Whole Blood Chromium Research Articles

Association of whole blood metals/metalloids with severity in sepsis patients: A prospective, single-center, pilot study

BackgroundTrace metals/metalloids were important for the biological functions of both the eukaryotic host and the microorganism. Their concentrations and variations may associate with the critical illness in sepsis, which still needs to be investigated. MethodsWe performed a prospective cohort study on the patients with sepsis admitted to Tongji hospital (Wuhan, China) from Jul 01 to Dec 31, 2021. Sepsis was diagnosed in accordance with the third international consensus definitions for sepsis and septic shock (Sepsis-3). The concentrations of metals/metalloids including magnesium (Mg), calcium (Ca), chromium (Cr), manganese (Mn), iron (Fe), copper (Cu), zinc (Zn), arsenic (As), cadmium (Cd), mercury (Hg), thallium (Tl) and lead (Pb) in whole blood were analyzed by ICP-MS based methods. ResultsCompared to the healthy controls, patients with sepsis showed higher levels of Ca, Cr and Cu, and lower levels of Mg, Mn, Fe, Zn, As, Hg and Pb. Further analysis between the critical illness and noncritical illness, revealed the Mn, Fe were significantly lower in the critically-ill sepsis. The longitudinal profile of the two metals show the differences appeared to exist almost throughout the clinical course. By performing the binary regression logistic analysis, we determined the Fe, Mn as independently risk factors for critical illness in sepsis, with effect sizes (β) of 17.14 (95%CI: 1.79–163.81) and 10.83 (1.96–59.83), respectively, which collectively discriminated 83.3% of all cases between critical-illness and non-critically illness. ConclusionsThe variations of whole blood metals/metalloids were associated with the critically-ill sepsis.

Analysis of Whole Blood and Urine Trace Elements in Children with Autism Spectrum Disorders and Autistic Behaviors

The relationship between trace elements and neurological development is an emerging research focus. We performed a case–control study to explore (1) the differences of 13 trace elements chromium (Cr), manganese (Mn), cobalt (Co), zinc (Zn), arsenic (As), selenium (Se), molybdenum (Mo), cadmium (Cd), stannum (Sn), stibium (Sb), mercury (Hg), titanium (TI), and plumbum (Pb) concentration in whole blood and urine between autism spectrum disorder (ASD) children and their typical development peers, and (2) the association between the 13 trace elements and core behaviors of ASD. Thirty ASD subjects (cases) and 30 age-sex-matched healthy subjects from Baise City, Guangxi Zhuang Autonomous Region, China, were recruited. Element analysis was carried out by inductively coupled plasma-optical emission spectrometry. Autistic behaviors were assessed using Autism Behavior Checklist (ABC), Childhood Autism Rating Scale (CARS), and Children Neuropsychological and Behavior Scale (CNBS). The whole blood concentrations of Mo (p = 0.004), Cd (0.007), Sn (p = 0.003), and Pb (p = 0.037) were significantly higher in the ASD cases than in the controls. Moreover, Se (0.393), Hg (0.408), and Mn (− 0.373) concentrations were significantly correlated between whole blood and urine levels in ASD case subjects. There were significant correlations between whole blood Sb (0.406), Tl (0.365), Mo (− 0.4237), Mn (− 0.389), Zn (0.476), and Se (0.375) levels and core behaviors of ASD. Although the mechanism of trace element imbalance in ASD is unclear, these data demonstrate that core behaviors of ASD may be affected by certain trace elements. Further studies are recommended for exploring the mechanism of element imbalance and providing corresponding clinical treatment measures.

