Test Catalog

Test Id : PBDC

Lead, Capillary, with Demographics, Blood

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

Detecting lead toxicity with capillary collections

Profile Information
A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.

Test Id Reporting Name Available Separately Always Performed
PBBC Lead, Capillary, B No Yes
DEMO7 Patient Demographics No Yes

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

Method Name
A short description of the method used to perform the test

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

NY State Available
Indicates the status of NY State approval and if the test is orderable for NY State clients.

Yes

Reporting Name
Lists a shorter or abbreviated version of the Published Name for a test

Lead, Capillary, w/Demographics, B

Specimen Type
Describes the specimen type validated for testing

Whole blood

Ordering Guidance

The CDC recommends venous collection of samples for lead testing. Capillary lead testing is acceptable for pediatrics and patients with phlebotomy considerations, but capillary blood collection may be more susceptible to contamination. Elevated capillary blood levels must be confirmed with a venous lead blood test (PBDV / Lead, Venous, with Demographics, Blood).

ORDER QUESTIONS AND ANSWERS

Question ID Description Answers
PTAD7 Patient Street Address
PTCI7 Patient City
PTST7 Patient State
PTZI7 Patient Zip Code
PTCN7 Patient County
PTPH7 Patient Home Phone
PTRA7 Patient Race
PTET7 Patient Ethnicity
PTOC7 Patient Occupation
PTEM7 Patient Employer
GDFN7 Guardian First Name
GDLN7 Guardian Last Name
MDOR7 Health Care Provider Name
MDAD7 Health Care Provider Street Address
MDCI7 Health Care Provider City
MDST7 Health Care Provider State
MDZI7 Health Care Provider Zip Code
MDPH7 Health Care Provider Phone
LABP7 Submitting Laboratory Phone

Specimen Required
Defines the optimal specimen required to perform the test and the preferred volume to complete testing

Patient Preparation: High concentrations of gadolinium and iodine are known to interfere with most metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.

Supplies: Microtainer (EDTA) Tube, 0.5 mL (T174)

Collection Container/Tube: BD Microtainer with EDTA

Specimen Volume: 0.4 mL

Collection Instructions:

1. See Trace Metals Analysis Specimen Collection and Transport for complete instructions.

2. Send specimen in original tube.

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

Forms

1. Lead and Heavy Metals Reporting (T491)

2. If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.

Specimen Minimum Volume
Defines the amount of sample necessary to provide a clinically relevant result as determined by the Testing Laboratory

0.1 mL

Reject Due To
Identifies specimen types and conditions that may cause the specimen to be rejected

Gross hemolysis OK
Gross lipemia OK
Gross icterus OK
Clotted Blood Reject

Specimen Stability Information
Provides a description of the temperatures required to transport a specimen to the performing laboratory, alternate acceptable temperatures are also included

Specimen Type Temperature Time Special Container
Whole blood Refrigerated (preferred) 28 days
Ambient 28 days
Frozen 28 days

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

Detecting lead toxicity with capillary collections

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

Lead is a heavy metal naturally found in the environment that can be an acute and chronic toxin. Lead can enter the environment through releases from mining lead and other metals, and from factories that make or use lead, lead alloys, or lead compounds. Lead is released into the air during burning coal, oil, or waste. Before the use of leaded gasoline in motor vehicles was banned (January 1, 1996), most of the lead released into the United States environment came from vehicle exhaust.

 

Lead was banned from household paints in 1978 but is still found in paint produced for nondomestic use and in artistic pigments. Ceramic products available from noncommercial suppliers (such as local artists) often contain significant amounts of lead that can be leached from the ceramic by weak acids such as vinegar and fruit juices. Lead is commonly found in soil especially near roadways, older houses, old orchards, mining areas, industrial sites, near power plants, incinerators, landfills, and hazardous waste sites. Recent data has also shown that inexpensive cosmetic jewelry pieces sold to the general public may contain high levels of lead, which can be transferred to the skin through routine handling. However, not much lead can get into your body through your skin.

