Ordering Recommendation

Recommended routine screening for lead exposure in pediatric populations. Confirm elevated results with Lead, Blood (Venous) (0020098).

New York DOH Approval Status

This test is New York state approved.

Specimen Required

Patient Preparation

Clean puncture site well with soap and water before collection procedure begins.

Collect

Lavender microtainer (K2EDTA)

Specimen Preparation

Invert specimen 10 times to prevent clot formation. Transport 0.5 mL whole blood in the original collection tube. (Min: 0.3 mL)

Storage/Transport Temperature

Room temperature. Also acceptable: Refrigerated.

Unacceptable Conditions

Specimens collected in tubes other than lavender microtainer (K2EDTA). Specimens transported in tubes other than trace element-free transport tubes or lavender microtainer (K2EDTA) tubes. Heparin anticoagulant. Clotted specimens.
Venous whole blood, refer to Lead, Blood (Venous) (ARUP test code 0020098).

Remarks

Trace Elements requisition form may be required (ARUP form #32990).

Stability

Ambient: Indefinitely; Refrigerated: Indefinitely; Frozen: Unacceptable

Methodology

Quantitative Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Performed

Sun-Sat

Reported

1-3 days

Reference Interval

Effective December 6, 2021

0-5 years Less than or equal to 3.4 µg/dL
6 years or above Less than or equal to 4.9 µg/dL

Interpretive Data

Analysis performed by inductively coupled plasma-mass spectrometry (ICP-MS).

Elevated results may be due to skin or collection-related contamination, including the use of a noncertified lead-free collection/transport tube. If contamination concerns exist due to elevated levels of blood lead, confirmation with a venous specimen collected in a certified lead-free tube is recommended.

Repeat testing is recommended prior to initiating chelation therapy or conducting environmental investigations of potential lead sources. Repeat testing collections should be performed using a venous specimen collected in a certified lead-free collection tube.

Information sources for blood lead reference intervals and interpretive comments include the CDC's "Childhood Lead Poisoning Prevention: Recommended Actions Based on Blood Lead Level" and the "Adult Blood Lead Epidemiology and Surveillance: Reference Blood Lead Levels (BLLs) for Adults in the U.S." Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.


Children
Concentration Comment
3.5-19.9 µg/dL Children under the age of 6 years are the most vulnerable to the harmful effects of lead exposure. Environmental investigation and exposure history to identify potential sources of lead. Biological and nutritional monitoring are recommended. Follow-up blood lead monitoring is recommended.
20-44.9 µg/dL Lead hazard reduction and prompt medical evaluation are recommended. Contact a Pediatric Environmental Health Specialty Unit or poison control center for guidance.
Greater than 44.9 µg/dL Critical. Immediate medical evaluation, including detailed neurological exam is recommended. Consider chelation therapy when symptoms of lead toxicity are present. Contact a Pediatric Environmental Health Specialty Unit or poison control center for assistance.

Adults
Concentration Comment
5-19.9 µg/dL Medical removal is recommended for pregnant women or those who are trying or may become pregnant. Adverse health effects are possible. Reduced lead exposure and increased blood lead monitoring are recommended.
20-69.9 µg/dL Adverse health effects are indicated. Medical removal from lead exposure is required by OSHA if blood lead level exceeds 50 µg/dL. Prompt medical evaluation is recommended.
Greater than 69.9 µg/dL Critical. Immediate medical evaluation is recommended.  Consider chelation therapy when symptoms of lead toxicity are present.

Compliance Category

Laboratory Developed Test (LDT)

Note

Hotline History

N/A

CPT Codes

83655

Components

Component Test Code* Component Chart Name LOINC
0020745 Lead, Blood (Capillary) 10368-9
* Component test codes cannot be used to order tests. The information provided here is not sufficient for interface builds; for a complete test mix, please click the sidebar link to access the Interface Map.

Aliases

  • BLL
  • Capillary blood level
  • Lead (Pediatric)
  • Pb
  • Pb, Blood
  • Pb, Pediatric
  • Pb, Whole Blood
Lead, Blood (Capillary)