Interlaboratory Comparison Investigations (ICIs) for human biomonitoring of chromium as part of the quality assurance programme under HBM4EU

BackgroundThe pan-European human biomonitoring initiative HBM4EU targets the harmonization of human biomonitoring (HBM) procedures and data for both environmental and occupational exposure, including chromium. The determination of chromium in urine (U-Cr), plasma (P-Cr) and whole blood (WB-Cr) is a common HBM application in employees occupationally exposed to chromium (VI) compounds. MethodsEuropean laboratories which have registered as candidate laboratories for chromium analysis within HBM4EU were invited to participate in a quality assurance/qualitycontrol (QA/QC) programme comprising interlaboratory comparison investigations (ICI) for the parameters U-Cr, P-Cr and WB-Cr. Participating laboratories received two samples of different concentrations in each of four rounds and were asked to analyse the samples using their standard analytical procedure. The data were evaluated by the Z-score approach and were reported to the participants after each round. ResultsThe majority of the 29 participating laboratories obtained satisfactory results, although low limits of quantification were required to quantify chromium concentrations in some of the ICI materials. The robust relative standard deviation of the participants’ results (study RSDR) obtained from all ICI runs ranged from 6 to 16 % for U-Cr, 7–18 % for P-Cr and 4–47 % for WB-Cr. The application of both inductively coupled plasma mass spectrometry (ICP-MS) and electrothermal atomic absorption spectrometry (EAAS) appeared appropriate for the determination of chromium in urine, plasma and whole blood with regard to occupational exposure levels. ConclusionThis QA/QC programme succeeded in establishing a network of laboratories with high analytical comparability and accuracy for the analysis of chromium across Europe.

Chromium and cobalt in blood and serum in the surveillance of metal-on-metal hip implants

Objective. The aim of this study is to evaluate the relationship between serum and whole blood chromium and cobalt levels in a group of patients with metal-on metal total hip arthroplasty (Depuy ASR™). A conversion formula was developed to allow adequate evaluation of patients and correctly interpret the measured value. Methods. The authors retrospectively reviewed a series of 150 patients and prospectively analysed 64 patients who satisfied inclusion criteria. We collected data by taking simultaneously sample of chromium and cobalt ionemia from blood and serum.Results. Statistical analyses revealed significant differences between chromium and cobalt values in serum and whole blood (p 0.007), but with a strong positive correlation for both chromium (r 0.927) and cobalt (r 0.935). The authors also calculated a conversion formula to convert whole blood ion levels into serum levels, Cr se = -0.32582 + 1.39018*Cr WB for chromium and Co se = 0.239637 + 0.804279* Co WB, for cobalt. Conclusions. The difference between serum and blood values of chromium and cobalt is highlighted in a strong positive correlation. The development of the conversion formula allows to better interpret laboratory data and improve care and monitoring of patients.

Metal ion levels in the blood of patients with metal-on-metal hip prostheses.

A BHR (Birmingham hip resurfacing) prosthesis was implanted in 445people in Norway. Adverse reactions can arise as a result of the release of metal ions from metal-on-metal joint surfaces made from cobalt-chromium alloy. The aim of the study was to analyse the release of metal ions during the first five years after surgery in patients with a BHR prosthesis and to investigate whether this was linked to clinical complications. Forty-four male patients (median age 53 years) implanted with a BHR prosthesis at the Coastal Hospital at Hagevik in the period October 2009 to May 2013 were monitored by means of blood samples before implantation and three months, one year, three years and five years afterwards. Analyses of cobalt and chromium in whole blood were performed. Function scoring was used to clinically assess the prosthetic joint. Metal ion concentrations increased between the surgery date and one year later (p < 0.001), and subsequently remained stable. After five years, the median concentrations (min.- max.) of cobalt and chromium were 1.1 µg/L (0.4-6.3 µg/L) and 1.4 µg/L (0.4-11.7 µg/L) respectively for unilateral prostheses (n = 36), and 2.3 µg/L (1.6-28.5 µg/L) and 2.6 µg/L (1.7-14.1 µg/L) respectively for bilateral prostheses (n = 8). Five patients underwent revision surgery, while other patients had good hip function. Patients with a BHR prosthesis had a significant increase in cobalt and chromium in their blood one to five years after surgery, but the median levels were still well below the threshold value of 7 μg/L, which indicates an increased risk of complications.

