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Test Code HMHA Heavy Metals, Hair

Performing Laboratory

Mayo Medical Laboratories in Rochester

Reporting Name

Heavy Metals, Hair

Specimen Type

Hair


Specimen Required


Supplies: Hair and Nails Collection Kit (T565)

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 in Special Instructions.

Additional Information: If known, indicate source of hair (axillary, head, or pubic).


Reject Due To

Hemolysis

NA

Lipemia

NA

Icterus

NA

Other

NA

Specimen Stability Information

Specimen Type Temperature Time
Hair Ambient (preferred)
  Frozen 
  Refrigerated 

Specimen Minimum Volume

0.05 g

Day(s) and Time(s) Performed

Tuesday; 3 p.m.

Specimen Retention Time

14 days

Analytic Time

2 days

Reference Values

ARSENIC

0-15 years: not established

≥16 years: 0.0-0.9 mcg/g of hair

 

LEAD

0.0-3.9 mcg/g of hair

Reference values apply to all ages.

 

MERCURY

0-15 years: not established

≥16 years: 0.0-0.9 mcg/g of hair

Useful For

Detection of nonacute arsenic, mercury, and lead exposure in hair specimens

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Test Classification

See Individual Test IDs

CPT Code Information

82175-Arsenic

83655-Lead

83825-Mercury

LOINC Code Information

Test ID Test Order Name Order LOINC Value
HMHA Heavy Metals, Hair In Process

 

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

Clinical Information

ARSENIC

Arsenic circulating in the blood will bind to protein by formation of a covalent complex with sulfhydryl groups of the amino acid cysteine. Keratin, the major structural protein in hair and nails, contains many cysteine residues and, therefore, is one of the major sites for accumulation of arsenic. Since arsenic has a high affinity for keratin, the concentration of arsenic in hair is higher than in other tissues.

 

Arsenic binds to keratin at the time of exposure, "trapping" the arsenic in hair. Therefore, hair analysis for arsenic is not only used to document that an exposure occurred, but when it occurred. Hair collected from the nape of the neck can be used to document recent exposure. Axillary or pubic hair are used to document long-term (6 months-1 year) exposure.

 

MERCURY

Once absorbed and circulating, mercury becomes bound to numerous proteins, including keratin. The concentration of mercury in hair correlates with the severity of clinical symptoms. If the hair can be segregated by length, such an exercise can be useful in identifying the time of exposure.

 

LEAD

Hair analysis for lead can be used to corroborate blood analysis or to document past lead exposure. If the hair is collected and segmented in a time sequence (based on length from root), the approximate time of exposure can be assessed.

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 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 that 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 has occurred

 

LEAD

Normal hair lead content is below 5.0 mcg/g. Hair lead content above 10.0 mcg/g indicates significant lead exposure.

Cautions

No significant cautionary statements

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;25:81-90

2. Pearse 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;408:2590-2599

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. Reg Toxicol Pharmacol 2007;49:17-24

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;114:302-306

5. Barbosa F, Tanus-Santos J, Gerlach R, Parsons P: A Critical review of biomarkers used for monitoring human exposure to lead: advantages, limitations, and future needs. Environ Health Perspect 2005;113:1669-1674

Method Description

Arsenic, mercury, and lead in hair are analyzed by inductively coupled plasma-mass spectrometry (ICP-MS) in kinetic energy discrimination (KED) mode using gallium, iridium, and lutetium as internal standards, and a salt matrix calibration.(Unpublished Mayo method)

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