Heavy metals urine

Random or 24 h urine collected into a trace element free container.

If the exposure to a heavy metal is not recent, testing should be done following intravenous calcium EDTA infusion.

Inductively coupled plasma mass spectrometry (ICP-MS).

Lead, Mercury, Arsenic, Cadmium are measured routinely; others eg, Thallium and Uranium are usually assayed only on specific request.

Arsenic: < 2.0 μmol/L (< 40 nmol/mmol Creat)

Cadmium: < 40 nmol/L (< 3 nmol/mmol Creat)

Copper: < 1 μmo​l/L (< 0.5 μmol/day)

Lead: < 0.4 μmol/L (​24 h < 0.3 μmol/day; spot < 21 nmol/mmol Creat)

Manganese: < 3 μmol/L (24 h 3-40 nmol/day; spot < 3.4 nmol/mmol Creat)

Mercury: < 0.1 μmol/L (spot < 10 nmol/mmol Creat)

Thallium: < 50 nmol/L (24 h < 20 nmol/day; spot < 1 nmol/mmol Creat)

Monitoring of patients at risk from occupational or environmental exposure.

Suspected poisoning. Investigation of patients with suspicious clinical features eg, neuropathy, encephalopathy, renal failure, Fanconi syndrome.

Elevated results indicate exposure.

Normal results exclude recent, clinically significant exposure to those metals analysed. Higher cut-offs may apply for industrial exposure.

See also Arsenic urine, Lead urine, Copper urine and Mercury urine.