Dear health care providers,
As part of ongoing efforts to improve our quality of service, LifeLabs Ontario will implement a new analytical platform for all in-house performed trace metals tests.
This change will go into effect on July 09. 2023
The new analytical platform, ICP-MS/MS (Inductively Coupled Plasma – Tandem Mass Spectrometer) is a gold standard for testing of trace metals. ICP-MS/MS will replace our current atomic absorption analytical platform.
Relevant information related to the reporting changes (reference values and reporting comments), and test-specific turn-around times (TAT) is listed below in Table 1.
Table 1. Trace Metals – TAT, New Reference Levels and Reporting Comments
|
Test |
TAT |
Reference Level/Units |
Reporting Comments (where applicable) |
|
Lead – Blood |
2-5 days |
< 0.10 µmol/L |
-Reference value based on non-occupationally exposed population: <0.10 µmol/L. –Blood Lead BEI (ACGIH): < 0.97 µmol/L; BEI (Biological Exposure Index): The level above which excessive exposure has occurred. -The U.S. Centers for Disease Control and Prevention (CDC) reference level for children 1-5 years: < 0.17 µmol/L (3.5 µg/dL). The CDC blood lead reference level for adults: < 0.24 µmol/L (5.0 µg/dL). |
|
Lead – 24h urine |
2-5 days |
<15.3 nmol/day |
Reference value based on non-occupationally exposed population: <15.3 nmol/day. Biological Exposure Index (ACGIH): not available. |
|
Lead – random urine |
2-5 days |
<1.91 µmol/mol creatinine |
Reference value based on non-occupationally exposed population: <1.91 µmol/mol creatinine. Biological Exposure Index (ACGIH): not available |
|
Cadmium -Blood |
2-5 days |
< 29.2 nmol/L |
–Blood Cadmium BEI (ACGIH): < 44.5 nmol/L; BEI (Biological Exposure Index): The level above which excessive exposure has occurred. -Reference value based on non-occupationally exposed population: <29.2 nmol/L. May be elevated in smokers. -Acute toxicity observed when the blood level exceeds 444.8 nmol/L |
|
Cadmium-24h urine |
2-5 days |
<18.0 nmol/day |
-Reference value based on non-occupationally exposed population: <18.0 nmol/D. –Biological Exposure Index (ACGIH): not available. |
|
Cadmium-random urine |
2-5 days |
<1.9 µmol/mol creatinine |
–BEI (ACGIH): < 5.0 µmol/mol creatinine; BEI (Biological Exposure Index): The level above which excessive exposure has occurred. -Reference value based on non-occupationally exposed population: <1.9 µmol/mol creatinine. |
|
Copper – Serum |
1-3 days |
F:11.0-30.0 μmol/L; M 9.0-23.0 μmol/L |
|
|
Zinc – Serum |
1-3 days |
8.8-16.2 μmol/L |
|
|
Zinc – 24h urine |
2-5 days |
1.5-9.2 μmol/day |
|
|
Zinc – random urine |
2-5 days |
70.0-1118.0 μmol/mol creatinine |
|
Please note: Due to changes in the analytical platform some reference values and reporting comments have been updated based on the internal verification procedures. Please interpret results in context of the reference value and interpretive comments provided on the report.
SAMPLE HANDLING REQUIREMENTS:
Applicable to Serum Zinc and Copper:
- Diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician) for 96 hours prior to blood draw. If gadolinium-, barium-, iodine-containing contrast media have been administered, a specimen collection should be delayed by 48-96 hours.
- Collect sample in trace metal-free Royal Blue Top tube (without additive). Separate serum from cells ASAP or within 2 hours of collection: Allow blood to clot at room temperature for 60 minutes and separate by centrifugation.
- After centrifugation, transfer serum (2ml minimum) using a plastic pipette into a new labelled Royal Blue tube (no additive). Do not ream serum or plasma specimen with a wooden stick to remove clots.
- Store and ship refrigerated at 2-8 ºC.
Applicable to Blood samples (Lead and Cadmium):
- If gadolinium-, barium-, iodine-containing contrast media have been administered, a specimen collection should be delayed by 48-96 hours.
- Collect in trace metal-free Royal Blue Top tube (K2EDTA). Mix thoroughly by gentle inversion. Send entire tube.
- Store and ship refrigerated at 2-8 ºC.
Applicable to 24h and random urine samples (Zinc, Lead, and Cadmium):
- If gadolinium-, barium-, iodine-containing contrast media have been administered, a specimen collection should be delayed by 48-96 hours.
24hr urine: must be collected in acid-washed container.
- Record Total volume and 1. Transfer 5 ml of urine into labelled royal blue top tube (without additive). 2. Transfer an additional 5 mL of urine into a separately labeled 6mL vacutainer aliquot tube. Cap tightly.
- Store and ship refrigerated at 2-8°C.
Random urine: Collect a minimum of 20 ml of random urine in a labelled acid washed container.
- Transfer 5 ml of urine into labelled trace metal-free Royal Blue Top tube (without additive). Transfer an additional 5 mL of urine into a separately labeled 6mL vacutainer aliquot tube. Cap tightly.
- Store and ship refrigerated at 2-8°C.
We are very excited about the new platform and test implementation and the benefits it will deliver to our clients. If you have any questions or concerns, please contact the LifeLabs Clinical Biochemist below or LifeLabs Customer Care Centre at 1-877-849-3637.
We welcome your feedback!
Danijela Konforte PhD, FCACB
Clinical Biochemist and Discipline Head, Special Chemistry
Medical-Scientific Department – Ontario
LifeLabs | 100 International Blvd. | Toronto, ON M9W 6J6
T 416-675-4530 Ext. 42207 | F 416-213-4206
