If trace metal tubes are not available then the following tubes are acceptable:
| non-exposed persons | 0 - 20 nmol/L |
Conversion factor:
result in nmol/L = result in ug/L (or ng/mL) x 19.2
Uncertainty of Measurement: 16%
Increased levels are found in patients with surgical implants containing chromium. The long-term health effects of increased chromium levels due to surgical implants are unknown.
Prosthesis wear is known to result in increased chromium levels. A modest increase (plasma chromium less than 60 nmol/L) is likely to be associated with a prosthetic device in good condition. Plasma concentrations >135 nmol/L suggests significant prosthesis wear.
The long-term health effects of raised cobalt levels due to surgical implants are unknown.
Cautions
Gadolini um and iodine are known to interfere with metals tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
As the concentrations of chromium in plasma and urine are extremely low,
specimen collection procedures require rigorous attention to clean
specimen collection and handling procedures, to prevent contamination.
References
1. Komaromy-Hiller G, Ash KO, Costa R, Howerton K. Comparison of representative ranges based on U.S. patient population and literature reference intervals for urinary trace elements. Clin Chim Acta. 2000;296:71-90
2. Keegan GM, Learmonth ID, Case CP. A systematic comparison of the actual, potential, and theoretical health effects of cobalt and chromium exposures from industry and surgical implants. Crit Rev Toxicol. 2008;38:645-674
3. Medical Device Alert. All metal-on-metal (MoM) hip replacements (MDA/2012/036). Medicines and Healthcare Products Regulatory Agency, 2012.
4. Sampson B, Hart A. Clinical usefulness of blood metal measurements to assess the failure of metal-on-metal hip implants. Ann Clin Biochem 2012;49(Pt 2):118-31.
Emails to chemicalpathologist@adhb.govt.nz will receive priority attention from the on-call chemical pathologist.
If the query concerns a specific patient please include the NHI number in your email.
If email is not a suitable option, please contact the on-call chemical pathologist via Lablink (Auckland City Hospital ext. 22000 or 09-3078995).
Individual chemical pathologists may be contacted but will not be available at all times.
After-hours : contact Lablink (Auckland City Hospital ext. 22000 or 09-3078995) or hospital operator for on duty staff after hours.
Dr Samarina Musaad (Clinical Lead) : SamarinaM@adhb.govt.nz ext. 22402
Dr Cam Kyle: CampbellK@adhb.govt.nz ext 22052
Dr Weldon Chiu: WeldonC@adhb.govt.nz ext. 23427
Dr Campbell Heron: CHeron@adhb.govt.nz ext. 23427
Dr Sakunthala Jayasinghe: Sakunthala@adhb.govt.nz ext. 23427