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Test Catalog

Test ID: PBUOE    
Lead Occupational Exposure, Random, Urine

Useful For Suggests clinical disorders or settings where the test may be helpful

Detecting clinically significant lead exposure due to occupational exposure

 

This test is not a substitute for blood lead screening.

Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test

Lead toxicity primarily affects the gastrointestinal, neurologic, and hematopoietic systems. Increased urine lead concentration per gram of creatinine indicates significant lead exposure. Measurement of urine lead concentration per gram of creatinine before and after chelation therapy has been used as an indicator of significant lead exposure. However, the American College of Medical Toxicology (ACMT 2010) position statement on post-chelator challenge urinary metal testing states that "post-challenge urinary metal testing has not been scientifically validated, has no demonstrated benefit, and may be harmful when applied in the assessment and treatment of patients in whom there is concern for metal poisoning."

 

Blood lead is the best clinical correlation of toxicity. For additional information, see PBDV / Lead, Venous, with Demographics, Blood.

Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.

Biological Exposure Index (BEI): <150 mcg/g creatinine

Interpretation Provides information to assist in interpretation of the test results

Measurements of urinary lead levels have been used to assess lead exposure. However, like lead blood, urinary lead excretion mainly reflects recent exposure and thus shares many of the same limitations for assessing lead body burden or long-term exposure.(1,2)

 

Urinary lead concentration increases exponentially with blood lead and can exhibit relatively high intra-individual variability, even at similar blood lead concentrations.(3,4)

Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances

No significant cautionary statements

Clinical Reference Recommendations for in-depth reading of a clinical nature

1. Sakai T: Biomarkers of lead exposure. Ind Health. 2000;38(2):127-142

2. Skerfving S: Biological monitoring of exposure to inorganic lead. In: Clarkson TW, Friberg L, Nordberg GF, Sager PR, eds. Biological Monitoring of Toxic Metals. Rochester Series on Environmental Toxicity. Springer; 1988:169-197

3. Gulson BL, Jameson CW, Mahaffey KR, et al: Relationships of lead in breast milk to lead in blood, urine, and diet of the infant and mother. Environ Health Perspect. 1998;106(10):667-674

4. Skerfving S, Ahlgren L, Christoffersson JO: Metabolism of inorganic lead in man. Nutr Res 1985;Suppl 1:601-607

5. Kosnett MJ, Wedeen RP, Rotherberg SJ, et al: Recommendations for medical management of adult lead exposure. Environ Health Perspect. 2007;115:463-471

6. De Burbane C, Buchet JP, Leroyer A, et al: Renal and neurologic effects of cadmium, lead, mercury, and arsenic in children: evidence of early effects and multiple interactions at environmental exposure levels. Environ Health Perspect. 2006;114:584-590

7. Strathmann FG, Blum LM: Toxic elements. In: Rafai N, Horwath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018:chap 42

Special Instructions Library of PDFs including pertinent information and forms related to the test