What is the role of blood lead level (BLL) tests in the workup of lead toxicity?

Updated: Jan 16, 2020
  • Author: Pranay Kathuria, MD, FACP, FASN, FNKF; Chief Editor: Tarakad S Ramachandran, MBBS, MBA, MPH, FAAN, FACP, FAHA, FRCP, FRCPC, FRS, LRCP, MRCP, MRCS  more...
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Although not an accurate measure of the whole-body burden of lead, the BLL is a reasonable approximation of lead exposure, [28] in that levels decline in a predictable manner after removal from the source of lead.

Capillary (ie, fingerstick) blood levels do provide a reliable measurement if performed correctly, though samples improperly collected may be contaminated by lead dust on the skin or from the collecting equipment. The blood must be drawn in an anticoagulated tube and one certified to be lead-free. Confirmation of BLL needs a venous blood sample. Trace metal tubes and anticoagulated tubes are available, but aside from certified tubes, they all tend to give high-biased levels. Because of laboratory limitations, the result may not be immediately available at all institutions.

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