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HelpTest Code PBDC Lead, Capillary, with Demographics, Blood
Ordering Guidance
The Centers for Disease Control and Prevention 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. See PBDV / Lead, Venous, with Demographics, Blood.
Specimen Required
Patient Preparation: High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based metal testing. 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 Metals Analysis Specimen Collection and Transport for complete instructions.
2. Send whole blood specimen in original tube. Do not aliquot.
Forms
1. Lead and Heavy Metals Reporting (T491) or Lead and Heavy Metals Reporting-Spanish (T956)
2. If not ordering electronically, complete, print, and send a General Request (T239) with the specimen.
Useful For
Detecting lead toxicity with capillary collections
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| PBBC | Lead, Capillary, B | No | Yes |
| DEMO7 | Patient Demographics | No | Yes |
Special Instructions
Method Name
Inductively Coupled Plasma Mass Spectrometry (ICP-MS)
Reporting Name
Lead, Capillary, w/Demographics, BSpecimen Type
Whole bloodSpecimen Minimum Volume
0.1 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole blood | Refrigerated (preferred) | 28 days | |
| Ambient | 28 days | ||
| Frozen | 28 days |
Reference Values
<3.5 mcg/dL
Critical values
Pediatrics (≤15 years): ≥20.0 mcg/dL
Adults (≥16 years): ≥70.0 mcg/dL
Interpretation
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 Centers for Disease Control and Prevention 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. The most recent National Health and Nutrition Examination Survey (NHANES) data shows that 97.5 percentile for blood lead levels in US adults aged 16 years and older is 3.46 mcg/dL. In concurrence with the reference value concept that there is no safe level of lead in blood, the Council of State and Territorial Epidemiologists Occupational Health Subcommittee approved lowering the blood lead threshold from 5 to 3.5 mcg/dL for adults. 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.
Clinical Reference
1. Centers for Disease Control and Prevention (CDC). National Report on Human Exposure to Environmental Chemicals. CDC; Updated September 29, 2023. Accessed October 24, 2023. 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 October 24, 2023. 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;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;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;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
7. Cantor AG, Hendrickson R, Blazina I, Griffin J, Grusing S, McDonagh MS. Screening for elevated blood lead levels in childhood and pregnancy: Updated evidence report and systematic review for the US Preventive Services Task Force. JAMA. 2019;321(15):1510-1526. doi:10.1001/jama.2019.1004
8. CSTE Occupational Subcommittee. Management Guidelines for Blood Lead Levels in Adults. 2021. Accessed October 24, 2023. Available at: https://cdn.ymaws.com/www.cste.org/resource/resmgr/occupationalhealth/publications/ManagementGuidelinesforAdult.pdf
Day(s) Performed
Monday through Saturday
Report Available
1 to 2 daysPerforming Laboratory
Mayo Clinic Laboratories in Rochester
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
83655
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| PBDC | Lead, Capillary, w/Demographics, B | 10368-9 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 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 |