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Journal Article
Research Support, Non-U.S. Gov't
Total arsenic screening prior to fractionation enhances clinical utility and test utilization in the assessment of arsenic toxicity.
American Journal of Clinical Pathology 2014 August
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.
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.
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