Test ID: HGOM
Mercury for Occupational Monitoring, Urine
Secondary ID 
A test code used for billing and in test definitions created prior to November 2011
NY State Approved Indicates the status of NY State approval and if the test is orderable for NY State clients.
Useful For Suggests clinical disorders or settings where the test may be helpful
Screening potentially exposed workers for mercury toxicity in settings where a 24-hour collection is problematic
Profile Information A profile is a group of laboratory tests that are ordered and performed together under a single Mayo Test ID. Profile information lists the test performed, inclusive of the test fee, when a profile is ordered and includes reporting names and individual availability.
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| HGCO | Hg Conc | No | Yes |
| CDCR | Creatinine Conc | No | Yes |
Special Instructions and Forms Describes specimen collection and preparation information, test algorithms, and other information pertinent to test. Also includes pertinent information and consent forms to be used when requesting a particular test
Method Name A short description of the method used to perform the test
HGCO/21666: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
CDCR/7243: Enzymatic Colorimetric Assay
Reporting Name A shorter/abbreviated version of the Published Name for a test; an abbreviated test name
Aliases Lists additional common names for a test, as an aid in searching
Mercury (Hg)
Specimen Type Describes the specimen type needed for testing
Specimen Required Defines the optimal specimen. This field describes the type of specimen required to perform the test and the preferred volume to complete testing. The volume allows automated processing, fastest throughput and, when indicated, repeat or reflex testing.
Collection Container/Tube: Clean, plastic urine collection container
Submission Container/Tube: Plastic, 6-mL tube (Supply T465) or a clean, plastic aliquot container with no metal cap or glued insert
Specimen Volume: 6 mL
Collection Instructions:
1. Patient should abstain from seafood (especially shellfish) for 2 days prior to urine collection.
2. Collect a random urine specimen.
3. Shake specimen gently.
4. See Metals Analysis-Collection and Transport in Special Instructions for complete instructions.
Specimen Minimum Volume Defines the amount of specimen required to perform an assay once, including instrument and container dead space. Submitting the minimum specimen volume makes it impossible to repeat the test or perform confirmatory or perform reflex testing. In some situations, a minimum specimen volume may result in a QNS (quantity not sufficient) result, requiring a second specimen to be collected.
Reject Due To Identifies specimen types and conditions that may cause the specimen to be rejected
| Hemolysis | NA |
| Lipemia | NA |
| Icterus | NA |
| Other | NA |
Specimen Stability Information Provides a description of the temperatures required to transport a specimen to the laboratory. Alternate acceptable temperature(s) are also included.
| Specimen Type | Temperature | Time |
|---|---|---|
| Urine | Refrigerated (preferred) | 7 days |
| Frozen | 7 days |
Clinical Information Discusses physiology, pathophysiology, and general clinical aspects, as they relate to a laboratory test
Mercury (Hg), a well-known toxin, is essentially nontoxic in its elemental form. However, once it is chemically modified to the ionized, inorganic species, Hg(++), it becomes toxic. Further bioconversion to an alkyl Hg, such as methyl Hg (CH[3]Hg[+]), yields a species of Hg that is highly selective for lipid-rich tissue, such as the myelin sheath, and is very toxic.
Industrial exposure is a major source of Hg intoxication.
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.
MERCURY/CREATININE
<35 mcg/g
Interpretation Provides information to assist in interpretation of the test results
Urinary mercury (Hg) is the most reliable way to assess exposure to inorganic Hg, but the correlation between the levels of excretion in the urine and clinical symptoms is poor.
The reference interval corresponds to the Occupational Safety and Health Administration (OSHA) guideline for Hg exposure.
The ordering physician will be contacted regarding any result exceeding OSHA thresholds to determine the level of workplace exposure and follow-up action.
Cautions Discusses conditions that may cause diagnostic confusion, including improper specimen collection and handling, inappropriate test selection, and interfering substances
Nitric acid should not be added to the collection. This test is intended for use as a screening tool for occupational monitoring. It is not a replacement of HMSU/8633 Heavy Metals Screen, 24 Hour, Urine.
