Clinical Use: Cobalt testing is useful in monitoring patients with metallic prosthetic implant wear e.g hip replacements, and detecting cobalt exposure.

In June 21 Medicines and Healthcare products Regulatory Agency released a medical device alert to annually monitor patients post-operatively after a metallic prosthetic implant and more frequently if the patient is showing symptoms of progressive soft tissue reaction to the wear debris associated with implants.

Background: Cobalt is rare but widely distributed in the environment. It is an essential cofactor in vitamin B12. While cobalt is an essential element, cobalt deficiency has not been reported in humans.

Cobalt is not highly toxic, but large doses will produce adverse clinical manifestations. Acute symptoms are pulmonary edema, allergy, nausea, vomiting, haemorrhage, and renal failure. Chronic symptoms include pulmonary syndrome, skin disorders, and thyroid abnormalities. The inhalation of dust during machining of cobalt alloyed metals can lead to interstitial lung disease.

Reference Ranges: Cobalt: Cobalt levels greater than 4 ug/L (ppb) may be associated with metallosis (local guidelines).
Urine: N/A
Associated Diseases:
Patient Preparation: None required
Specimen Requirements: Cobalt: Whole blood – EDTA sample
Urine: Collect into a plain white top universal
Turnaround Time: 4 weeks
Additional Information: Cobalt: To convert from nmol/L to ug/L: – Cobalt x 0.059
Urine: Complies with MHRA guidelines (2010).
Referred Test: Referred test
Location: Trace Element Laboratory