No association between blood count levels and whole-blood cobalt and chromium levels in 1,900 patients with metal-on-metal hip arthroplasty

Background and purpose — The accelerated wear of poorly functioning metal-on-metal (MoM) hip implants may cause elevated whole-blood cobalt (Co) and chromium (Cr) levels. Hematological and endocrinological changes have been described as the most sensitive adverse effects due to Co exposure. We studied whether there is an association between whole-blood Co/Cr levels and leukocyte, hemoglobin, or platelet levels. Patients and methods — We analyzed whole-blood Co and Cr values and complete blood counts (including leukocytes, hemoglobin, platelets) from 1,900 patients with MoM hips. The mean age at the time of whole-blood metal ion measurements was 67 years (SD 10). The mean time from primary surgery to whole-blood metal ion measurement was 8.2 years (SD 3.0). The mean interval between postoperative blood counts and metal ion measurements was 0.2 months (SD 2.7). Results — The median Co value was 1.9 µg/L (0.2–225), Cr 1.6 µg/L (0.2–125), mean leukocyte count 6.7 × 109/L (SD 1.9), hemoglobin value 143 g/L (SD 13), and platelet count 277 × 109/L (SD 70). We did not observe clinically significant correlations between whole-blood Co/Cr and leukocyte, hemoglobin, or platelet counts. Interpretation — Elevated whole-blood Co and Cr values are unlikely to explain abnormal blood counts in patients with MoM hips and the reason for possible abnormal blood counts should be sought elsewhere.

Repeated cobalt and chromium ion measurements in patients with bilateral large-diameter head metal-on-metal ReCap-M2A-Magnum total hip replacement

Background and purpose — Whole-blood (WB) chromium (Cr) and cobalt (Co) measurements are vital in the follow-up of metal-on-metal total hip replacement (MoM THR) patients. We examined whether there is a substantial change in repeated WB, Co, and Cr levels in patients with bilateral ReCap-M2A-Magnum THR. We also specified the number of patients exceeding the safe upper limit (SUL) of WB Co and Cr in the repeated measurement.Patients and methods — We identified 141 patients with bilateral ReCap-M2A-Magnum THR operated in our institution. 61 patients had repeated WB metal ion measurements with bilateral MoM implants still in situ in the second measurement. The mean time elapsing from the first measurement (initial measurement) to the second (control measurement) was 1.9 years (SD = 0.6, range 0.2–3.5). We used earlier established SUL levels for bilateral implants by Van Der Straeten et al. (2013).Results — The median (range) Co and Cr values decreased in the repeated measurement from 2.7 (0.6–25) to 2.1 (0.5–21) and 2.6 (0.8–14) to 2.1 (0.5–18) respectively. In 13% of the patients Co levels exceeded the SUL in the initial measurement and the proportion remained constant, at 13%, in the repeated measurement. In 5% of the patients, Cr levels were above SUL in the initial measurement and an equal 5% in the control measurement.Interpretation — Repeated WB metal ion levels did not increase in patients with bilateral ReCap-M2A-Magnum THR with a mean 1.9-year measurement interval. Long-term development of WB metal ion levels is still unclear in these patients.

Concentration of chromium in whole blood and erythrocytes showed different relationships with serum apolipoprotein levels in Cr(VI) exposed subjects

ObjectiveTo explore the effects of hexavalent chromium [Cr(VI)] on apolipoprotein(Apo) metabolism. MethodsOne hundred and six long-term Cr(VI) exposed subjects and fifty five non-exposed individuals were recruited. The blood metals, glucose and lipid parameters were measured to evaluate the effects of hexavalent chromium on the apolipoproteins. ResultsThe quantity and homeostasis of multi-elements were significantly different between Cr(VI)exposed subjects and the controls(P < 0.05). The levels of serum TG, FPG, LDL-C, Apo AI, AII, CII, CIII, E and Lp(a) also changed significantly (P < 0.05). Concentration of chromium in whole blood and erythrocytes had different relationships with serum apolipoprotein levels in Cr(VI)exposed subjects. ConclusionsExposure of hexavalent chromium could significantly change the homeostasis of multi-elements as well as the levels of serum apolipoproteins. Cr(III) and Cr(VI)may have different effects on the apolipoproteins.

