Test Category: Specialist Biochemistry
Investigation Name:Arsenic- Urine
Alias or Abbreviation:Urine As, 24 hour urine arsenic excretion, urine arsenic to creatinine ratio
Accreditation:UKAS ISO15189:2022 accredited test: On scope
Intro:
Arsenic is a non-essential element, and exposure, predominantly to the inorganic tri- and penta-valent forms, has the potential to produce severe toxicity. Exposure may occur from occupational sources, the environment, and also “traditional” remedies. Acute ingestion of soluble inorganic salts can induce severe vomiting, abdominal pain and diarrhoea and in extreme circumstances, cardiac arrhythmias and arrest. >br/> Chronic exposure may precipitate less severe, but re-current, gastro-intestinal symptoms and eventually peripheral neuropathy and renal damage. Concern regarding the exposure of industrial workers has increased following the realisation that the element may be carcinogenic. An antidote to arsenic poisoning is available: British Anti Lewisite (BAL) or Dimercaprol.Blood arsenic has a very short half-life (hours) and is therefore of little clinical utility, with the exception of assessing very recent, acute exposure. Urine arsenic is the investigation of choice for assessing arsenic exposure.
Organic arsenic compounds are found in fish and shellfish; these are non-toxic and excreted unchanged. However, to aid interpretation of the results, it is advised to exclude dietary sources of arsenic five days prior to collecting samples for blood and/or urine arsenic, wherever possible.
Pathology Laboratory:Trace Elements Laboratory
Requestable Seperately?Yes
Units:nmol/mmol creatinine
Minimum Sample Volume:2 mL urine
Expected Turnaround Time:7 working days.
Urgent analysis where clinically indicated may be arranged directly with the laboratory.
Test Code:UAS
Sample Type:
Investigation of toxicity & occupational monitoring:Spot urine collected into a plain white -top universal container.
For monitoring 24hr arsenic excretion during chelation treatment:
24h urine collection in polypropylene collection container or polyethylene container
Specimens can be aliquoted into a plain white -top universal container prior to transportation
24-hour collection period dates, time and total volume MUST be recorded.
Complex Reference Range:Spot urine: < 17 nmol/mmol creatinine
where fish and seafood, and other sources of dietary arsenic have been excluded from the diet for 5 days prior to collecting the sample.
Collection Conditions / Other Information:If total arsenic concentrations are extremely high, arsenic speciation can be performed to determine whether the source of exposure is due to non-toxic dietary arsenic, or toxic in-organic arsenic species. This can be arranged via discussion with the laboratory.
For occupational monitoring, a spot urine collected end of shift, end of working week is recommended.
Referred to Another Laboratory?No
Storage Requirements:Store at 4 °C prior to dispatch.>br/> If dispatching within 24 hours of collection, store for longer periods at −20 °C
Posting Address / Requirements:1st class post at ambient temperature
Sandwell Health Campus,
Specialist Chemistry,
Pathology Department,
Lyndon,
B71 4HJ.
NPEX / PDF Reporting Available:Yes
EQA Scheme:UK NEQAS for Trace Elements
Further information:We are a designated Supra-Regional Assay Service (SAS) Laboratory for Trace Elements.
Lead Contact Details:Dr Nicola Barlow, Consultant Clinical Scientist, SAS Director Trace Elements Laboratory,
Email: nicola.barlow1@nhs.net
Email Address For Chasing Results:rwh-tr.bcpsspecialistchemistryenquiries@nhs.net
Methodology:Inductively coupled plasma mass spectrometry
Site Sample Tested:Sandwell Health Campus
Cost:Please email bcpspathology.info@nhs.net for further details
Contact Number: Tel: 0121 507 5162
