Ordering Recommendation

Recommended for routine testing for lead exposure in pediatric populations. Confirm elevated results with Lead, Blood (Venous) (0020098).

Mnemonic
LEAD CAP
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

Clean puncture site well with soap and water before collection procedure begins.

Collect

Lavender Pediatric (EDTA).

Specimen Preparation

Invert specimen 10 times to prevent clot formation. Transport 0.5 mL whole blood. (Min: 0.3 mL)

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Unacceptable Conditions

Specimens collected in tubes other than Lavender Pediatric (EDTA). Specimens transported in tubes other than trace-element free transport tubes or Lavender Pediatric (EDTA) tubes. Heparin anticoagulant. Clotted specimens.
Venous whole blood, refer to Lead, Blood (Venous) 0020098.

Remarks

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

Stability

Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable

Reference Interval

Less than or equal to 4.9 µg/dL

Interpretive Data

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified lead-free collection/transport tube. If contamination concerns exist due to elevated levels of blood lead, confirmation with a venous specimen collected in a certified lead-free tube is recommended.

Repeat testing is recommended prior to initiating chelation therapy or conducting environmental investigations of potential lead sources. Repeat testing collections should be performed using a venous specimen collected in a certified lead-free collection tube.

Information sources for reference intervals and interpretive comments 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 ages 5-9.9 µg/dL Adverse health effects are possible, particularly in children under 6 years of age and pregnant women. Discuss health risks associated with continued lead exposure. For children and women who are or may become pregnant, reduce lead exposure.
All ages 10-19.9 µg/dL Reduced lead exposure and increased biological monitoring are recommended.
All ages 20-69.9 µg/dL Removal 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.
Less than 19 years of age Greater than 44.9 µg/dL Critical.  Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.
Greater than 19 years of age Greater than 69.9 µg/dL Critical.  Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.

Compliance Category

Laboratory Developed Test (LDT)

Note
Hotline History
N/A
CPT Codes

83655

Components
Component Test Code* Component Chart Name LOINC
0020745 Lead, Blood (Capillary) 10368-9
* 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
  • Capillary blood level
  • Lead (Pediatric)
  • Pb
  • Pb, Blood
  • Pb, Pediatric
  • Pb, Whole Blood
Lead, Blood (Capillary)