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LEAD, INDUSTRIAL EXPOSURE PANEL, ADULT

Mnemonic

LEAD WB IND

Synonym

Blood Lead Level – BLL – Venous Blood Lead – ZnPP - ZPP

Includes

Lead, Zinc Protoporphyrin (ZPP), and Zinc Protoporphyrin-to-Heme Ratio (ZPPH)

Guidelines

Recommended for the assessment of industrial lead exposure in adults and provides exposure guidance in accordance with OSHA regulations. To assess lead exposure in a non-occupational setting, order either Lead, Whole Blood  or Lead and Zinc Protoporphyrin.

Specimen Collection Requirements

Patient Preparation

Collect from patient aged 16 years or older.

Collect

Preferred: Venous Whole Blood, one certified lead-free 6.0 mL royal blue (K2EDTA or Na2EDTA) top tube. Also acceptable: Venous whole blood, one 4.0 mL lavender (EDTA) top tube. PROTECT FROM LIGHT

NOTE: All elevated Lead blood levels collected in a non-certified lead-free tube (i.e., EDTA lavender top tube) will be run with the following disclaimer: “Specimen was collected in a non-certified lead-free tube. Recommend confirming elevated level of blood lead with a second specimen collected in a lead-free tube."

 

 

Handling

Guard the specimen against environmental contamination. Keep the specimen sealed in the original container. PROTECT FROM LIGHT. Do not separate the plasma from the red blood cells.

Preferred Volume

3.0 mL EDTA whole blood

Minimum Volume

1.2 mL EDTA whole blood

Transport

Refrigerated (2-8 ºC), PROTECT FROM LIGHT

Rejection Criteria

Serum and plasma specimens
Whole blood collected in tube with anticoagulant other than EDTA
Frozen specimens
Grossly hemolyzed specimens
Clotted specimens
Specimens not protected from light
 

Stability

Room Temperature (18-26°C): 24 hours; Refrigerated (2-8°C): 20 days; Frozen (≤ -20°C): Unacceptable

Testing Information

Note

Elevated blood lead levels may be due to skin or collection-related contamination, including use of non-certified lead free tubes. Elevated levels of blood lead should be confirmed with a second specimen collected in a lead-free tube. 

Performed

Mon, Wed, Fri

Reported

24-72 hours

Method

Atomic Absorption Spectroscopy- Graphite Furnace, Hematofluorometry

Reference Values

Toxic Levels

Lead: See Recommended Actions Based on Blood Lead Levels 
ZPP: Not established
ZPPH: Not established
 

Comments

Legacy reports ZPP and ZPPH assuming a hematocrit of 42%. Interpret results with caution if the patient’s hematocrit is significantly different (i.e., pediatric or anemic patients).

All blood lead levels are reported to the Oregon or Washington Health Division.
 

CPT Codes

Lead: 83655, ZPP: 84202

Last Updated: Thursday, October 19, 2017 08:56:07 AM


Client Services: 503-413-1234