Sorted By Test Name - Mayo Medical Laboratories

NIS
8622
NICRU
60442
Environmental Survey on Children 2003-2006 (GerES IV). Int J Hyg Environ Health 2009;212:637-647
Nickel, Serum
Clinical Information: Nickel (Ni) is a silvery white metal that is widely distributed in the earth's
crust. Nickel is essential for the catalytic activity of some plant and bacterial enzymes but its role in
humans has not been defined. Elemental nickel may be essential for life at very low concentrations and is
virtually nontoxic. Nickel is commonly used in industry. It is a pigment in glass, ceramics, and fabric
dyes; is converted in the Mond process to nickel carbonyl, Ni(CO)4, and used as a catalyst in petroleum
refining and in the plastics industry, is frequently employed in the production of metal alloys (which are
popular for their anticorrosive and hardness properties) in nickel-cadmium rechargeable batteries, and is
used as a catalyst in hydrogenation of oils. Ni(CO)4, a liquid with low vapor pressure, is 1 of the most
toxic chemicals known to man. Ni(CO)4 is absorbed after inhalation, readily crosses all biological
membranes, and noncompetitively inhibits ATP-ase and RNA polymerase. When Ni(CO)4 vapor is
inhaled it binds avidly to hemoglobin with resultant inability to take up oxygen. The affinity for
hemoglobin is higher than carbon monoxide. The binding to hemoglobin is the main transport mechanism
for spreading Ni(CO)4 throughout the body. Urine is the specimen of choice for the determination of
nickel exposure via inhalation. Patients undergoing dialysis are exposed to nickel and accumulate nickel
in blood and other organs; there appear to be no adverse health affects from this exposure.
Hypernickelemia has been observed in patients undergoing renal dialysis. At the present time, this is
considered to be an incidental finding as no correlation with toxic events has been identified. Routine
monitoring of patients undergoing dialysis is currently not recommended. Breathing dust high in nickel
content has been associated with development of neoplasms of the respiratory system and nasal sinuses.
Most reactions to nickel are localized skin sensitivity and allergic skin disorders that occur on contact
with nickel-containing alloys. These reactions do not correlate to blood concentrations; patients
experiencing skin sensitivity reactions to nickel are likely to have normal circulating concentrations of
nickel.
Useful For: Urine nickel is the test of choice for detecting nickel toxicity in patients exposed to nickel
carbonyl
Interpretation: Values >2.0 ng/mL represent possible environmental or job-related exposure. Toxic
concentrations are > or =10 ng/mL. Normal values are based on a Mayo Clinic study using healthy
volunteers. Toxic values have been deduced from observation and unpublished internal study. Clinical
concern about nickel toxicity should be limited to patients with potential for exposure to toxic nickel
compounds such as nickel carbonyl. Hypernickelemia, in the absence of exposure to that specific form of
nickel, may be an incidental finding or could be due to specimen contamination.
Reference Values: