Introduction

Toxic elements, often thought of as heavy metals, are essential or non-essential elements that can contribute to or cause adverse health effects, including death. Exposure may occur as a result of an acute incident, such as an industrial accident or poisoning, or chronically, such as through long-term use of contaminated well water. Symptoms of exposure can be non-specific and may mimic an adverse drug reaction or disease. Thus, detection of toxic element exposure depends on laboratory testing. It is important to identify exposure to toxic elements because many symptoms or pathological processes resulting from exposure can be stopped or reversed by removing of the toxic element (decontamination). This chapter addresses pre-analytical and analytical considerations in testing for toxic elements, as well as interpretation of results, from a non-forensic perspective. Six common toxic elements for which laboratory testing is routinely performed are discussed in detail: aluminum, arsenic, cadmium, iron, lead, and mercury.

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