A healthy volunteer study to investigate trace element contamination of blood samples by stainless steel venepuncture needles

Abstract

Context. The trace elements cobalt (Co), chromium (Cr), manganese (Mn) and nickel (Ni) are normally present at low concentrations in blood. There has been a concern that stainless steel venepuncture needles typically used for collection of blood samples may contaminate these samples, leading to the masking of deficiency states or causing potential clinical confusion as to whether an individual has a “toxic” concentration. Objective. To determine whether there is any difference between the concentrations of the trace elements obtained by different methods of blood sampling. Methods. We took blood samples using a standard venepuncture needle, a “butterfly” winged infusion needle (three consecutive samples) and a plastic intravenous cannula (three consecutive samples) from 10 healthy volunteers. We measured the concentrations of Co, Cr, Mn and Ni in the samples using Inductively Coupled Plasma Mass Spectrometry, and used analysis of variance (ANOVA) to investigate if there was any difference between the methods of blood sampling. Results. The mean ± standard deviation blood metal concentrations were: Co 0.33 ± 0.2 μg/l, Cr 2.43 ± 1.55 μg/l, Mn 8.07 ± 7.74 μg/l and Ni 10.4 ± 4.69 μg/l. There was considerable variation between blood metal concentrations of individual subjects and a few sporadic high values. By ANOVA, there was no significant difference between the metal concentrations measured using different methods of blood collection. Conclusions. It is not necessary to routinely use a plastic cannula for blood sampling for trace element analysis. However, it is possible that sporadic contamination due to stainless steel needles may occur, so we would recommend that unexpected high concentrations are verified by taking a second sample taken through a plastic cannula.

Keywords:

• Needle
• Stainless steel
• Manganese
• Chromium
• Cobalt
• Nickel

Acknowledgements

We would like to thank the volunteers for taking part in the study, and Pam Conran for her assistance with study organisation. We also thank the staff in the Trace Elements laboratory (Audrey Duffy and Asia Iqbal) for helping carry out the analysis. Funding was from Guy's and St Thomas’ NHS Trust/King's College London research grant.

Declaration of interest The authors report no conflicts of interest. The authors alone are responsible for the content and writing of the article.