What is Arsenic Urine test?

Arsenic is a toxic element naturally found in water and soil. Some amount of arsenic is also found in seafood. It can enter our body through the food chain and affect multiple organ systems, causing cancers, skin diseases, cardiovascular disorders and neurological conditions. Arsenic is also present in insecticides, pesticides, certain metal alloys and wood preservatives. In mining areas, it is present in high amount in the air and enters the lungs as arsenic dust. 

There are two types of arsenic – organic arsenic and inorganic arsenic.

Organic arsenic is non-toxic and readily eliminated in urine. Inorganic arsenic can be toxic; however, it gets metabolised to its methylated form in the body, which is less toxic. In case of long term exposure to arsenic or chronic arsenic poisoning, these metabolites, along with some unchanged inorganic arsenic, are constantly eliminated in the urine.

An arsenic urine test is done to check for chronic arsenic poisoning. It determines the amount of arsenic eliminated in the urine as inorganic, organic and methylated arsenic.

  1. Why is an Arsenic Urine test performed?
  2. How do you prepare for Arsenic Urine test?
  3. How is Arsenic Urine test performed?
  4. Arsenic Urine test results and normal range

The ingested arsenic does not stay for more than 2 days in the bloodstream. Most of it distributes to various tissues and is finally eliminated in the urine. Thus, urine is the preferred sample for testing chronic arsenic exposure. Arsenic is eliminated in the urine within six days from the time of exposure.

Your doctor may order this test if you have the following symptoms of chronic arsenic exposure:

  • Abdominal pain
  • Diarrhoea
  • Sore throat
  • Increased risk of diabetes mellitus
  • Skin conditions:
    • Hyperpigmentation as ‘raindrop appearance’, dark spots or diffuse darkening of the skin
    • Keratosis on the palms and soles as discrete nodules or uniform thickening
    • Skin cancers such as Bowen’s disease and basal cell carcinoma
    • White lines in the nails known as Mee’s lines
  • Gastrointestinal symptoms:
  • Cardiovascular symptoms:
  • Neurological symptoms:
  • Risks of developing cancers in the following different organs:
    • Lung
    • Kidney
    • Skin
    • Liver
    • Bladder
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Do not consume seafood before this test as it will increase the amount of arsenic in your urine. If you have undergone any test that uses gadolinium-containing contrast medium, wait for at least 48 hours before sample collection as gadolinium may affect the test results.

Earlier, a 24-hour urine sample was collected for this test but now a spot urine sample collection - a single sample at any time of the day - is done.

You will be provided with a container for sample collection. As you collect the sample, make sure that it does not get contaminated with blood or faecal matter. A ‘clean catch method’, as follows, is used for spot urine collection to prevent contamination of the sample:

  • Wash your hands and genital area before collecting the sample.
  • While you are urinating, let some urine flow into the toilet first and stop the flow. 
  • Then urinate carefully into a container till the marking on the container. 
  • Finish urinating into the toilet.

Close the container and take it to the laboratory for testing or store it in the refrigerator till you submit it to the laboratory for testing.  

For infants, the sample collection is a little different. You will be provided with a bag with a sticky edge, which will fit over the genital area of the baby. The test is performed as follows:

  • Clean the genital area of the infant with soap and water.
  • Place the bag over the genitals of your infant.
  • In case of boys, include the entire penis in the bag and for girls, position the bag over the labia.
  • You can make the baby wear the diaper over the bag.
  • Repeatedly check if the infant has urinated and once the bag is filled, remove it.
  • Move the sample into the container and take it to the laboratory.
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Normal results:

The normal values of arsenic in the urine are in the range of 0-34.9 mcg/L. This range includes a combination of inorganic arsenic and its methylated metabolites. Humans consume about 5-25 mcg arsenic on a daily basis. Consuming seafood will raise the levels of arsenic in the urine up to 300 mcg/L; however, the amount declines after a day.

Abnormal results:

Arsenic toxicity is diagnosed by correlating the test results with the signs and symptoms of arsenic toxicity. In the case of toxicity, the total urine arsenic content may exceed 1000 mcg/L. If total arsenic values in urine are in the range 35-2000mcg/L, they are fractionated for proportions of inorganic arsenic, methylated metabolites and organic arsenic to determine toxicity. The total arsenic concentration may be higher than the sum of organic, inorganic and methylated arsenic due to the presence of unidentified arsenic species.

Disclaimer: All results must be clinically correlated with the patient’s complaints to make a complete and accurate diagnosis. The above information is provided from a purely educational point of view and is in no way a substitute for medical advice by a qualified doctor.


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  2. National Institute of Environmental Health Sciences [Internet]. National Institute of Health. U.S.A. Arsenic
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  4. Deborah E. Keil, Jennifer Berger-Ritchie, Gwendolyn A. McMillin. Testing for Toxic Elements: A Focus on Arsenic, Cadmium, Lead, and Mercury . Laboratory Medicine, Volume 42, Issue 12, December 2011, Pages 735–742, https://doi.org/10.1309/LMYKGU05BEPE7IAW
  5. Caldwell KL, Jones RL, Verdon CP, et al. Levels of urinary total and speciated arsenic in the US population: National Health and Nutrition Examination Survey 2003-2004. J Expo Sci Environ Epidemiol 2009;19:59-68. PMID: 18523458
  6. Beth A. Baker. Arsenic Exposure, Assessment, Toxicity, Diagnosis, and Management: Guidance for Occupational and Environmental Physicians. JOEM Volume 60, Number 12, December 2018
  7. Nicolle LE, Norrby SR. Approach to the patient with urinary tract infection. In: Goldman L, Schafer AI, eds. Goldman-Cecil Medicine. 25th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 284.
  8. Germann CA, Holmes JA. Selected urologic disorders. In: Walls RM, Hockberger RS, Gausche-Hill M. Rosen's Emergency Medicine: Concepts and Clinical Practice. 9th ed. Philadelphia, PA: Elsevier; 2018:chap 89.
  9. Johns Hopkins Medicine [Internet]. The Johns Hopkins University, The Johns Hopkins Hospital, and Johns Hopkins Health System; 24-Hour Urine Collection
  10. EPI Manual: Iowa Department of Public Health [Internet]. U.S.A. Arsenic Poisoning
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