Detection of nonacute arsenic exposure
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
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 1 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 hair are used to document long-term (6 months-1 year) exposure.
Reference Values Describes reference intervals and additional information for interpretation of test results. May include intervals based on age and sex when appropriate. Intervals are Mayo-derived, unless otherwise designated. If an interpretive report is provided, the reference value field will state this.
0-15 years: not established
> or =16 years: 0.0-0.9 mcg/g of hair
Hair grows at a rate of approximately 0.5 inch/month. Hair keratin synthesized today will protrude through the skin in approximately 1 week. Thus, a hair specimen collected at the skin level represents exposure of 1 week ago, 1 inch distally from the skin represents exposure 2 months ago, etc.
Hair arsenic >1.00 mcg/g dry weight indicates excessive exposure. It is normal for some arsenic to be present in hair, as everybody is exposed to trace amounts of arsenic from the normal diet.
The highest hair arsenic observed at Mayo Clinic was 210 mcg/g dry weight in a case of chronic exposure that was the cause of death.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Sthiannopkao S, Kim K-W, Cho KH, et al: Arsenic levels in human hair, Kandal Province, Cambodia: The influences of groundwater arsenic, consumption period, age and gender. Applied Geochemistry 2010;25:81–90
2. Pearse DC, Dowling K, Gerson, AR, et. al: Arsenic microdistribution and speciation in toenail clippings of children living in a historic gold mining area. Science of the Total Environment 2010;408:2590–2599