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, Whole Blood (Venous) (0020098) is preferred.

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Collect from patient aged 16 years or older.

Collect

Royal blue(K2EDTA), Royal blue (NaHep) or tan (K2EDTA).

Specimen Preparation

Transport 3 or 6 mL whole blood (royal blue) (Min: 0.5 mL) OR Transport 3 mL whole blood (tan) (Min: 0.5 mL)

Storage/Transport Temperature

Refrigerated.

Unacceptable Conditions

Serum. Specimens collected in tubes other than Royal blue(K2EDTA), Royal blue (NaHep), or tan (K2EDTA). Hemolyzed or clotted specimens.

Remarks
Stability

Ambient: 30 hours; Refrigerated: 5 weeks; Frozen: Unacceptable

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)/Hematofluorometry

Performed

Sun-Sat

Reported

1-5 days

Reference Interval

Test Number
Components
Reference Interval
  Lead, Industrial, Whole Blood Less than or equal to 3.4 µg/dL
  Zinc Protoporphyrin (ZPP), Whole Blood 0-40 µg/dL
  Zinc Protoporphyrin (ZPP) WholeBld Ratio 0-69 µmol ZPP/mol heme

Interpretive Data

Interpretive Data
Reference intervals are based on the CDC's Blood Lead Reference Value (BLRV). 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. Actions described by OSHA in 1978 and finalized in 1983 are shown below.


Elevated results may be due to skin- or collection-related contamination, including the use of tubes that are not certified to be trace element free. If an elevated result is suspected to be due to contamination, confirmation with a second specimen collected in a certified trace element-free tube is recommended.

Methodology: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS).


"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
1 Greater than 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.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

N/A

CPT Codes

83655; 84202

Components

Component Test Code* Component Chart Name LOINC
0020606 Zinc Protoporphyrin (ZPP) WholeBld Ratio 29763-0
0020613 Zinc Protoporphyrin (ZPP), Whole Blood 2895-1
0025015 Lead, Industrial, Whole Blood 77307-7
* 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

  • Blood Lead Test
  • BLL
  • Lead, blood
  • Blood Lead Level
  • Lead
  • Pb
  • Lead Exposure
Lead, Industrial, Whole Blood