CHANGES OF NONESSENTIAL TRACE ELEMENTS LEVELS IN WHOLE BLOOD OF END STAGE RENAL DISEASE ADULT PATIENTS

Aims: Accumulation of trace elements occurs in conditions of decreased or termination of kidneys functions. In some conditions increased trace elements can obtain toxic features. On other hand, researches are showing that concentration of some trace elements could be decreased in ERSD patients, too. The most important factor affecting trace element concentration in ERSD patient is the degree of renal failure and using of replacement therapy.&#x0D; Materials and methods: We determined the concentration of microelements (beryllium, boron, aluminum, vanadium, chromium, nickel, arsenic, rubidium, strontium, cadmium, cesium, barium, thallium and lead) in whole blood of 41 ESRD patients with chronic kidney disease stage VD, who were treated with hemodialysis / hemodiafiltration and in 61 conditionally healthy donors. Determination of whole bloods trace elements content was conducted using inductive coupled plasma mass- spectrometry (ICPMS).&#x0D; Results: It is determinate that levels of beryllium, boron, aluminum, vanadium, chromium, strontium, cadmium, barium, thallium and lead is reliable increased in ESRD patients. Decreased levels are observed for nickel, arsenic, cesium and rubidium.&#x0D; Conclusions: ESRD is accompanied with substantial and multidirectional changes of trace elements blood levels. During researches has shown that in ESRD patients processes of trace elements accumulation are prevailing over elimination ones.

High blood metal ion levels in 19 of 22 patients with metal-on-metal hinge knee replacements

Background and purpose — There has been increasing alarm regarding metal-on-metal (MoM) joint replacements leading to elevated levels of metal ions and adverse reactions to metal debris (ARMDs). There is little information available concerning the prevalence of and risk factors for these adverse reactions, except with MoM hip joint replacements. We determined the levels of metal ions in blood and the rate of revision due to ARMDs in patients treated with MoM hinge total knee arthroplasty (TKA).Patients and methods — 22 patients with TKAs and MoM hinge connecting mechanisms were studied for whole-blood chromium and cobalt levels at 6 months, 1 year, and/or ≥2 years after surgery. Possible ARMDs were investigated by MRI. 12 patients with TKAs and metal-on-polyethylene (MoP) connecting mechanisms served as controls.Results — The cobalt levels were over 5 ppb in 19 of the 22 patients in the MoM group and in 1 of the 12 patients in the MoP group. The chromium levels were over 5 ppb in 11 of the 22 patients in the MoM group and in none of the 12 patients in the MoP group. Pseudotumors were operated in 4 of the 22 patients in the MoM group and in none of the patients in the MoP group.Interpretation — Our results clearly show that the MoM hinge TKA carries a high risk of increased levels of systemic metal ions and also local ARMD, leading to complicated knee revisions. We therefore discourage the use of MoM hinge TKA.

Biomonitoring method for the analysis of chromium and cobalt in human whole blood using inductively coupled plasma - kinetic energy discrimination - mass spectrometry (ICP-KED-MS).

