CADMIUM EXPOSURE PANEL - OSHA

Components
Blood cadmium levels can be used to monitor acute toxicity. In combination with cadmium urine and B-2 microglobulin is the preferred method for monitoring occupational exposure.
Urine cadmium estimates cadmium body burden.
Urine Beta-2 Microglobulin is an early marker of irreversible kidney damage and disease.
Urine creatinine values less than 20 mg/dL represent very dilute urine and collections should be repeated.

Specimen Required
To avoid contamination, please collect specimens at the beginning of work shift. Blood and urine should be collected the same day.
Urine: diet, medication, and nutritional supplements may introduce interfering substances. Patients should be encouraged to discontinue nutritional supplements, vitamins, minerals, and non-essential over-the-counter medications (upon the advice of their physician). High concentrations of iodine may interfere with elemental testing. Collection of urine specimens from patients receiving iodinated or gadolinium-based contrast media should be avoided for a minimum of 72 hours post-exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 72 hours post-exposure. Collection from patients with impaired kidney function should be avoided for a minimum of 14 days post contrast media exposure.
Cadmium, Blood: Draw blood in a dark blue EDTA. Send 7.0 mL whole blood (0.5 mL minimum) refrigerated in original collection tube.
Urine: Collect 40.0 mL random urine
Cadmium, Urine: Send 7 mL urine from the random collection. Send refrigerated in a blue-capped ARUP metal-free screw-capped plastic vial labeled "Cadmium".
Creatinine, Urine: Send 5.0 mL urine from the random collection refrigerated in an IATA-approved screw-capped plastic vial labeled "creatinine".
B-2-Microglobulin, Urine: Send 4.0 mL urine from the random collection, adjusted to pH 6-8 using 1M HCl or 5% NaOH, frozen in an IATA-approved screw-capped plastic vial, labeled B2M. Freeze within one hour of collection.

Rejection Criteria
Blood - Specimens collected in tubes other than Dark Blue EDTA.
Hepatinized specimens. Clotted specimens.
Cadmium, Urine - Specimens not in blue-capped ARUP metal-free vials. Specimens containing blood or fecal material.
Specimens collected within 72 hours after administration of iodinated or gadolinium-based contrast media.

Methodology
Cadmium, Urine & Blood: Inductively Coupled Plasma/Mass Spectrometry
Urine: Chemiluminescent Immunoassay
Creatinine, Urine: Spectrophotometry
B-2-Microglobulin, Urine: Chemiluminescent Immunoassay

Stability
Cadmium, Blood: If the sample is drawn and stored in the appropriate container, the trace element values do not change with time.
Cadmium, Urine: Room Temperature: 7 days; Refrigerated: 14 days; Frozen: 1 year
Creatinine, Urine: Room Temperature: 24 hours; Refrigerated: 4 days; Frozen: 2 months
Beta-2-Microglobulin, Urine: Room Temperature: 8 hours; Refrigerated: 2 days; Frozen: 2 months

Reference Range
Cadmium, Urine - per volume:   0.0-1.0 ug/L  
Cadmium, Urine - per 24h:   0.0-3.2 ug/d  
Cadmium, Urine - ratio to CRT   0.0-3.2 ug/g CRT  

Performed
Monday-Friday

Turnaround Time5-7 days
Test CodeCADEP
CPT-4 Code (s)
82300 x 2, 82232
LOINC Codes
Cadmium, blood   5609-3  
Cadmium, urine   5611-9  
Creatinine, random urine   2161-8  
Cadmium per gram of Creatinine   13471-8  
B-2 Microglobulin, urine   1953-9  
B-2 Microglobluin per gram of Creatinine   13485-8  

Warde
Medical
Laboratory