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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.

Method Name

Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Cobalt, B

Specimen Type

Whole blood

Specimen 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 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

CPT 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