The Centers for Disease Control and Prevention developed a biomonitoring method to rapidly and accurately quantify chromium and cobalt in human whole blood by ICP-MS. Many metal-on-metal hip implants which contain significant amounts of chromium and cobalt are susceptible to metal degradation. This method is used to gather population data about chromium and cobalt exposure of the U.S. population that does not include people that have metal-on-metal hip implants so that reference value can be established for a baseline level in blood. We evaluated parameters such as; helium gas flow rate, choice and composition of the diluent solution for sample preparation, and sample rinse time to determine the optimal conditions for analysis. The limits of detection for chromium and cobalt in blood were determined to be 0.41 and 0.06 μg/L, respectively. Method precision, accuracy, and recovery for this method were determined using quality control material created in-house and historical proficiency testing samples. We conducted experiments to determine if quantitative changes in the method parameters affect the results obtained by changing four parameters while analyzing human whole blood spiked with National Institute of Standard and Technology traceable materials: the dilution factor used during sample preparation, sample rinse time, diluent composition, and kinetic energy discrimination gas flow rate. The results at the increased and decreased levels for each parameter were statistically compared to the results obtained at the optimized parameters. We assessed the degree of reproducibility obtained under a variety of conditions and evaluated the method's robustness by analyzing the same set of proficiency testing samples by different analysts, on different instruments, with different reagents, and on different days. The short-term stability of chromium and cobalt in human blood samples stored at room temperature was monitored over a time period of 64 hours by diluting and analyzing samples at different time intervals. The stability of chromium and cobalt post-dilution was also evaluated over a period of 48 hours and at two storage temperatures (room temperature and refrigerated at 4°C). The results obtained during the stability studies showed that chromium and cobalt are stable in human blood for a period of 64 hours.

Cognitive deficits and ALA-D-inhibition in children exposed to multiple metals

Children are especially vulnerable to adverse effects of multiple metals exposure. The aim of this study was to assess some metals concentrations such as lead (Pb), arsenic (As), chromium (Cr), manganese (Mn) and iron (Fe) in whole blood, serum, hair and drinking water samples using inductively coupled plasma-mass spectrometry (ICP-MS) in rural and urban children. In addition, evaluate the adverse effects of multiple metals exposure on cognitive function and δ-aminolevulinate dehydratase (ALA-D) activity. The cognitive ability assessment was performed by the Raven's Colored Progressive Matrices (RCPM) test. The ALA-D activity and ALA-D reactivation index (ALA-RE) activity with DTT and ZnCl2 also were determined. Forty-six rural children and 23 urban children were enrolled in this study. Rural children showed percentile IQ scores in the RCPM test significantly decreased in relation to urban children. According to multiple linear regression analysis, the Mn and Fe in hair may account for the cognitive deficits of children. Manganese and Fe in hair also were positively correlated with Mn and Fe in drinking water, respectively. These results suggest that drinking water is possibly a source of metals exposure in children. ALA-D activity was decreased and ALA-RE with DTT and ZnCl2 was increased in rural children in comparison to urban children. Moreover, ALA-D inhibition was correlated with Cr blood levels and ALA-RE/DDT and ALA-RE/ZnCl2 were correlated with levels of Cr and Hg in blood. Thus, our results indicated some adverse effects of children's exposure to multiple metals, such as cognitive deficits and ALA-D inhibition, mainly associated to Mn, Fe, Cr and Hg.

235 Airborne and internal exposure to chromium among welders

ObjectivesThe objective of this analysis was to investigate levels and determinants of exposure to respirable and urinary chromium (CrR, CrU), and chromium in whole blood and in erythrocytes (CrBl, CrEry)...

Understanding Why Metal-on-Metal Hip Arthroplasties Fail

A large proportion of metal-on-metal hip arthroplasty failures are due to unexplained pain. The mechanism of failure has been thought to be associated with factors that increase material loss, including specific design features and surgical positioning of components. However, recent evidence suggests that there is not a simple dose-response relationship. An analysis of failed metal-on-metal hip arthroplasties involving a single design was performed in an attempt to help resolve this issue. Our aim was to identify the clinical and component variables associated with failure of metal-on-metal hip arthroplasties, particularly in patients undergoing revision arthroplasty because of unexplained hip pain, and to clarify the role of material loss. We prospectively recruited fifty-five patients who were undergoing revision of a metal-on-metal Birmingham Hip Resurfacing System (BHR) arthroplasty (Smith & Nephew). We collected clinical data preoperatively, intraoperatively, and following the revision arthroplasty. Data included chromium and cobalt levels in whole blood, which were measured with use of inductively coupled plasma mass spectrometry (ICPMS), and component orientation, which was typically measured with use of computed tomography (CT) scans. The wear of the retrieved components was also quantified postoperatively. All parameters were compared with those in a comparable group of patients with a well-functioning BHR arthroplasty. Sixty-nine percent of the patients who underwent revision arthroplasty did so following a diagnosis of unexplained hip pain. When compared with patients with a well-functioning arthroplasty, patients who underwent revision arthroplasty had a significantly higher acetabular cup inclination angle (p &lt; 0.01), a significantly smaller femoral head diameter (p &lt; 0.01), and significantly higher blood cobalt and chromium ion levels (p &lt; 0.01). However, almost 50% of the patients who underwent revision arthroplasty had blood metal ion levels below the clinical threshold of 7 ppb and low component wear rates of &lt;5 μm/year. In a large number of patients with unexplained hip pain leading to revision of a metal-on-metal hip arthroplasty, the acetabular cup orientation was satisfactory and the material loss rate was low. We suspect that patient-specific factors may have been responsible for the failure in a large proportion of these patients.

