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22516 Heavy Metals Screen, Occupational Exposure, Random Urine (HMSUO)

Heavy Metals Screen, Occupational Exposure, Random Urine (HMSUO)
Test Code: METSUSO
Synonyms/Keywords
Lab Ref Code:  82385, ​Arsenic (As), Cadmium (Cd), Lead (Pb), Mercury (Hg), Lead (Pb), Metals Screen
Test Components
​Includes arsenic, mercury, cadmium, and lead.
Useful For
​Useful for screening potentially exposed workers for heavy metal toxicity in settings where a 24 hour collection is problematic. Includes arsenic, mercury, cadmium, and lead. Elevation of arsenic due to non-toxic arsenicals can occur with seafood intake.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Random Urine ​Plastic container with no metal cap or glued insert. ​Plastic 6 mL tube ​10 mL ​5 mL ​
Collection Processing Instructions

​Aliquot into plastic container with no metal cap or glued insert.

Patient should abstain from eating seafood for 48 hours prior to collection.

If gadolinium or iodine containing contrast media has been administered, specimen cannot be collected for 96 hours.

Specimen Stability Information
Specimen Type Temperature Time
​Random Urine ​ ​Refrigerated (preferred) ​7 days
​Frozen ​7 days
Rejection Criteria
Urine collected in any other container other than as described above is unacceptable.
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories​ ​Monday through Friday; 3 p.m. - 9 p.m.; Saturday; 8 a.m. – 3 p.m./Continuously ​1 day

​Enzymatic Colorimetric Assay

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reference Lab
Mayo Clinic Laboratories
Test Information
​Nitric acid cannot be added to either the collection or aliquot container. Nitrate interferes with the extraction procedure that would need to take place in the event of a positive arsenic result.
 
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 cannot be collected for 96 hours. 
 
This test is intended for use as a screening tool for occupational monitoring. It is not a replacement of HMSU/8633 Heavy Metals Screen, 24 Hour, Urine.
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories​ ​ARSENIC/CREATININE
<50 mcg/g
 
MERCURY/CREATININE
<35 mcg/g
 
CADMIUM/CREATININE
<3.0 mcg/g
 
LEAD/CREATININE
<5 mcg/g
Interpretation
​The reference intervals for this test are Occupational Safety and Health Adminstration (OSHA) thresholds.
 
The ordering physician will be contacted regarding any result exceeding OSHA thresholds to determine the level of workplace exposure and follow-up action.
 
Arsenic results exceeding the OSHA threshold will be fractionated to confirm the presence of toxic forms.
 
Measurement of urine excretion rates either before or after chelation therapy has been used as an indicator of lead exposure. However, blood lead analysis has the strongest correlation with toxicity.
 
Normally, the excretion of cadmium is proportional to creatinine. When renal damage has occurred, cadmium excretion increases relative to creatinine.
 
The correlation between the levels of mercury in the urine and clinical symptoms is poor, but urinary mercury is the most reliable way to assess exposure to inorganic mercury.
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
82175​ ​ ​1 ​Arsenic ​
​83825 ​ ​1 ​Mercury ​
​82300 ​ ​1 ​Cadmium ​
​83655 ​ ​1 ​Lead ​
​82570 ​ ​1 ​Creatinine ​
Synonyms/Keywords
Lab Ref Code:  82385, ​Arsenic (As), Cadmium (Cd), Lead (Pb), Mercury (Hg), Lead (Pb), Metals Screen
Test Components
​Includes arsenic, mercury, cadmium, and lead.
Ordering Applications
Ordering Application Description
If the ordering application you are looking for is not listed, contact your local laboratory for assistance.
Specimen Requirements
Specimen Type Preferred Container/Tube Acceptable Container/Tube Specimen Volume Specimen Minimum Volume
(allows for 1 repeat)		 Pediatric Minimum Volume
(no repeat)
​Random Urine ​Plastic container with no metal cap or glued insert. ​Plastic 6 mL tube ​10 mL ​5 mL ​
Collection Processing

​Aliquot into plastic container with no metal cap or glued insert.

Patient should abstain from eating seafood for 48 hours prior to collection.

If gadolinium or iodine containing contrast media has been administered, specimen cannot be collected for 96 hours.

Specimen Stability Information
Specimen Type Temperature Time
​Random Urine ​ ​Refrigerated (preferred) ​7 days
​Frozen ​7 days
Rejection Criteria
Urine collected in any other container other than as described above is unacceptable.
Useful For
​Useful for screening potentially exposed workers for heavy metal toxicity in settings where a 24 hour collection is problematic. Includes arsenic, mercury, cadmium, and lead. Elevation of arsenic due to non-toxic arsenicals can occur with seafood intake.
Test Components
​Includes arsenic, mercury, cadmium, and lead.
Reference Range Information
Performing Location Reference Range
​Mayo Medical Laboratories​ ​ARSENIC/CREATININE
<50 mcg/g
 
MERCURY/CREATININE
<35 mcg/g
 
CADMIUM/CREATININE
<3.0 mcg/g
 
LEAD/CREATININE
<5 mcg/g
Interpretation
​The reference intervals for this test are Occupational Safety and Health Adminstration (OSHA) thresholds.
 
The ordering physician will be contacted regarding any result exceeding OSHA thresholds to determine the level of workplace exposure and follow-up action.
 
Arsenic results exceeding the OSHA threshold will be fractionated to confirm the presence of toxic forms.
 
Measurement of urine excretion rates either before or after chelation therapy has been used as an indicator of lead exposure. However, blood lead analysis has the strongest correlation with toxicity.
 
Normally, the excretion of cadmium is proportional to creatinine. When renal damage has occurred, cadmium excretion increases relative to creatinine.
 
The correlation between the levels of mercury in the urine and clinical symptoms is poor, but urinary mercury is the most reliable way to assess exposure to inorganic mercury.
For more information visit:
Performing Laboratory Information
Performing Location Day(s) Test Performed Analytical Time Methodology/Instrumentation
​Mayo Medical Laboratories​ ​Monday through Friday; 3 p.m. - 9 p.m.; Saturday; 8 a.m. – 3 p.m./Continuously ​1 day

​Enzymatic Colorimetric Assay

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reference Lab
Mayo Clinic Laboratories
For billing questions, see Contacts
Outreach CPTs
CPT Modifier
(if needed)		 Quantity Description Comments
82175​ ​ ​1 ​Arsenic ​
​83825 ​ ​1 ​Mercury ​
​82300 ​ ​1 ​Cadmium ​
​83655 ​ ​1 ​Lead ​
​82570 ​ ​1 ​Creatinine ​
For most current information refer to the Marshfield Laboratory online reference manual.