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HelpTest Code HMHA Heavy Metals, Hair
Reporting Name
Heavy Metals, HairUseful For
Detection of nonacute arsenic, mercury, and lead exposure using hair specimens
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ASHA | Arsenic, Hair | Yes | Yes |
| PBHA | Lead, Hair | Yes | Yes |
| HGHAR | Mercury, Hair | Yes | Yes |
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
HairNecessary Information
Indicate source of hair (axillary, head, or pubic) if known
Specimen Required
Supplies: Hair and Nails Collection Kit (T565)
Source: Head, beard, mustache, chest, pubic
Specimen Volume: 0.2 g
Collection Instructions: Prepare and transport specimen per the instructions in kit or see Collecting Hair and Nails for Metals Testing.
Specimen Minimum Volume
0.05 g
Specimen Stability Information
| Specimen Type | Temperature | Time |
|---|---|---|
| Hair | Ambient (preferred) | |
| Frozen | ||
| Refrigerated | ||
Special Instructions
Reference Values
ARSENIC
0-15 years: Not established
≥16 years: <1.0 mcg/g of hair
LEAD
<4.0 mcg/g of hair
Reference values apply to all ages.
MERCURY
0-15 years: Not established
≥16 years:<1.0 mcg/g of hair
Day(s) Performed
Wednesday
Test Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
82175
83655
83825
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HMHA | Heavy Metals, Hair | 34667-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 31896 | Arsenic, Hair | 5584-8 |
| 31900 | Mercury, Hair | 5686-1 |
| 31898 | Lead, Hair | 5673-9 |
| PBHSC | Specimen Source | 31208-2 |
| HGHSC | Specimen Source | 31208-2 |
| ASHSC | Specimen Source | 31208-2 |
Interpretation
Hair grows at a rate of approximately 0.5 inch/month. Hair keratin synthesized today will protrude through the skin in approximately 1 week. Thus, a hair specimen collected at the skin level represents exposure of 1 week ago, 1 inch distally from the skin represents exposure 2 months ago, etc.
Arsenic:
Hair arsenic levels above 1.00 mcg/g dry weight may indicate excessive exposure. It is normal for some arsenic to be present in hair, as everybody is exposed to trace amounts of arsenic from the normal diet.
The highest hair arsenic observed at Mayo Clinic was 210 mcg/g dry weight in a case of chronic exposure, which was the cause of death.
Mercury:
Normally, hair contains less than 1 mcg/g of mercury; any amount more than this indicates that exposure to more than normal amounts of mercury may have occurred.
Lead:
Normal hair lead content is below 4.0 mcg/g. While hair lead content above 10.0 mcg/g may indicate significant lead exposure, hair is also subject to potential external contamination with environmental lead and contaminants in artificial hair treatments (eg, dyeing, bleaching, or permanents). Ultimately, the hair lead content needs to be interpreted in addition to the overall clinical scenario including symptoms, physical findings, and other diagnostic results when determining further actions.
Clinical Reference
1. Sthiannopkao S, Kim K-W, Cho KH, et al. Arsenic levels in human hair, Kandal Province, Cambodia: The influences of groundwater arsenic, consumption period, age and gender. Applied Geochemistry. 2010;25(1):81-90
2. Pearce DC, Dowling K, Gerson, AR, et al. Arsenic microdistribution and speciation in toenail clippings of children living in a historic gold mining area. Sci Total Environ. 2010;408(12):2590-2599
3. Marques RC, Dorea JG, Bastos WR, Malm O. Changes in children hair-Hg concentrations during the first 5 years: maternal, environmental and iatrogenic modifying factors. Regul Toxicol Pharmacol. 2007;49(1):17-24
4. Canuel R, de Grosbois SB, Atikesse L, et al. New evidence on variations of human body burden of methylmercury from fish consumption. Environ Health Perspect. 2006;114(2):302-306
5. Barbosa F Jr, Tanus-Santos JE, Gerlach RF, Parsons PJ. A critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. Environ Health Perspect. 2005;113(12):1669-1674
6. DiPietro ES, Phillips DL, Paschal DC, Neese JW. Determination of trace elements in human hair. Reference intervals for 28 elements in nonoccupationally exposed adults in the US and effects of hair treatments. Biol Trace Elem Res. 1989;22(1):83-100
7. Strathmann FG, Blum LM. Toxic elements. In: Rifai N, Chiu RWK, Young I, Burnham CAD, Wittwer CT, eds. Tietz Textbook of Laboratory Medicine. 7th ed. Elsevier; 2023:chap 44
Report Available
2 to 14 daysMethod Name
Triple-Quadrupole Inductively Coupled Plasma Mass Spectrometry (ICP-MS/MS)