Prediction of Type-2 Diabetes Based on Several Element Levels in Blood and Chemometrics

The present study was designed to evaluate the levels of eight elements including lithium, zinc, chromium, copper, iron, manganese, nickel and vanadium in whole blood of type-2 diabetes patients, to compare them with age-matched healthy controls and to investigate the feasibility of combining them with an ensemble model for diagnosing purpose. A dataset involving 158 samples, among which 105 were taken from healthy adults and the remaining 53 from patients with type-2 diabetes, was collected. All samples were split into the training set and the test set with the equal size. Based on a simple variable selection, two elements, i.e., chromium and iron, are also picked out as the most important elements. Three kinds of algorithms, i.e., fisher linear discriminate analysis (FLDA), support vector machine (SVM) and decision tree (DT), were used for constructing member models. The best ensemble classifiers constructed on the training set were validated on the independent test set, and the prediction results were compared with those from clinical diagnostics on the same subjects. The results reveal that almost all ensemble classifiers exhibit similar performance, implying that these elements coupled with an appropriate ensemble classifier can serve as a valuable tool of diagnosing diabetes type-2.

Biomonitorization of cadmium, chromium, manganese, nickel and lead in whole blood, urine, axillary hair and saliva in an occupationally exposed population

Heavy metal contamination from occupational origin is a cause for concern because of its potential accumulation in the environment and in living organisms leading to long term toxic effects. This study was aimed to assess Cd, Cr, Mn, Ni and Pb levels in whole blood, urine, axillary hair and saliva from 178 individuals with occupational exposure to heavy metals. Levels of metal compounds were determined by atomic absorption spectrometry. We collected information on occupation, lifestyle habits and food intake by questionnaire. Multiple linear regression analyses for metal ion concentration in whole blood, urine, axillary hair and saliva were adjusted for age, gender, smoking and alcohol consumption, lifetime workplace exposure, residence area and food habits. Overall, blood and urine median concentrations found for the five metals analyzed do not exceed biological exposure indexes, so that they are very similar to a non-occupationally exposed population. Toxicokinetic differences may account for the lack of correlations found for metal levels in hair and saliva with those in blood or urine. For those heavy metals showing higher median levels in blood with respect to hair (Cd, Mn and Pb) indicating lesser hair incorporation from blood, the lifetime working experience was inversely correlated with their hair levels. The longer the lifetime working experience in industrial environments, the higher the Mn and Ni concentration in saliva. Axillary hair and saliva may be used as additional and/or alternative samples to blood or urine for biomonitoring hair Mn, and saliva Ni in subjects with occupational exposure.

