Cobalt, Blood
Use
This test is useful for monitoring exposure to cobalt using whole blood specimens, and for monitoring metallic prosthetic implant wear. It is especially important for symptomatic patients with metal-on-metal hip implants, as blood cobalt concentrations can be elevated in such cases. High cobalt levels in the blood may indicate possible environmental or occupational exposure, and in the context of failed metal-on-metal prosthetics, it is often preceded by physical symptoms such as reduced range of motion, swelling, and joint pain.
Special Instructions
This test is not useful for assessing vitamin B12 activity. It requires ultraclean specimen collection and handling due to the use of mass spectrometry for detection. Patients should avoid gadolinium or iodine-based contrast media for 96 hours prior to specimen collection to avoid potential interference.
Limitations
Because mass spectrometry detection is used, the radioactive form of cobalt, (60)Co, is not quantified. Elevated blood cobalt results may be misleading if proper ultraclean collection procedures are not followed. This test should not be ordered for assessing vitamin B12 activity due to the presence of cobalt in vitamin B12. Interpretation requires consideration of exposure source.
New York Approved
Methodology
Mass Spectrometry (ICP-MS)
Biomarkers
LOINC Codes
- 5625-9
- 5625-9
Result Turnaround Time
1-5 days
Related Documents
For more information, please review the documents below
Specimen
Whole Blood
Volume
1 mL
Minimum Volume
0.4 mL
Container
Royal blue-top BD vacutainer with EDTA blood collection tube (3 mL) (T989) (BD catalog no. 367777)
Collection Instructions
1. See Metals Analysis Specimen Collection and Transport for complete instructions. 2. Send whole blood specimen in original tube. Do not aliquot.
Patient Preparation
High concentrations of gadolinium and iodine are known to potentially interfere with most inductively coupled plasma mass spectrometry-based metal tests. If either gadolinium- or iodine-containing contrast media has been administered, a specimen should not be collected for 96 hours.
Causes for Rejection
Microtainer
Stability Requirements
| Temperature | Period |
|---|---|
| Room Temperature | 28 days |
| Refrigerated | 28 days |
| Frozen | 28 days |