Blood/serum/plasma:
Since chromium is widely present in the environment, it is easy to contaminate specimens with chromium. Great care is needed to ensure blood and urine testing is only done with metal-free containers (such as a royal blue top vacutainer). Blood or plasma testing for chromium is not common.
The main indication for chromium testing is a recommendation by the US Food and Drug Administration concerning certain orthopedic implants. Prosthetic devices produced by several companies contain chromium, cobalt, and molybdenum. The FDA states that orthopedic surgeons should consider measuring and following serial chromium concentrations in EDTA anticoagulated whole blood in patients experiencing possible prosthetic joint failure. Blood chromium concentrations are likely to be increased above the reference range in patients with metallic joint prosthesis, and increasing elevations over time can indicate mechanical failure. Some reference laboratories also offer chromium measurement in synovial fluid samples for prosthetic joint assessment.
Urine chromium:
Urine chromium levels correlate with exposure. Urine testing, like testing in blood/plasma/serum, is not common and is usually only indicated in cases of industrial exposure or concerning specific brands of prosthetic joints that may be failing.
