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HelpTest Code HMHA Heavy Metals, Hair
Reporting Name
Heavy Metals, HairUseful For
Detection of nonacute arsenic, mercury, and lead exposure using hair specimens
Profile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| ASHA | Arsenic, Hair | Yes | Yes |
| PBHA | Lead, Hair | Yes | Yes |
| HGHAR | Mercury, Hair | Yes | Yes |
Method Name
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Performing Laboratory
Mayo Clinic Laboratories in Rochester
Specimen Type
HairNecessary Information
Indicate source of hair (axillary, head, or pubic), if known
Specimen Required
Supplies: Hair and Nails Collection Kit (T565)
Specimen Volume: 0.2 g
Collection Instructions: Prepare and transport specimen per the instructions in kit or see Collecting Hair and Nails for Metals Testing.
Specimen Minimum Volume
0.05 g
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Hair | Ambient (preferred) | ||
| Frozen | |||
| Refrigerated | |||
Reject Due To
All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.Special Instructions
Reference Values
ARSENIC
0-15 years: Not established
≥16 years: <1.0 mcg/g of hair
LEAD
<4.0 mcg/g of hair
Reference values apply to all ages.
MERCURY
0-15 years: Not established
≥16 years:<1.0 mcg/g of hair
Day(s) Performed
Tuesday
CPT Code Information
82175-ASHA
83655-PBHA
83825-HGHAR
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| HMHA | Heavy Metals, Hair | 34667-6 |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 31896 | Arsenic, Hair | 5584-8 |
| 31900 | Mercury, Hair | 5686-1 |
| 31898 | Lead, Hair | 5673-9 |
| PBHSC | Specimen Source | 31208-2 |
| HGHSC | Specimen Source | 31208-2 |
| ASHSC | Specimen Source | 31208-2 |
Clinical Information
ARSENIC
Arsenic circulating in the blood will bind to protein by formation of a covalent complex with sulfhydryl groups of the amino acid cysteine. Keratin, the major structural protein in hair and nails, contains many cysteine residues and, therefore, is one of the major sites for accumulation of arsenic. Since arsenic has a high affinity for keratin, the concentration of arsenic in hair is higher than in other tissues.
Arsenic binds to keratin at the time of exposure, "trapping" the arsenic in hair. Therefore, hair analysis for arsenic is not only used to document that an exposure occurred, but when it occurred. Hair collected from the nape of the neck can be used to document recent exposure. Axillary or pubic hairs are used to document long-term (6 months-1 year) exposure.
MERCURY
Once absorbed and circulating, mercury becomes bound to numerous proteins, including keratin. The concentration of mercury in hair correlates with the severity of clinical symptoms. If the hair can be segregated by length, such an exercise can be useful in identifying the time of exposure.
LEAD
Hair analysis for lead can be used to corroborate blood analysis or to document past lead exposure. If the hair is collected and segmented in a time sequence (based on length from root), the approximate time of exposure can be assessed.