Test Name Results Units Bio. Ref. Interval

Transcription

1 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final METAL SCREEN 3, URINE - ARSENIC,CADMIUM,CHROMIUM,COBALT, COER, LEAD, MANGANESE, MERCURY, NICKEL, SELENIUM, THALLIUM, ZINC ARSENIC 24-HOUR URINE µg/l < Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy/trace metals in biological tissues 2. Urine is the preferred specimen if symptoms are present or in cases of acute exposure Arsenic is used in ant poisons, rodenticides, herbicides, weed killers, insecticides, paints, wood preservatives, ceramics, production of various metal alloys, livestock feed, tanning agents and in medicines. Occupational exposure to arsenic usually occurs in the manufacture of pesticides, herbicides and other agricultural products. High exposure to arsenic fumes occurs in smelting industries. Environmental arsenic exposure usually occurs from arsenic contaminated drinking water. Seafood may contribute significantly to daily arsenic intake. Epidemiological studies suggest that arsenic is carcinogenic in humans. CADMIUM, 24-HOUR URINE 1.00 µg/l < Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy/trace metals in biological tissues 2. To assess occupational exposure sample should be collected at the end of the shift on the last day of the work week 3. Antacids, Antibiotics & Anti-tuberculous therapy falsely reduce the levels Cadmium ranks close to lead and mercury as one of the top toxic substances. About 75% of cadmium produced is used in batteries, especially nickel-cadmium batteries. Food is the major source for general population specially shell fish, animal liver & kidney, grains like rice & wheat & tobacco. Cigarette smoking is a major non-occupational source of cadmium exposure. Occupations potentially at risk from cadmium exposure include those involved in refining zinc and lead ores, iron production, manufacture of cement, paints & pigments, cadmium nickel batteries, electroplating & fossil fuel combustion. CHROMIUM, 24-HOUR URINE 2.00 µg/l <5.00 atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 1 of 7

2 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final 1. Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy/trace metals in biological tissues 2. To assess occupational exposure sample should be collected at the end of the shift on the last day of the work week Chromium is a naturally occurring essential trace nutrient required as a co-factor in the initiation of insulin action on peripheral tissues. Reduced chromium intake maybe an aggravating factor in the disturbed glucose tolerance of marasmic infants, maturity onset diabetes and some elderly persons. Toxicity is mostly from occupational exposure in electroplating, welding, steel making, leather tanning, photography, dyeing & chemical manufacture industries. COBALT, 24-HOUR URINE 1.10 µg/l Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues 2. To assess occupational exposure sample should be collected at the end of the shift on the last day of the work week Cobalt is an integral component of vitamin B12, found in most foods and readily absorbed from the GI tract. Cobalt concentrations may be increased in individuals with deteriorating orthopedic implants. Cobalt is usually used in treating cancers of oral cavity, pharynx, larynx & penis as well as radiosensitive tumors.toxic effects due to excessive cobalt intake have been noted in renal patients receiving erythropoietic agents and in heavy drinkers of beer with added cobalt.deficiency has not been reported in humans. COER, 24-HOUR URINE Copper, 24 hour urine ug/l Copper, 24 hour urine ug/day Total Urine Volume ml/day atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 2 of 7

3 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final 1. Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues 2. Urine assay is useful in diagnosing / assessing treatment for Wilson s disease Copper is the third most abundant trace element in the human body required for enzymatic reactions. Dietary sources of copper are liver, shell fish, chocolate, nuts and seeds. Copper pipes or vessels do not increase the copper content of water unless exposed to acids. Smoking, strenuous exercise, infections and injuries increase the body s need for copper. Ceruloplasmin, a copper containing protein is a useful indicator of copper status. Increased Levels Wilson s disease, Chronic active hepatitis, Biliary cirrhosis, Rheumatoid arthritis & proteinuria rotein malnutrition LEAD, 24-HOUR URINE # µg/l <80.00 To assess occupational exposure sample should be collected at the end of the shift on the last day of the work week Lead is the most ubiquitous toxic metal detectable in practically all phases of the inert environment and in all biological systems. Industrial exposure to lead is seen in industries manufacturing lead containing paints & ceramic glazes, batteries, water pipes & ammunition. Major exposure of the general population is through food & water. Lead containing toys & paints are a primary source of lead exposure in children. Centre for Disease Control (CDC) recommends universal screening of children from 6 months of age. Acute toxicity is uncommon as compared to chronic toxicity leading to intellectual deficit and lead induced anemias in children. MANGANESE, 24-HOUR URINE 1.00 µg/l < Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues 2. To assess occupational exposure sample should be collected at the end of the shift on the last day of the work week atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 3 of 7

