Gwendolyn A McMillin PhD and Joshua A Bornhorst PhD

Contents

1. Introduction

2. Specimens

3. Laboratory Methods

4. Interpretation of Toxic Element Testing Results

5. Treatment of Toxic Element Poisoning

6. Other Toxic Elements

7. Conclusions

Elements are the basis of all things. However, human exposure to significant amounts of some elements can lead to adverse health effects including death. Laboratory testing can help identify unrecognized exposures as well as monitor-associated decontamination efforts. Regular testing is also important to identify exposures in populations that are at high risk for exposure to a specific toxic element. For example, aluminum is important to monitor in dialysis patients. Lead is important to monitor in children that live in areas in which environmental lead contamination is prevalent. Mercury is important to monitor in dental workers and individuals for whom predatory fish frequents the diet. Arsenic and cadmium are important to monitor in certain industrial settings. Iron is important to monitor for individuals at risk for iron overload. The quality of laboratory results depends on collection of the appropriate specimen and efforts to minimize external contamination of the specimen with the element of interest. Interpretation of results should also consider the time between specimen collection and exposure, whether the exposure is acute or chronic, the specific elemental form involved, and the clinical status of the patient. Pre-analytical, analytical, and post-analytical factors important to the investigation of known or unknown toxic elemental exposures are discussed in this chapter, particularly relating to aluminum, arsenic, cadmium, iron, lead, and mercury.

Key Words: Aluminum; arsenic; cadmium; iron; lead; mercury; metals.

Summary

From: Handbook of Drug Monitoring Methods Edited by: A. Dasgupta © Humana Press Inc., Totowa, NJ

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