Chemical Terrorism: How Prepared Are the Clinical Laboratories?

A survey of clinical laboratory professionals has found that less than half think their laboratory could effectively respond in a hazardous chemical emergency. As a result of these findings, the American Society for Clinical Pathology (ASCP), which conducted the survey under a cooperative agreement with the US Centers for Disease Control and Prevention, will launch a series of online training courses to help clinical laboratories better prepare for a hazardous chemical event´┐Żanything from a train derailment to a chemical attack.

The survey results appear in an article titled "Chemical Terrorism: How Prepared are the Clinical Laboratories?" in the February issue of ASCP's LABMEDICINE magazine.

"ASCP has recognized the need to support the clinical laboratory in preparing for a hazardous chemical event," wrote authors Donna Surges Tatum, PhD, CAE, of Meaningful Measurement, Inc., in Chicago, and William Becker, DO, MPH, of the Ohio Department of Health Laboratory in Columbus. "Online training courses are under development to fill the gaps and provide guidance where necessary."

ASCP sent a link to the online survey to 13,396 laboratory professionals who work in such roles as medical laboratory director, assistant medical laboratory director, administrative laboratory director, section or department heads, and manager and assistant manager. The survey was open from Aug. 17, 2005, through Nov. 14, 2005. It included 100 questions in six sections covering hospital services and facilities, planning and communication, pathology and clinical laboratory services and equipment, specimen collection and handling, chemical warfare agents, and training. It took about 30 minutes to complete. Five hundred ninety nine people responded, an impressive 4.5 percent response rate. Of these, 582 submitted useable surveys. Responses came from 45 US states plus the District of Columbia and eight locations outside the United States.

"Results from this survey provided crucial information on the state of preparedness for a catastrophic chemical event," the authors wrote. "Hospital laboratories have some serious concerns about their ability to respond. The laboratories may not have adequate resources and instruments. There is a need for written protocols for specimen collection and handling, and they do not have adequate information concerning chemical warfare agents."

Among the key findings:


  • Sixty percent understood the laboratory's roles and responsibilities in an external hazardous chemical exposure emergency situation, but less than half indicated their laboratory could effectively respond.

  • Only one-third responded that their laboratory had adequate resources in the clinical pathology area, and less than one-fourth had adequate resources in the anatomic pathology areas to recover and ship a high volume of tissues and/or body fluid samples in a hazardous chemical emergency.

  • Only 35 percent of the laboratories had a written protocol for collection of specimens from patients suspected of exposure to chemical agents.

  • Only half the respondents were familiar with various categories of chemical warfare agents and the medical consequences of exposure to them.

  • Only 20 percent were familiar with patient laboratory test results correlating with exposure to chemical warfare agents and had quick chemical warfare reference guides available in the laboratory.

  • More than 75 percent of the respondents were interested in receiving training on this important topic and nearly 90 percent said they would use an online training course.

ASCP will launch a four-part series of online training courses March 2007. The series will address the following topics:


  • Chemical Agents

  • Communication and Coordination

  • Specimen Collection and Handling

  • Emergency Planning


Clinical laboratories, which are designed to support patient care, have different responsibilities than public health laboratories, which use epidemiology and forensics to determine the cause of a particular event. Clinical laboratories would be requested to assist the public health laboratories in the collection and shipping of samples to public health laboratories.

"In any type of hazardous emergency event, we need as much cooperation as possible," said Dr. Becker. "All clinical laboratories should know how to contact their local or state public health laboratories 24/7."

Details are available at www.ascp.org/AboutUs/NewsRoom/NewsArticle.aspx?PrimaryCode=CHEM.


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