4 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final Manganese is an essential element used as a co-factor for a number of enzymatic reactions. Main intake is derived from food, vegetables, germinal portions of grains, fruits, nuts, tea and some spices. It is used in industries dealing with steel alloys, dry cell batteries, electrical coils, ceramics, matches, glass tiles, welding rods, animal food additives & fertilizers. Individuals working in industries with high concentrations of manganese dust show a 30 times greater incidence of respiratory disease than normal individuals. Manganese exposure leads to abnormal electrocardiogram and inhibits myocardial contraction. Increased Levels Acute hepatitis Industrial exposure Myocardial infarction Seizures henylketonuria MERCURY, 24-HOUR URINE Interpretation REFERENCE GROU REFERENCE RANGE IN ug/l Normal individuals <10 Occupational exposure Toxicity >150 Lethal levels > µg/l < Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues. 2. Urine is the recommended specimen for measuring inorganic mercury. 3. Dimercaprol and enicillamine increase urinary mercury levels when used to treat poisoning while iodine containing medication reduces the level Mercury is essentially non-toxic in its elemental form, but once ionized it becomes highly toxic. It is used as a atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 4 of 7

5 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final conductor in electrical switches, home thermostats, pulp and paper industry, synthesis of plastics and latex paints. It is also used in dentistry & scientific instruments. Dietary sources can also contribute to mercury body burden e.g fish. Acute poisoning usually results from oral ingestion of inorganic mercury while chronic poisoning is from inhalation or ingestion. Acute toxicity with elemental, inorganic or most organic forms of mercury can be diagnosed from urinary levels. NICKEL, 24-HOUR URINE Nickel, 24-Hrs Urine 3.00 µg/l <5.20 Volume 2.00 Liters 1. Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues 2. To assess occupational exposure sample should be collected at the end of the shift on the last day of the work week Nickel is ubiquitous in nature and general population is exposed to low levels of nickel in air, cigarette smoking, water and food. However these exposures are generally too low to be of toxicological concern. Occupational exposure occurs by inhalation of nickel containing aerosols, dust, fumes or dermal contact in workers engaged in nickel production / nickel using operations / nickel-cadmium batteries. Nickel allergy affects 10-15% of the population and can develop from occupational exposure or exposure to nickel containing jewelry & implanted prosthesis. Urinary nickel correlates closely with exposure to airborne levels of insoluble nickel compounds thus serving as a suitable measure of current nickel exposure. Increased Levels Industrial exposure, Nickel carbonyl intoxication, Acute Myocardial Infarction, Acute Stroke, Extensive thermal burns, dialysis patients, Disulfiram therapy Hepatic & Renal diseases SELENIUM, 24-HOUR URINE µg/l < atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 5 of 7

6 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues Selenium is an essential element that is toxic in high doses. Foods are a good source of selenium especially seafood like shrimp, meat, milk products & grains. Combustion of coal and other fossil fuels are the primary sources of airborne selenium. Occupational exposure comes from selenium refining / metal smelting / milling operations, manufacture of glass pigments, paints, dyes, electronic equipments, fungicides, rubber & semiconductors. Acute selenium toxicity in humans is rare. Chronic selenium toxicity (Selenosis) can occur with environmental exposure when the intake exceeds the excretory capacity. THALLIUM, 24-HOUR URINE 1.00 µg/l <2.00 Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues Thallium is one of the most toxic metals. Thallium salts are used in medication, cosmetics, pesticides & radiological procedures. It has been used medicinally as a depilatory. One of the commonest source of human thallium poisoning is in the form of rodenticides & pesticides. Thallium poisoning occurs from ingestion or absorption through intact skin and mucous membranes and alopecia is the main effect. Thallium can transfer across placenta and is found in breast milk thereby leading to toxicity in the offspring. ZINC, 24-HOUR URINE µg/l Inductively Coupled lasma Mass Spectrometry is used to determine the level of heavy / trace metals in biological tissues Zinc is second to iron as the most abundant trace element in the body.most zinc is in the skeletal muscle (60%) and bone (30%).It is involved in almost all aspects of metabolism.dietary sources of zinc are oysters, shell fish & meat.zinc is required for wound healing, immune function and fetal development.human zinc deficiency is often associated with diets low in animal derived protein but high in cereals that bind zinc.nutritional zinc deficiency is fairly prevalent despite wide availability of zinc in foods.long term zinc supplementation may induce copper deficiency.zinc toxicity is rare in humans. Inhalation of zinc oxide fumes is the most common cause of metal fume fever. atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 6 of 7

7 Age 32 Years Gender Female 7/9/ AM 7/9/ M 8/9/ M Ref By Final Hypogonadal dwarfism & Zinc deficiency Increased levels Hyperparathyroidism, Alcoholism, Sickle cell anemia, Cirrhosis liver, Viral hepatitis, ost surgery & Total parenteral nutrition Dr Himangshu Mazumdar MD (Biochemistry) Consultant Biochemist Dr. Nimmi Kansal MD (Biochemistry) HOD Biochem & IA End of report atientreportscsuperanel.s_general_temlate01_sc (Version 7) age 7 of 7