Test Code COWB Cobalt, Blood
Ordering Guidance
This test should not be ordered to assess vitamin B12 activity. For that assessment see B12 / Vitamin B12 Assay, Serum or ACASM / Pernicious Anemia Cascade, Serum.
High concentrations of gadolinium and iodine are known to interfere with most metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Specimen Required
Container/Tube: Royal blue top (EDTA) Vacutainer plastic trace element blood collection tube
Specimen Volume: 1 mL
Collection Instructions:
1. See Metals Analysis Specimen Collection and Transport for complete instructions
2. Send whole blood specimen in original tube. Do not aliquot.
Useful For
Monitoring exposure to cobalt using whole blood specimens
Monitoring metallic prosthetic implant wear
This test is not useful for assessment of vitamin B12 activity.
Special Instructions
Method Name
Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)
Reporting Name
Cobalt, BSpecimen Type
Whole bloodSpecimen Minimum Volume
0.3 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Whole blood | Refrigerated (preferred) | 28 days | |
Ambient | 28 days | ||
Frozen | 28 days |
Reject Due To
Gross hemolysis | OK |
Gross lipemia | OK |
Gross icterus | OK |
Microtainer | Reject |
Reference Values
0-17 years: Not established
≥18 years: <1.0 ng/mL
Interpretation
Concentrations of 1.0 ng/mL and above indicate possible environmental or occupational exposure.
Cobalt concentrations associated with toxicity must be interpreted in the context of the source of exposure. In the context of failed metal-on-metal prosthetics, elevated cobalt in serum or blood is rarely the initial finding and is often preceded by physical symptoms including reduced range of motion, swelling, inflammation around the joints, and general discomfort or pain.
The American Conference of Governmental Industrial Hygienists (ACGIH) Biological Exposure Index (BEI) for cobalt in blood is 1 mcg/L (1 ng/mL), which should be collected at the end of shift at the end of the work week.
Day(s) Performed
Tuesday, Wednesday, Friday
Report Available
1 to 4 daysPerforming Laboratory
Mayo Clinic Laboratories in RochesterCPT Code Information
83018
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
COWB | Cobalt, B | 5625-9 |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
60355 | Cobalt, B | 5625-9 |