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Test Code PBDC Lead, Capillary, with Demographics, Blood

Specimen Required

Patient Preparation:

-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 should not be collected for 96 hours.

-CDC recommends venous collection of samples for lead testing.

-Capillary lead testing is acceptable for pediatrics and patients with phlebotomy considerations, but capillary blood collection may be more susceptible to contamination. Elevated capillary blood levels must be confirmed with a venous lead blood test.

Supplies: Microtainer (EDTA) Tube, 1.5 mL (T174)

Collection Container/Tube: BD Microtainer with EDTA (T174)

Specimen Volume: 0.4 mL

Collection Instructions:

1. See Trace Metals Analysis Specimen Collection and Transport in Special Instructions for complete instructions.

2. Send specimen in original tube.


1. Lead/Heavy Metals Reporting Form (T491) in Special Instructions

2. If not ordering electronically, complete, print, and send a General Request Form (T239) with the specimen (

Secondary ID


Useful For

Detecting lead toxicity with capillary collections

Profile Information

Test ID Reporting Name Available Separately Always Performed
PBBC Lead, Capillary, B No Yes
DEMO7 Patient Demographics No Yes

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Lead, Capillary, w/Demographics, B

Specimen Type

Whole blood

Specimen Minimum Volume

0.1 mL

Specimen Stability Information

Specimen Type Temperature Time
Whole blood Refrigerated (preferred) 28 days
  Ambient  28 days
  Frozen  28 days

Reject Due To


Mild OK; Gross OK


Mild OK; Gross OK


Mild OK; Gross reject


Green-top (heparin) tube

Clinical Information

Lead is a heavy metal commonly found in man's environment that can be an acute and chronic toxin.


Lead was banned from household paints in 1978, but is still found in paint produced for nondomestic use and in artistic pigments. Ceramic products available from noncommercial suppliers (such as local artists) often contain significant amounts of lead that can be leached from the ceramic by weak acids such as vinegar and fruit juices. Lead is found in dirt from areas adjacent to homes painted with lead-based paints and highways where lead accumulates from use of leaded gasoline. Use of leaded gasoline has diminished significantly since the introduction of nonleaded gasolines that have been required in personal automobiles since 1972. Lead is found in soil near abandoned industrial sites where lead may have been used. Water transported through lead or lead-soldered pipe will contain some lead with higher concentrations found in water that is weakly acidic. Some foods (eg, moonshine distilled in lead pipes) and some traditional home medicines contain lead.


Lead expresses its toxicity by several mechanisms. It avidly inhibits aminolevulinic acid dehydratase and ferrochelatase, 2 of the enzymes that catalyze synthesis of heme; the end result is decreased hemoglobin synthesis resulting in anemia.


Lead also is an electrophile that avidly forms covalent bonds with the sulfhydryl group of cysteine in proteins. Thus, proteins in all tissues exposed to lead will have lead bound to them. The most common sites affected are epithelial cells of the gastrointestinal tract and epithelial cells of the proximal tubule of the kidney.


The typical diet in the United States contributes 1 to 3 mcg of lead per day, of which 1% to 10% is absorbed; children may absorb as much as 50% of the dietary intake, and the fraction of lead absorbed is enhanced by nutritional deficiency. The majority of the daily intake is excreted in the stool after direct passage through the gastrointestinal tract. While a significant fraction of the absorbed lead is rapidly incorporated into bone and erythrocytes, lead ultimately distributes among all tissues, with lipid-dense tissues such as the central nervous system being particularly sensitive to organic forms of lead. All absorbed lead is ultimately excreted in the bile or urine. Soft-tissue turnover of lead occurs within approximately 120 days.


Avoidance of exposure to lead is the treatment of choice. However, chelation therapy is available to treat severe disease. Oral dimercaprol may be used in the outpatient setting except in the most severe cases.

Reference Values

All ages: 0.0-4.9 mcg/dL

Critical values

Pediatrics (≤15 years): ≥20.0 mcg/dL

Adults (≥16 years): ≥70.0 mcg/dL


The 95th percentile of the gaussian distribution of whole blood lead concentration in a population of unexposed adults is below 6 mcg/dL. For pediatric patients, there may be an association with blood lead values of 5 to 9 mcg/dL and adverse health effects. Follow-up testing in 3 to 6 months may be warranted. Chelation therapy is indicated when whole blood lead concentration is above 25 mcg/dL in children or above 45 mcg/dL in adults.


The Occupational Safety and Health Administration has published the following standards for employees working in industry:

-Employees with a single whole blood lead result greater than 60 mcg/dL must be removed from workplace exposure.

-Employees with whole blood lead levels greater than 50 mcg/dL averaged over 3 blood specimens must be removed from workplace exposure.

-An employee may not return to work in a lead exposure environment until their whole blood lead level is less than 40 mcg/dL.

Clinical Reference


2. de Burbure C, Buchet J-P, Leroyer A, et al: Renal and neurologic effects of cadmium, lead, mercury, and arsenic in children: evidence of early effects and multiple interactions at environmental exposure levels. Environ Health Perspect 2006;114:584-590

3. Kosnett MJ, Wedeen RP, Rothenberg SJ, et al: Recommendations for medical management of adult lead exposure. Environ Health Perspect 2007;115:463-471

4. Jusko T, Henderson C, Lanphear B, et al: Blood lead concentrations <10 mcg/dL and child intelligence at 6 years of age. Environ Health Perspect 2008;116:243-248

Day(s) and Time(s) Performed

Monday through Friday; 5 p.m.

Saturday; 2 p.m.

Analytic Time

1 day

Performing Laboratory

Mayo Medical Laboratories in Rochester

Test Classification

See Individual Test IDs

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
PBDC Lead, Capillary, w/Demographics, B 10368-9


Result ID Test Result Name Result LOINC Value
65639 Lead, Capillary, B 10368-9
VECP7 Venous/Capillary 31208-2
PTAD7 Patient Street Address 56799-0
PTCI7 Patient City 68997-6
PTST7 Patient State 46499-0
PTZI7 Patient Zip Code 45401-7
PTCN7 Patient County 87721-7
PTPH7 Patient Home Phone 42077-8
PTRA7 Patient Race 32624-9
PTET7 Patient Ethnicity 69490-1
PTOC7 Patient Occupation 11341-5
PTEM7 Patient Employer 80427-8
GDFN7 Guardian First Name 79183-0
GDLN7 Guardian Last Name 79184-8
MDOR7 Health Care Provider Name 52526-1
MDAD7 Health Care Provider Street Address 74221-3
MDCI7 Health Care Provider City 52531-1
MDST7 Health Care Provider State 52532-9
MDZI7 Health Care Provider Zip Code 87720-9
MDPH7 Health Care Provider Phone 68340-9
LABP7 Submitting Laboratory Phone 65651-2