Because the symptoms of lead poisoning are nonspecific, the clinical l
aboratory plays a central role in the evaluation of exposure. Specimen
collection requirements are stringent because of the ease of contamin
ation with external lead. The preferred specimen is whole blood. Finge
rstick blood is adequate for screening children, although elevated val
ues should be confirmed with venous blood. Several agencies regulate l
aboratories measuring lead, depending on the specimen type. Categories
include clinical specimens, specimens from workplace exposure, and en
vironmental specimens, such as drinking water. Government agencies set
reference intervals for blood lead. The most important step in treatm
ent of lead poisoning is to stop further exposure. Other steps include
education, removal of lead from the environment, ensurance of proper
nutrition, and the use of chelating agents. This is the first article
in a four-part continuing education update series on toxicology. Other
articles deal with alcohol, trace metals, and nonabusive causes of po
sitive blood screens.