Ordering Recommendation

Useful in the assessment of recent exposure to arsenic, cadmium, mercury, and lead. For chronic exposure or the determination of arsenic species, refer to Heavy Metals Panel 4, Urine with Reflex to Arsenic Fractionation (0020572). For occupational exposure, consider Lead, Industrial Exposure Panel, Adults (0025016) and/or Cadmium Exposure Panel - OSHA (0025013).

Mnemonic
HY MET B4
Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry

Performed

Sun-Sat

Reported

1-3 days

New York DOH Approval Status
This test is New York DOH approved.
Specimen Required
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.

Collect

Royal blue (K2EDTA or Na2EDTA).

Specimen Preparation

Transport 7 mL whole blood. (Min: 0.5 mL)

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Unacceptable Conditions

Specimens collected in tubes other than Royal Blue (EDTA). Specimens transported in containers other than Royal Blue (EDTA) tube or Trace Element-Free Transport Tube. Heparin anticoagulant. Clotted specimens.

Remarks

Trace Elements requisition form may be required (ARUP form #32990).

Stability

Ambient: 1 week; Refrigerated: 1 week; Frozen: Unacceptable

Reference Interval
Test Number
Components
Reference Interval
0099045 Arsenic, Blood 0.0-12.0 µg/L
0099675 Cadmium, Blood 0.0-5.0 µg/L
0099305 Mercury, Whole Blood 0.0-10.0 µg/L
0020098 Lead, Blood (Venous) 0.0-4.9 µg/dL

Interpretive Data

Refer to report.

Compliance Statement B: For laboratory developed tests not using a RUO kit, and for FDA approved, cleared or 510(k) exempt assays with alterations. 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

Mercury is volatile; concentration may decrease over time.  If the specimen is drawn and stored in the appropriate container, the arsenic, cadmium, and lead values do not change with time.

Hotline History
N/A
CPT Codes

82175; 83655; 83825; 82300

Components
Component Test Code* Component Chart Name LOINC
0020098 Lead, Blood (Venous) 77307-7
0099045 Arsenic Blood 5583-0
0099305 Mercury Blood 5685-3
0099675 Cadmium, Blood 5609-3
* 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
  • Arsenic
  • AS blood level
  • Cadmium
  • Cd blood level
  • Heavy metals blood levels
  • Hg blood level
  • Lead
  • Mercury
  • Pb blood level
Heavy Metals Panel 4, Blood