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- Title
Total Arsenic Screening Prior to Fractionation Enhances Clinical Utility and Test Utilization in the Assessment of Arsenic Toxicity.
- Authors
Hackenmueller, Sarah A.; Strathmann, Frederick G.
- Abstract
Objectives: The objective was to evaluate the utility of a screen with reflex-to-fractionation testing compared with direct-to-fractionation testing for suspected toxic exposure. Methods: This study was based on a retrospective data analysis of urine arsenic results from previously tested samples (n = 12,960). Total urine arsenic by inductively coupled plasma mass spectrometry was used as a screening method to identify elevated arsenic concentrations. Arsenic fractionation was the speciation assay to differentiate toxic and benign arsenic species. Results: Screening samples based on total arsenic concentration resulted in less than 10% of samples requiring arsenic fractionation, with a final positivity rate of less than 1% for toxic arsenic. Samples with fractionation ordered directly had a positivity rate for toxic arsenic of 3.3%. The overall positivity rate for exposure to toxic arsenic was less than 1%. Conclusions: A total arsenic screen before fractionation reduces the number of samples requiring fractionation by more than 91%, supporting the use of a screen with a reflex- to-fractionation approach for urine arsenic.
- Subjects
DOSE fractionation; ARSENIC in the body; TOXICITY testing; URINALYSIS; PHYSIOLOGICAL effects of arsenic
- Publication
American Journal of Clinical Pathology, 2014, Vol 142, Issue 2, p184
- ISSN
0002-9173
- Publication type
Article
- DOI
10.1309/AJCPHUB0YEHPRAWA