 

People may be exposed to lead by eating food or drinking water that contains lead. Drinking (tap) water in houses containing lead pipes may contain lead, especially if the water is acidic or "soft". Foods may contain small amounts of lead. Leafy fresh vegetables grown in lead-containing soils may have lead-containing dust on them. Lead may also enter foods if they are put into improperly glazed pottery or ceramic dishes and from leaded-crystal glassware. However, since lead solder is no longer used in cans, very little lead is typically found in food.

 

The typical diet in the United States contributes 1 to 3 mcg of lead per day, of which 1% to 10% is absorbed; children may absorb as much as 50% of the dietary intake, and the fraction of lead absorbed is enhanced by nutritional deficiency. The majority of the daily intake is excreted in the stool after direct passage through the gastrointestinal tract. While a significant fraction of the absorbed lead is incorporated into bone (approximately 94% adults; approximately 73% children) and erythrocytes, lead ultimately distributes among all tissues, with lipid-dense tissues such as the central nervous system being particularly sensitive to organic forms of lead. All absorbed lead is ultimately excreted in the bile or urine. Soft-tissue turnover of lead occurs within approximately 120 days.

 

Other alternative sources of lead include moonshine distilled in lead pipes, some traditional home medicines, non-Western cosmetics (eg, surma and kohl), and some types of hair colorants, cosmetics, and dyes.

 

Lead expresses its toxicity by several mechanisms:

1) It avidly inhibits aminolevulinic acid dehydratase and ferrochelatase, 2 of the enzymes involved in the synthesis of heme. In the end, this inhibition causes decreased hemoglobin synthesis resulting in anemia.

2) Lead is also an electrophile that avidly forms covalent bonds with the sulfhydryl group of cysteine in proteins. Thus, proteins in all tissues exposed to lead will have lead bound to them. The most common sites affected are epithelial cells of the gastrointestinal tract and epithelial cells of the proximal tubule of the kidney.

 

Avoidance of exposure to lead is the treatment of choice. However, chelation therapy is available to treat severe disease and may be necessary especially in children if the blood lead is higher than 25 mcg/dL. The standard chelating agents currently in use are dimercaprol (British Anti-Lewisite: BAL), CaNa2-EDTA (or EDTA), penicillamine, and 2,3-dimercaptosuccinic acid (DMSA; Succimer).

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.

0-5 years: <3.5 mcg/dL

> or =6 years: <5.0 mcg/dL

Critical values

Pediatrics (< or =15 years): > or =20.0 mcg/dL

Adults (> or =16 years): > or =70.0 mcg/dL

Interpretation
Provides information to assist in interpretation of the test results

No safe blood lead level in children has been identified. Lead exposure can affect nearly every system in the body. Because lead exposure often occurs with no obvious symptoms, it frequently goes unrecognized. The current reference level at which the CDC recommends public health actions be initiated is 3.5 mcg/dL in patients 0 to 5 years old and 5 mcg/dL for patients 6 years and older. Chelation therapy is generally indicated in children when whole blood lead concentrations are above 25 mcg/dL.

 

The Occupational Safety and Health Administration (OSHA) has published the following standards for employees working in industry. OSHA Standards for General Industry (CFR 1910.1025) and Construction (CFR 1926.62) apply to workers exposed to airborne lead levels 30 mcg/m(3) or greater time-weighted average and require the removal of workers if a periodic and follow-up blood lead level is 60 mcg/dL (2.9 mcmol/L) or greater, 50 mcg/dL (2.4 mcmol/L) or greater for construction, or the average blood lead level of all tests over a 6-month period (or if there are fewer than 3 tests over a 6-month period, the average of 3 consecutive tests) is 50 mcg/dL (2.4 mcmol/L) or greater. Workers with a single blood lead level meeting the numerical criteria for medical removal must have their blood lead level retested within 2 weeks. If a worker is medically removed, a new blood lead level must be measured monthly during the removal period. Workers are permitted to return to work when their blood lead level is 40 mcg/dL (1.9 mcmol/L) or less. According to OSHA Lead Standards, a zinc protoporphyrin is also required on each occasion a blood lead level measurement is made.

