Reference Interval:
| Test Number
| Components
| Reference Interval
| | | Lead, Blood
| 0-4.9 µg/dL
| | | Zinc Protoporphyrin (ZPP), Whole Blood
| 0-40 µg/dL
| | | Zinc Protoporphyrin (ZPP) to Heme Ratio
| 0-69 µmol ZPP/mol heme
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| Interpretive Data: |
Elevated results may be due to skin or collection-related contamination, including use of a noncertified lead-free tube. Elevated levels of blood lead should be confirmed with a second specimen collected in a lead-free tube.
Reference interval and interpretive comments are based on the Recommendations for Medical Management of Adult Lead Exposure, Environmental Health Perspectives, 2007. Thresholds and time intervals for retesting, medical evaluation, and response vary by state and regulatory body. Actions described by OSHA in 1978 are shown below. Contact your State Department of Health and/or applicable regulatory agency for specific guidance on medical management recommendations.
| Concentration
| Comment
| | 5-9.9 µg/dL
| Adverse health effects are possible, particularly in pregnant women. Discuss health risks associated with continued lead exposure. For women who are or may become pregnant, reduce lead exposure.
| | 10-19.9 µg/dL
| Reduced lead exposure and increased biological monitoring are recommended.
| | 20-69.9 µg/dL
| Removal from lead exposure and prompt medical evaluation are recommended. Consider chelation therapy when concentrations exceed 50 µg/dL and symptoms of lead toxicity are present.
| | Greater than 69.9 µg/dL
| Critical. Immediate medical evaluation is recommended. Consider chelation therapy when symptoms of lead toxicity are present.
|
| Action required for workers with Elevated Lead Values OSHA, Occupational Exposure to Lead, 1978
| | No. of Tests
| Lead
| Action Required
| | 1
| Greater than or equal to 40.0 µg/dL
| Notification of worker in writing; medical examination of worker and consultation.
| | 3 (average)
| Greater than or equal to 50.0 µg/dL
| Removal of worker from job with potential lead exposure.
| | 1
| Greater than or equal to 60.0 µg/dL
| Removal of worker from job with potential lead exposure.
| | 2
| Less than 40.0 µg/dL
| Reinstatement of worker in job with potential lead exposure is based upon symptoms and medical evaluation.
| | | | OSHA requirements in effect since 1978 call for the measurement of whole blood lead and zinc protoporphyrins (ZPP) (NCCLS document C42-A, Nov. 1996) to evaluate the occupational exposure to lead. OSHA requires ZPP whole blood testing to be reported in units of µg/dL. For adults, conversion of ZPP units of µg/dL whole blood assumes a hematocrit of 45 percent. Conversion factor: umol/mol heme x 0.584= µg/dL.
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| CPT Code(s): |
83655 Lead; 84202 Zinc Protoporphyrin
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