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Test Code COUO Cobalt Occupational Exposure, Random, Urine


Ordering Guidance


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


Supplies: Urine Tubes, 10 mL (T068)

Collection Container/Tube: Clean, plastic urine collection container

Submission Container/Tube: Plastic 10 mL urine tube or a clean, plastic aliquot container with no metal cap or glued insert

Specimen Volume: 3 mL

Collection Instructions:

1. At the end of the work week, collect a random urine specimen at the end of the employee's work shift.

2. See Metals Analysis Specimen Collection and Transport for complete instructions.


Useful For

Screening for occupational exposure to cobalt

Profile Information

Test ID Reporting Name Available Separately Always Performed
CRETR Creatinine, Random, U No Yes
COUOE Cobalt Occupational Exposure, U No Yes

Method Name

CRETR: Enzymatic Colorimetric Assay

COUOE: Inductively Coupled Plasma-Mass Spectrometry (ICP-MS)

Reporting Name

Cobalt Occupat Exp, Random, U

Specimen Type

Urine

Specimen Minimum Volume

2 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Urine Refrigerated (preferred) 28 days
  Frozen  28 days
  Ambient  14 days

Reject Due To

  All specimens will be evaluated at Mayo Clinic Laboratories for test suitability.

Clinical Information

Cobalt is rare but widely distributed in the environment. It is an essential cofactor in vitamin B12. While cobalt is an essential element, cobalt deficiency has not been reported in humans.

 

Cobalt is used in the manufacture of hard alloys with high melting points and resistance to oxidation. Cobalt salts are also used in the glass and pigment industry. Previously, cobalt salts were sometimes used as foam stabilizers in the brewing industry; this practice was banned due to the cardiovascular diseases it induced. The radioactive isotope of cobalt, (60)Co, is used as a gamma emitter in experimental biology, cancer therapy, and industrial radiography.

 

Cobalt is not highly toxic, but large doses will produce adverse clinical manifestations. Acute symptoms are pulmonary edema, allergy, nausea, vomiting, hemorrhage, and kidney failure. Chronic symptoms include pulmonary syndrome, skin disorders, and thyroid abnormalities. The inhalation of dust during machining of cobalt alloyed metals can lead to interstitial lung disease. Improperly handled (60)Co can cause radiation poisoning from exposure to gamma radiation.

Reference Values

COBALT:

0-17 years: Not established

≥18 years: The American Conference of Governmental Industrial Hygienists Biological Exposure Index for cobalt in urine is an end-of-shift concentration above14.9 mcg/L at the end of the work week.

 

CREATININE:

≥18 years old: 16-326 mg/dL

Reference values have not been established for patients who are younger than 18 years of age.

Interpretation

For occupational exposure, the sampling time is at the end of the shift at the end of the work week. The American Conference of Governmental Industrial Hygienists Biological Exposure Index for cobalt is a concentration of 15.0 mcg/L or above at the end of the work week.

Cautions

Normal specimens have extremely low levels of cobalt; elevated results could easily be a result of external contamination. Precautions must be taken to ensure the specimen is not contaminated. Metal-free urine collection procedures must be followed. Refrigeration is preferred over chemical methods of preservation.

Method Description

The metal of interest is analyzed by inductively coupled plasma mass spectrometry.(Unpublished Mayo method)

Specimen Retention Time

14 days

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Test Classification

This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.

CPT Code Information

83018

82570

LOINC Code Information

Test ID Test Order Name Order LOINC Value
COUO Cobalt Occupat Exp, Random, U 13468-4

 

Result ID Test Result Name Result LOINC Value
607763 Cobalt Occupational Exposure 13468-4
CRETR Creatinine, Random, U 2161-8
608389 Cobalt Concentration 5628-3

Day(s) Performed

Tuesday, Wednesday, Friday

Report Available

1 to 4 days