Empirically determined lead-poisoning screening cutoff for the Protofluor-Z hematofluorometer

A recently introduced hematofluorometer, the "Protofluor-Z" (Helena Laboratories, Beaumont, TX), has several novel features, most notably reporting units expressed as the molar ratio of zinc protoporphyrin (ZPP) to heme, i.e., micromoles of ZPP per mole of heme. We analyzed human blood specimens on the Protofluor-Z and by an ethyl acetate/acetic acid extraction procedure. Data from three laboratories were pooled and used to provide a comparison of the two methods. Results indicate that, with the Protofluor-Z, a value of 70 mumol of ZPP per mole of heme is approximately equivalent to the recommended screening cutoff of 35 micrograms of erythrocyte protoporphyrin per 100 mL of whole blood used in programs for pediatric lead-poisoning prevention. This empirically determined value is slightly lower than either that recommended by the manufacturer or a theoretical cutoff value that was determined mathematically.