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. Centers for Disease Control and Prevention (CDC). National Report on Human Exposure to Environmental Chemicals. CDC; Updated March 2021. Accessed November 19, 2021. Available at www.cdc.gov/exposurereport

2. Agency for Toxic Substances and Disease Registry: Toxicological Profile for Lead. US Department of Health and Human Services; August 2020. Accessed September 8, 2021. Available at: www.atsdr.cdc.gov/ToxProfiles/tp13.pdf

3. de Burbure 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 Apr;114(4):584-590

4. Kosnett MJ, Wedeen RP, Rothenberg SJ, et al: Recommendations for medical management of adult lead exposure. Environ Health Perspect. 2007 Mar;115(3):463-471

5. Jusko T, Henderson C, Lanphear B, et al: Blood lead concentrations <10 mcg/dL and child intelligence at 6 years of age. Environ Health Perspect. 2008 Feb;116(2):243-248

6. Strathmann FG, Blum LM: Toxic elements. In Rifai N, Horwath AR, Wittwer CT, eds. Tietz Textbook of Clinical Chemistry and Molecular Diagnostics. 6th ed. Elsevier; 2018: 907-910

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

Method Description
Describes how the test is performed and provides a method-specific reference

Lead in whole blood is analyzed by inductively coupled plasma-mass spectrometry in standard mode using iridium as an internal standard and using a salt matrix calibration.(Unpublished Mayo method)

PDF Report
Indicates whether the report includes an additional document with charts, images or other enriched information

No

Day(s) Performed
Outlines the days the test is performed. This field reflects the day that the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time before the test is performed. Some tests are listed as continuously performed, which means that assays are performed multiple times during the day.

Monday through Saturday

Report Available
The interval of time (receipt of sample at Mayo Clinic Laboratories to results available) taking into account standard setup days and weekends. The first day is the time that it typically takes for a result to be available. The last day is the time it might take, accounting for any necessary repeated testing.

1 to 2 days

Specimen Retention Time
Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded

14 days

Performing Laboratory Location
Indicates the location of the laboratory that performs the test

Rochester

Fees
Several factors determine the fee charged to perform a test. Contact your U.S. or International Regional Manager for information about establishing a fee schedule or to learn more about resources to optimize test selection.

  • Authorized users can sign in to Test Prices for detailed fee information.
  • Clients without access to Test Prices can contact Customer Service 24 hours a day, seven days a week.
  • Prospective clients should contact their Regional Manager. For assistance, contact Customer Service.

Test Classification
Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR) product.

This test was developed, and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. This test has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information
Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Clinic Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.

CPT codes are provided by the performing laboratory.

83655

LOINC® Information
Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the order and results codes of this test. LOINC values are provided by the performing laboratory.

Test Id Test Order Name Order LOINC Value
PBDC Lead, Capillary, w/Demographics, B 10368-9
Result Id Test Result Name Result LOINC Value
Applies only to results expressed in units of measure originally reported by the performing laboratory. These values do not apply to results that are converted to other units of measure.
65639 Lead, Capillary, B 10368-9
PTAD7 Patient Street Address 56799-0
PTCI7 Patient City 68997-6
PTST7 Patient State 46499-0
PTZI7 Patient Zip Code 45401-7
PTCN7 Patient County 87721-7
PTPH7 Patient Home Phone 42077-8
PTRA7 Patient Race 32624-9
PTET7 Patient Ethnicity 69490-1
PTOC7 Patient Occupation 11341-5
PTEM7 Patient Employer 80427-8
GDFN7 Guardian First Name 79183-0
GDLN7 Guardian Last Name 79184-8
MDOR7 Health Care Provider Name 52526-1
MDAD7 Health Care Provider Street Address 74221-3
MDCI7 Health Care Provider City 52531-1
MDST7 Health Care Provider State 52532-9
MDZI7 Health Care Provider Zip Code 87720-9
MDPH7 Health Care Provider Phone 68340-9
LABP7 Submitting Laboratory Phone 65651-2

Test Setup Resources

Setup Files
Test setup information contains test file definition details to support order and result interfacing between Mayo Clinic Laboratories and your Laboratory Information System.

Excel | Pdf

Sample Reports
Normal and Abnormal sample reports are provided as references for report appearance.

Normal Reports | Abnormal Reports

SI Sample Reports
International System (SI) of Unit reports are provided for a limited number of tests. These reports are intended for international account use and are only available through MayoLINK accounts that have been defined to receive them.

SI Normal Reports | SI Abnormal Reports