Metal exposures in an inner-city neonatal population

Objectives We measured concentrations of lead (Pb), manganese (Mn), chromium (Cr), and copper (Cu) in umbilical cord whole blood and examined sources of environmental Pb exposures in a predominantly African-American population. Methods Between April and July 2006, we collected reproductive histories, questionnaires, and blood samples from 102 women, aged 16–45 years, who delivered at a Memphis, TN hospital. Results The prevalence of preeclampsia and low birth weight infancy in the study population was 11% and 10%, respectively. Twenty-eight percent of mothers reported living near a potential Pb-contaminated area, while 43% lived in a residence built before 1978. Geometric mean (GM) concentrations for umbilical cord blood in the study population were 1.3, 3.5, 9.0, and 52.0 µg/dL for Pb, Mn, Cr, and Cu, respectively. Six neonates had cord blood Pb (CBL) concentrations above 10 µg/dL, while 20 had CBL concentrations ≥ 2 µg/dL. GM umbilical CBL levels were higher in neonates born to women living near a potential Pb-contaminated area (2.2 vs. 1.1 µg/dL) and those with friends, family or household members exposed to lead products (1.6 vs. 1.1 μg/dL). Some evidence of an exposure–response relationship was also detected between all four metal concentrations and an increasing number of maternal lead exposures. After adjustment for confounding, proximity to a Pb-contaminated area was the strongest environmental determinant of CBL levels among neonates with CBL concentrations of ≥ 2 µg/dL (odds ratio = 5.1; 95% CI = 1.6, 16.7). Conclusions Metal concentrations were elevated in this population, and CBL levels were associated with proximity to Pb-contaminated areas.

Validation of a method to quantify chromium, cadmium, manganese, nickel and lead in human whole blood, urine, saliva and hair samples by electrothermal atomic absorption spectrometry

For biological monitoring of heavy metal exposure in occupational toxicology, usually whole blood and urine samples are the most widely used and accepted matrix to assess internal xenobiotic exposure. Hair samples and saliva are also of interest in occupational and environmental health surveys but procedures for the determination of metals in saliva and hair are very scarce and to our knowledge there is no validation of a method to quantify Cr, Cd, Mn, Ni and Pb in four different human biological materials (whole blood, urine, saliva and axilary hair) by electrothermal atomization atomic absorption spectrometry (ETAAS). In the present study, quantification methods for the determination of Cr, Cd, Mn, Ni and Pb in whole blood, urine, saliva and axilary hair were validated according to the EU common standards. Pyrolisis and atomization temperatures have been determined. The main parameters evaluated were: detection and quantification limits, linearity range, repeatability, reproducibility, recovery and uncertainty. Accuracy of the methods was tested with the whole blood, urine and hair certified reference materials and recoveries of the spiked samples were acceptable ranged from 96.3 to 107.8%.

Six-year results of a prospective study of metal ion levels in young patients with metal-on-metal hip resurfacings

We describe the findings at six years in an ongoing prospective clinicoradiological and metal ion study in a cohort of 26 consecutive male patients with unilateral Birmingham Hip Resurfacing arthroplasties with one of two femoral head sizes (50 mm and 54 mm). Their mean age was 52.9 years (29 to 67). We have previously shown an early increase in the 24-hour urinary excretion of metal ions, reaching a peak at six months (cobalt) and one year (chromium) after operation. Subsequently there is a decreasing trend in excretion of both cobalt and chromium. The levels of cobalt and chromium in whole blood also show a significant increase at one year, followed by a decreasing trend until the sixth year.

Determination of chromium in whole blood by DRC–ICP–MS: spectral and non-spectral interferences

Quantification of chromium in whole blood has been performed by ICP-quadrupole MS. The spectrometer was equipped with a dynamic reaction cell (DRC) with ammonia as reaction gas. The rejection parameter q (RPq) of the DRC and the flow rate of ammonia (NH3) were optimized and set at 0.7 and 0.6 mL min(-1), respectively. Blood was diluted 1:51 (v/v) with an aqueous solution containing 0.1 mg L(-1) NH4OH, 0.1 g L(-1) EDTA, 5 mg L(-1) n-butanol, and 0.1 per thousand Triton X100. Non-spectral matrix effects observed when using the DRC were confirmed by use of vanadium. External calibration with blank and standard solutions prepared in purified water led to biased results for quality control samples. Standard addition calibration was therefore used and its validity verified. By comparing the slopes and calculating residues, it was proved that the plot obtained with standard additions and the plot obtained from blood samples of different concentrations were aligned down to 0.05 microg L(-1) after dilution.