Cobalt (Co) and Chromium (Cr) are minerals required as dietary components in trace amounts; but, when present at high concentrations, both metals have toxic effects. Recently, doctors have become concerned about health effects caused by toxic levels of Co and Cr in the bloodstream released by failure of metal-on-metal (MoM) bearing surface and metallic junctions of hip implants. The Centers for Disease Control and Prevention (CDC) developed a biomonitoring method to rapidly and accurately quantify Co and Cr in human whole blood by inductively coupled dynamic reaction cell mass spectrometry (ICP-DRC-MS). Currently, our laboratory uses this method in the National Health and Nutrition Examination Survey (NHANES) to gather population data about Cr and Co exposure in the US population, in participants that are 40+ years old. NHANES values will become Cr and Co reference values for baseline levels in blood. Knowing US baseline population exposure values will help to more accurately correlate adverse health effects with specific exposure levels.<br/>Validity of analytical results depends not only on the instrumentation and analytical method, but also on preanalytical steps, such as contamination control, proper specimen collection, and storage. Contamination control is especially critical in determining the amount of Co and Cr in whole blood, because these elements are present at low levels in most clinical samples. We will describe a process of lot screening to pre-screen all devices used in collecting, processing, analyzing, and storing blood samples to avoid possible Co and Cr contamination. Blood collection is a critical step in the preanalytical process. To ensure test reliability, well-trained staff should conduct proper blood collection. We conducted a study measuring Co and Cr concentration levels in two consecutive blood draws from 150 donors to determine if Co and Cr leach from needles into blood samples during collection. Additionally, this presentation will fill some existing gaps in literature on long-term stability of Cr and Co in human whole blood. We conducted a study monitoring concentrations of Co and Cr in human blood at four different temperatures (-70°C, -20°C, 4°C, and RT) over one year. We will describe the lot screening process, and results of blood collection and stability studies.<br/><br/>Findings and conclusions in this study are those of the authors and do not necessarily represent the views of the U.S. Department of Health and Human Services.

Significance of preanalytical factors in measuring Cr and Co levels in human whole blood

256th National Meeting (2018)

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