Clinical Reference Provides recommendations for further in-depth reading of a clinical nature
1. Lee R, Middleton D, Caldwell K, et al. A review of events that expose children to elemental mercury in the United States. Environ Health Perspect 2009 Jun;117(6):871-878
2. Bjorkman L, Lundekvam BF, Laegreid T, et al: Mercury in human brain, blood, muscle and toenails in relation to exposure: an autopsy study. Environ Health 2007 Oct 11;6:30
Method Description Describes how the test is performed and provides a method-specific reference
Mercury can be readily analyzed on an inductively coupled plasma-mass spectrometer (ICP-MS). Aqueous acidic calibrating standards are diluted with a matrix urine containing normal concentrations of these elements and aqueous acidic diluent containing internal standards. Blanks are diluted with the aqueous acidic diluent containing internal standards but no urine matrix. Quality control specimens and patient specimens also are diluted in an identical manner. In turn, all diluted blanks, calibrating standards, quality control specimens, and patient specimens are aspirated into a pneumatic nebulizer and the resulting aerosol directed to the hot plasma discharge by a flow of argon. In the annular plasma the aerosol is vaporized, atomized, and then ionized. The ionized gasses plus neutral species formed in the annular plasma space are aspirated from the plasma through an orifice into a quadrupole mass spectrometer. The mass range from 1 to 263 amu is rapidly scanned multiple times and ion counts tabulated for each mass of interest. Instrumentation response is defined by the linear relationship of analyte concentration versus ion count (analyte ion count/internal standard ion count). Analyte concentrations are derived by reading the ion count ratio for each mass of interest and determining the concentration. (Nixon DE, Burritt MF, Moyer TP: The determination of mercury in whole blood and urine by inductively coupled plasma mass spectrometry. Spectrochimica Acta, Part B-Atomic Spectroscopy 1999;54:1141-1153; Hanley MM, Eckdahl SJ, Kiedrowski B, et al: A comparison of methods for attenuation of oxide interferences in cadmium and mercury analysis by ICP-MS [Abstract 627]. 38th Federation of Analytical Chemistry and Spectroscopy Societies, Reno, NV, October 2-6, 2011)
Day(s) and Time(s) Test Performed Outlines the days and times the test is performed. This field reflects the day and time the sample must be in the testing laboratory to begin the testing process and includes any specimen preparation and processing time required before the test is performed. Some tests are listed as continuously performed, which means assays are performed several times during the day.
Monday through Friday; 3 p.m. - 9 p.m.; Saturday; 8 a.m. – 3 p.m./Continuously
Analytic Time Defines the amount of time it takes the laboratory to setup and perform the test. This is defined in number of days. The shortest interval of time expressed is "same day/1 day," which means the results may be available the same day that the sample is received in the testing laboratory. One day means results are available 1 day after the sample is received in the laboratory.
Maximum Laboratory Time Defines the maximum time from specimen receipt at Mayo Medical Laboratories until the release of the test result
Specimen Retention Time Outlines the length of time after testing that a specimen is kept in the laboratory before it is discarded
Performing Laboratory Location The location of the laboratory that performs the test
Test Classification Provides information regarding the medical device classification for laboratory test kits and reagents. Tests may be classified as cleared or approved by the US Food and Drug Administration (FDA) and used per manufacturer's instructions, or as products that do not undergo full FDA review and approval, and are then labeled as an Analyte Specific Reagent (ASR), Investigation Use Only (IUO) product, or a Research Use Only (RUO) product.
CPT Code Information Provides guidance in determining the appropriate Current Procedural Terminology (CPT) code(s) information for each test or profile. The listed CPT codes reflect Mayo Medical Laboratories interpretation of CPT coding requirements. It is the responsibility of each laboratory to determine correct CPT codes to use for billing.
83825
LOINC® Code Information Provides guidance in determining the Logical Observation Identifiers Names and Codes (LOINC) values for the result codes returned for this test or profile.
| Result ID | Reporting Name | LOINC Code |
|---|---|---|
| CDCR | Creatinine Conc | 35674-1 |
| 21667 | Hg Conc | 5689-5 |
| 21679 | Hg/Creatinine Ratio | 13465-0 |
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