Trace Elements

Blood: TREL (list trace elements in prompt box.  If inadequate space or element not listed in prompt box, list all trace elements in chartable comments)
Urine: UTREL (list trace elements in prompt box.  If inadequate space or element not listed in prompt box, list all trace elements in chartable comments)
Hair or Tissue: MISCSO

NOTE: for blood Copper, Lead, Zinc, or urine Mercury, see individual test pages.

For trace elements testing ordered by Dr. Hoffman, order test mnemonic HOFF.

Blood:
1 x 10 mL dark green top GLASS sodium heparin tube with rubber stopper (available from CLS Referrals Department)

Wear non-powdered gloves throughout blood collection.

Urine:
80 mL aliquot of 24 hr or random urine in plastic Starplex container

24 hour urine is preferable to random. Urine container is kept in the refrigerator during collection.  Collect away from suspected exposure site.  If workplace exposure suspected, collect during off-hours, away from work environment. 

Blood:
Centrifuge within 1 hour of collection:
1. Mix tube thoroughly and centrifuge.
2. Aliquot plasma using a plastic pipet (not glass) to a plastic screwcap Sardstedt2 aliquot tube (aliquot tubes available from Referrals).  Screw the caps on tightly to avoid leakage.
3. Discard middle layer (residual plasma and approximately 1/8 inch of the upper RBC layer) using the same pipet.
4. Aliquot RBC using a new plastic pipet (NOT glass) to a plastic screwcap Sarstedt2 aliquot tube.  Screw the caps on tightly to avoid leakage.
5. Send both aliquots (RBC and plasma) to DSC (do not send original sodium heparin tube). 

PSC: Transport to DSC on ice.  Send specimen in a separate bag with a photocopy of the requisition.
RRL & extra-regional: Freeze aliquots and transport to DSC on dry ice.

Urine:
For 24 hr urine, measure total urine volume and aliquot. 

PSC: Transport to DSC on ice.  Send specimen in a separate bag with a photocopy of the requisition.
RRL & extra-regional: Freeze aliquots and transport to DSC on dry ice.

See table below for trace element availability on various specimens:

Element	Blood	Urine	Element	Blood	Urine
Aluminum	X	X 1	Molybdenum	X	X
Antimony	X	X	Nickel	X	X
Arsenic	X	X 2	Palladium	Hair only
Barium		X	Platinum	Hair only
Beryllium		X	Selenium	X	X
Bismuth	Hair only		Silicon	Tissue only
Boron		X	Silver		X
Cadmium	X	X	Strontium		X
Chromium	X	X 3	Thallium	X	X
Cobalt	X	X	Tin		X
Copper	see below*	X	Titanium	Hair or tissue
Iodine	X		Uranium		X
Lead	see below*	X	Vanadium	X	X
Manganese	X	X	Zinc	see below*	X
Mercury	X	see below*

*NOTE: for blood Copper, Lead, Zinc, or urine Mercury, see individual test pages.

Dietary restrictions:
1. Aluminum - limit fruit juices and tea 24 hours prior to collecting sample
2. Arsenic - avoid seafood consumption for five days prior to collecting sample
3. Chromium - avoid mineral/multivitamins for one week prior to collecting sample

If it is requested that the test be sent to a lab other than London Health, contact CLS Referrals at 770-3285.