Heavy Metals Surveillance: New York State Heavy Metals Registry
The New York State Department of Health (NYSDOH) Heavy Metals Registry (HMR) is a tool for the surveillance of adult exposures to lead, mercury, cadmium and arsenic. These metals are widely used in industry, and all have the potential to cause illness due to either acute or chronic exposure. Examination of the registry data can identify exposures in both communities and workplaces, thus allowing for early initiation of measures to help prevent exposures and potential illness.
The NYSDOH receives reports of all blood lead tests performed on New York State residents, along with reportable levels of mercury, arsenic and cadmium. Once reports are received, registry staff conduct interviews to determine the source of exposure, for those heavy metal levels exceeding certain thresholds, which vary by metal and gender. When the threshold is exceeded, information is provided to exposed individuals and employers on reducing hazards and eliminating exposure. Where it appears that family members (especially children) may be exposed, recommendations are made for reducing exposure and the local health department is contacted, if applicable.
What are the regulations that mandate laboratories to report all blood lead levels and other heavy metals found in blood and urine samples?
Who is required to report to the Heavy Metals Registry, and what metals are reported?
All clinical laboratories, physicians and health facilities, both in and out of New York State, performing tests for lead, mercury, arsenic and cadmium on individuals residing or employed in New York State must report the results of the test to the NYSDOH. For cadmium, mercury and arsenic, those test results listed below are required to be submitted to the NYSDOH. All blood lead results, regardless of level, are required to be reported.
Reportable levels of heavy metals in blood and urine
The following levels of heavy metals in blood and urine samples are reportable to the Department of Health:
Metal Sample Reportable at or above Lead Blood All Cadmium Blood 10 ng/ml Urine 5 ug/l Mercury Blood 5 ng/ml Urine 20 ng/ml Arsenic Urine 50 ug/l
Laboratories can report heavy metal test results electronically or manually to the NYSDOH.
What happens to information that gets reported to the Heavy Metal Registry?
All information reported to the HMR is confidential, and records and computer files are maintained in accordance with NYSDOH regulations concerning medical data containing personal information. Access to the data by anyone other than HMR personnel is restricted to ensure that confidentiality is maintained.
What information should the report contain?
Patient information including, but not limited to, name, address, phone number, date of birth, gender and ethnicity, as well as exposure and diagnostic information. The patient's employer information should be reported in the guardian field on the laboratory report.
Where can I find additional information on heavy metals reporting requirements?
Laboratories can report heavy metal test results electronically through the Electronic Clinical Laboratory Reporting System (ECLRS) or manually on paper forms (DOH-383) to the NYSDOH.
A laboratory accesses ECLRS through the New York State Health Commerce System (HCS), and either manually enters test results or uploads a special data file. The HCS is a secure network that meets Health Insurance Portability and Accountability Act of 1996 (HIPAA) and New York State health data security policy requirements.
Why is it important to collect information on heavy metal exposures?
Regular surveillance of heavy metal exposures allows for the early identification of individuals at risk for potential poisoning through occupational and environmental sources, and presents an opportunity to provide interventions that can help prevent further exposures and potential illness.
- Heavy Metals Registry Annual Reports
- Community Health Assessment Indicators
- New York State Community Health Data Set
What is a heavy metal?
The term heavy metal refers to a group of metallic chemical elements that have a relatively high density. Some of these metals may be toxic when inhaled or ingested at certain concentrations. Examples of heavy metals include mercury (Hg), cadmium (Cd), arsenic (As), and lead (Pb).
Why are these metals dangerous?
Heavy metals are dangerous because they can damage vital systems of the body. With on-going exposure, heavy metals can bioaccumulate, or increase in concentration over time. Compounds may accumulate in living things any time they are taken up and stored faster than they are broken down and/or excreted.
How may I be exposed to heavy metals?
Exposure to metals may occur through diet, medications, the environment, work or hobbies.
Resources and Links
Industrial Hygiene Services - The NYSDOH is committed to the prevention of workplace injuries, illnesses and fatalities. Industrial hygiene staff provide technical assistance and expertise to individual companies for controlling workplace hazards. There is no fee for these services. Staff also conduct industry-wide research studies to identify and develop new and more cost-effective hazard control strategies. Recommendations and other useful information are shared with worksites and other stakeholders through informational mailings, presentations at meetings and seminars, publications in trade and scientific journals, and through other outreach activities.
US Department of Labor's OSHA program has valuable technical and regulatory information about heavy metals.
If you live or work in New York State, there are occupational health clinics located across the State that may be able to provide you with assistance.
If you have any questions about heavy metals or are interested in learning more about the heavy metals registry, please contact us at 518-402-7900.