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) (0020098) is preferred.
Quantitative Inductively Coupled Plasma-Mass Spectrometry/Hematofluorometry
Collect from patient aged 16 years or older.
Royal blue (K2EDTA or Na2EDTA) or tan (K2EDTA).
Transport 7 mL whole blood (royal blue), (Min: 2 mL) OR Transport 3 mL whole blood (tan) (Min: 2 mL)
Serum. Specimens collected in tubes other than Royal Blue (K2EDTA or Na2EDTA) or tan (K2EDTA). Heparinized, hemolyzed or clotted specimens.
Trace Elements requisition form may be required (ARUP form #32990).
Ambient: 30 hours; Refrigerated: 5 weeks; Frozen: Unacceptable
|Lead, Industrial, Whole Blood||Less than or equal to 4.9 µg/dL|
|Zinc Protoporphyrin, Blood||0-40 µg/dL|
|Zinc Protoporphyrin (ZPP) WholeBld Ratio||0-69 µmol ZPP/mol heme|
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 second specimen collected in a certified lead-free tube is recommended.
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
|1||Greater than or equal to 40.0 µg/dL||Notification of worker in writing; medical examination of worker and consultation.|
|3 (average)||Greater than or equal to 50.0 µg/dL||Removal of worker from job with potential lead exposure.|
|1||Greater than or equal to 60.0 µg/dL||Removal of worker from job with potential lead exposure.|
|2||Less than 40.0 µg/dL||Reinstatement 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.
|All ages||5-9.9 µg/dL||Adverse 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 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.|
|<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.|
|≥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.|
Laboratory Developed Test (LDT)
|Component Test Code*||Component Chart Name||LOINC|
|0020606||Zinc Protoporphyrin (ZPP) WholeBld Ratio||29763-0|
|0020613||Zinc Protoporphyrin, Blood||2895-1|
|0025015||Lead, Industrial, Whole Blood||77307-7|
- Blood Lead Level
- Blood Lead Test
- Lead Exposure
- Lead, blood