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Lead, Industrial Exposure Panel, Adults
0025016
Ordering Recommendation
Recommended for the assessment of industrial lead exposure in adults and provides exposure guidance in accordance with OSHA regulations. To assess lead exposure in a non-occupational setting, Lead, Blood (Venous) testing (0020098) is preferred.
Mnemonic
LEAD-IND
Methodology
Quantitative Inductively Coupled Plasma-Mass Spectrometry/Hematofluorometry
Performed
Mon-Fri
Reported
1-5 days
New York DOH Approval Status
This test is New York DOH approved.
Submit With Order
Specimen Required
Patient Preparation
Collect from patient aged 16 years or older.  
Collect
Royal blue (K2EDTA or Na2EDTA) or tan (K2EDTA).  
Specimen Preparation
Transport 7 mL whole blood (royal blue) OR 3 mL whole blood (tan) (Min: 2 mL)  
Storage/Transport Temperature
Refrigerated.  
Unacceptable Conditions
Serum. Heparinized, hemolyzed or clotted specimens.  
Remarks
Trace Elements requisition form may be required (ARUP form #32990).  
Stability
Ambient: 30 hours; Refrigerated: 5 weeks; Frozen: Unacceptable  
Reference Interval
Test Number
Components
Reference Interval
 Lead, Industrial, Whole Blood0-4.9 µg/dL
 Zinc Protoporphyrin, Blood0-40 µg/dL
 Zinc Protoporphyrin - Ratio to Hgb0-69 µmol ZPP/mol heme

Interpretive Data
Elevated results may be due to skin or collection-related contamination, including use of a noncertified lead-free tube. Elevated levels of blood lead should be confirmed with a second specimen collected in a lead-free tube.

Reference interval and interpretive comments are based on 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. Actions described by OSHA in 1978 and finalized in 1983 are shown below. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.

"Occupational Safety and Health Standards: Lead (1983). 29 CFR Part 1910.1025 App C"


Action required for workers with Elevated Lead Values OSHA, Occupational Exposure to Lead, 1978
No. of Tests
Lead
Action Required
1Greater than or equal to 40.0 µg/dLNotification of worker in writing; medical examination of worker and consultation.
3 (average)Greater than or equal to 50.0 µg/dLRemoval of worker from job with potential lead exposure.
1Greater than or equal to 60.0 µg/dLRemoval of worker from job with potential lead exposure.
2Less than 40.0 µg/dLReinstatement of worker in job with potential lead exposure is based upon symptoms and medical evaluation.
OSHA requirements in effect since 1978 call for the measurement of whole blood lead and zinc protoporphyrins (ZPP) (NCCLS document C42-A, Nov. 1996) to evaluate the occupational exposure to lead. OSHA requires ZPP whole blood testing to be reported in units of µg/dL. For adults, conversion of ZPP units of µg/dL whole blood assumes a hematocrit of 45 percent. Conversion factor: µmol/mol heme x 0.584= µg/dL.

Information sources for reference intervals and interpretive comments provided below 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.

Age
Concentration
Comment
All ages5-9.9 µg/dLAdverse health effects are possible, particularly in children under 6 years of age pregnant women. Discuss health risks associated with continued lead exposure. For children and women who are or may become pregnant, reduce lead exposure.
All ages10-19.9 µg/dLReduced lead exposure and increased biological monitoring are recommended.
All ages20-69.9 µg/dLRemoval 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.
<19 years of ageGreater than 44.9 µg/dLCritical. Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.
{>=}19 years of ageGreater than 69.9 µg/dLCritical. Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.

Compliance Statement B: This test was developed and its performance characteristics determined by ARUP Laboratories. The U.S. Food and Drug Administration has not approved or cleared this test; however, FDA clearance or approval is not currently required for clinical use. The results are not intended to be used as the sole means for clinical diagnosis or patient management decisions.
Note
CPT Code(s)
83655; 84202
Components
Component Test Code*Component Chart NameLOINC
0020606Zinc Protoporphyrin - Ratio to Hgb29763-0
0020613Zinc Protoporphyrin, Blood2895-1
0025015Lead, Industrial, Whole Blood5671-3
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.
Aliases
  • BLL
  • Blood Lead Level
  • Blood Lead Test
  • Lead
  • Lead Exposure
  • Lead, blood
  • Pb