services at (800) 522-2787. (Min: 2 mL)
- Storage/Transport Temperature
- Refrigerated. Also acceptable: Room temperature or frozen.
- Unacceptable Conditions
- Urine collected within 72 hours after administration of iodinated or gadolinium-based contrast media. Acid preserved urine. Specimens contaminated with blood or fecal material. Specimens transported in non-trace element-free transport tube (with the exception of the original device).
- Ambient: 1 week; Refrigerated: 2 weeks; Frozen: 1 year
|Test Number||Components||Reference Interval|
| ||Arsenic Urine - per volume||Effective November 13, 2017|
0.0-34.9 µg/L (based on Biological Exposure Index)
| ||Arsenic, Urine - ratio to CRT||Effective November 13, 2017|
|0020734||Arsenic, Fractionated, Urine|
| ||Lead, Urine - ratio to CRT||Effective November 12, 2018|
| ||Lead, Urine - per volume||Effective November 12, 2018|
| ||Mercury, Urine - per volume||Effective November 12, 2018|
| ||Mercury, Urine - ratio to CRT||Effective November 13, 2017|
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 tremors. 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 a total arsenic concentration of 35 to 2000 µg/L, fractionation is automatically performed to determine the proportions of inorganic, methylated and organic species. It may be appropriate to request fractionation for specimens with a total arsenic greater than 30 µg/gCRT despite a total arsenic concentration less than 35 µg/L. If low-level chronic poisoning is suspected, the µg/gCRT ratio may be a more sensitive indicator of arsenic exposure than the total arsenic concentration.
|Component Test Code*||Component Chart Name||LOINC|
|0020207||Creatinine, Urine - per volume||2161-8|
|0025001||Arsenic Urine - per volume||5586-3|
|0025052||Mercury, Urine - per volume||5689-5|
|0025054||Mercury, Urine - ratio to CRT||13465-0|
|0025058||Arsenic, Urine - ratio to CRT||13463-5|
|0025062||Lead, Urine - per volume||5676-2|
|0025065||Lead, Urine - ratio to CRT||13466-8|
- Mercury concentation
- Urine AS
- Urine AS concentration
- Urine concentration