81410:ARSENIC (As), HAIR or NAILS

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81410:ARSENIC (As), HAIR or NAILS
Alias Names: Metals testing
Methodology: Inductively Coupled Plasma (ICP) / Mass Spectrometry (MS)
Edit Date: 10/8/2009 4:58:20 PM
Performed: Monday-Friday
CPT Code: 82175-90
Specimen Collection Details
Collection: Hair or nail clippings in a clean plastic vial. Have professional or patient cut hair.
Handling: Tape at least 0.5 gm hair to a 3×5 index card. Note patient’s name on card. Indicate the distal end of the specimen.
Standard Volume: 0.5 gm hair or nails.
Transport: Ambient.
Comments: Useful in the detection of nonacute arsenic exposure

Reference Range:
<1.00 mcg/g of hair or nails 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.

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 one of the major sites for

accumulation of arsenic. Since arsenic has a high affinity for keratin, the concentration of arsenic in hair or nails 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.

Several weeks after exposure, transverse white striae, called “Mees’ lines,” may appear in the fingernails.

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.

Several weeks after exposure, transverse white striae, called

“Mees’ lines,” may appear in the fingernails.