Toxicology

Serum: Collect blood in plain red-top evacuated tube. Do not use gel barrier tubes. Allow blood to clot at room temperature for 20-30 minutes. Separate serum from red cells by centrifugation at 800-1000 g for 10-15 minutes, at room temperature (approximately 15-25°C). Pour off serum in a polyethylene or polypropylene transport tube. Ship at the appropriate temperature (see individual test requirements).

Plasma: Collect blood in lavender-top evacuated tube (EDTA). Allow red cells to settle. Pipette plasma using glass, polypropylene or polyethylene pipettes into polypropylene or polyethylene transport tubes. Ship at the appropriate temperature (see individual test requirements).

For determination of trace elements

Serum: Royal blue-top evacuated tubes certified free of the trace element in question are required for specimen collection. Please note that not all commercially available royal blue-top evacuated tubes are suitable for aluminum and selenium determination. A trace element serum collection package is provided containing acid-washed shipping containers (red label) and royal blue-top tubes (red label) suitable for aluminum, chromium, manganese, selenium, copper, and zinc in serum. Patients should refrain from taking vitamins, mineral supplements or antacids at least three days prior to specimen collection. (See individual test requirements.)

Allow the specimen to clot at room temperature (15-30°C) for 30 minutes. Centrifuge the tube at 800-1000 g for 10-15 minutes, at room temperature. Pour the serum into a plastic trace element shipping container (red label). Use powderless gloves as part of standard precautions. Firmly replace the cap on the red labeled vial and ship the specimen refrigerated (2-10°C).

Plasma: Royal blue-top evacuated tubes (EDTA) certified free of the trace element in question are required for specimen acquisition arid transport. Many commercially available royal blue-top tubes are suitable for zinc and copper determinations in plasma. Acid-washed shipping containers (lavender-labeled) are available for determinations of aluminum, chromium, manganese, selenium, copper, and zinc in plasma. Be sure to gently mix the specimen promptly after phlebotomy. Centrifuge the tube and pour the plasma into a plastic trace element shipping container. Use powderless gloves. Firmly replace the cap on the lavender-labeled vial and ship the specimen refrigerated. Avoid royal blue-top tubes containing heparin since the specimen frequently will gel or develop micro clots over time. Be sure to confirm that the specific tubes used are free of the trace element in question. Patients should refrain from taking vitamins, mineral supplements or antacids at least three days prior to specimen collection. (See individual test requirements.)

Whole Blood: Specimens requiring whole blood are collected in EDTA containing royal blue-top evacuated tubes, free of the trace element in question. Analytes such as arsenic, cadmium, cobalt, lead, manganese, mercury, molybdenum, strontium, and thallium are sometimes analyzed in whole blood.

Be sure to gently mix the specimen immediately after collection. Alternatively, whole blood may be poured into a plastic trace element shipping container (lavender label). Ship refrigerated. Use powderless gloves. Patients should refrain from eating seafood, antacids, or taking mineral or herbal

supplements at least three days prior to specimen collection. (See individual test requirements.) For Lead and Zinc Protoporphyrin, Blood (test code 3699N), collect whole blood in EDTA containing royal blue-top evacuated tubes. Wrap tube in aluminum foil to protect from light. Ship refrigerated.

Urine:

Container
Collect urine in clean, trace element-free, or acid-washed plastic (polypropylene) containers without preservatives and glued inserts. The cap must be plastic. Do not expose container to direct sunlight or warm surface.

Collection Conditions
Inadvertent contamination of the specimen during collection is a problem. Frequent causes include introduction of dust from outer clothing and from hands contaminated by trace elements. This is a particular problem if the work environment contains large amounts of the element in question. Patients should be instructed to wash their hands each time before opening the container. Collect specimen in an area away from the work environment. Patients should refrain from eating seafood, antacids, mineral or herbal supplements at least three days prior to specimen collection. (See individual test requirements.) Specimen Collection

Specimen transfers and shipping

Acid-washed shipping containers are available. After collection, be sure the urine is mixed well before transferring to the shipping container. Carefully pour the designated amount of urine directly from the collection container into the acid washed shipping container (yellow label). For random urine, prepare two aliquots if practical. One aliquot is used for creatinine determination. Be careful not to expose the urine to contaminants, such as using a non-acid washed pipette for specimen transfer or measuring the total urine volume in a contaminated graduated cylinder. Do not add any hydrochloric acid or preservative to avoid contamination. Finally, be sure the cap is firmly closed on the shipping container. Ship refrigerated. For mercury determinations, ship and store frozen if the specimen is not sent within 24 hours of collection. Please note urine type on the test request form (random or 24-hr urine). Generally, the urine is suitable for trace element determination under the following conditions: room temperature – 2 days, refrigerated – 5 days, frozen – 2 weeks.

Immune cell function assay

This lymphocyte stimulation assay requires that testing be performed in less than 30 hours from the time of phlebotomy. Please contact Customer Service at (800) 553-5445 prior to specimen collection for optimal phlebotomy and logistics services in order to meet this critical time requirement.