Collection Tubes Can Cause False Elevations in Occupational and Clinical Evaluation of Antimony Exposure

Occupational exposure to antimony has become rare in the past decades due to antimony mine closures and technological improvement in antimony processing plants in the USA. Although antimony's ubiquitous presence in plasticwares does not pose known health risk, it can present as a potential contaminant to antimony analysis for occupational exposure assessment. To understand the level of antimony contamination from plastic collection devices, we evaluated two different whole-blood plastic collection tubes that are routinely used for trace and toxic element assessment: royal blue BD Vacutainer® EDTA tube and Greiner VACUETTE® trace elements sodium heparin tube. We analyzed how different fill volumes may impact the concentrations of antimony detected. Although both collection tubes can introduce antimony contaminations to nitric acid and neutral buffer rinse, the Greiner heparin tube introduces a significantly lower amount of antimony to freshly collected whole-blood samples compared to the BD EDTA tube. When patients' samples are collected with BD EDTA tubes, they would exhibit elevated antimony concentrations that can be interpreted as potential antimony exposure. We conclude that the royal blue BD EDTA plastic tube is not suitable to evaluate blood antimony levels, and laboratories need to validate their own alternative sources when the glass tubes are not available.