A four-year-old child from a Burari neighbourhood is admitted to AIIMS with abdominal pain, anaemia and developmental concerns. The paediatrician suspects chronic lead exposure and orders venous blood lead. The vial, drawn into a metal-free royal-blue-top tube containing K2-EDTA, is logged at the AIIMS biochemistry laboratory and queued for the next ICP-MS batch.
Sample preparation is microwave-assisted nitric acid digestion. A 0.5 mL aliquot of whole blood is transferred to a Teflon vessel with 5 mL of trace-metal-grade nitric acid and 1 mL of 30 percent hydrogen peroxide, sealed, and run through a microwave programme that ramps to 200 degrees Celsius and holds for 15 minutes. The clear digestate is diluted to 25 mL with ultrapure water and rhodium internal standard is added at 10 parts per billion final concentration.
The instrument is an Agilent 7900 ICP-MS in helium collision-cell mode at 4.5 mL per minute helium flow. Lead is read at masses 206, 207 and 208 against an external calibration curve from 0.1 to 50 parts per billion in 2 percent nitric acid with matched internal standard. SRM 955c bovine blood, certified at 5.92 micrograms per decilitre, is run at the start of the batch and recovers at 5.81, within the acceptable plus-or-minus 10 percent window.
The patient sample reads a mean blood lead of 28.4 micrograms per decilitre across the three lead masses, well above the CDC reference value of 3.5 that triggers public health follow-up. The follow-up environmental investigation traces the exposure to glazed earthenware cooking vessels purchased from a local market. Total elapsed time from blood draw to signed report is approximately 30 hours, of which about 90 minutes is actual instrument time.