Bioterrorism: impact on external quality assessment service delivery

Safety issues related to the design, production and distribution of simulated specimens for microbiology external quality assessment (EQA) have occupied scheme organisers for many years. Since the anthrax attacks in Washington, USA in October 2001, there has been heightened awareness in the public domain regarding the transport of infectious substances. For instance, in direct response to the anthrax incident in the US, microbiology institutes in the UK that handle dangerous pathogens (like the Health Protection Agency) are registered with the national police force and are inspected regularly to ensure compliance with current legislation covering the control of these pathogens. The fear of a complete ban on the movement of infectious substances following the anthrax incident has not yet been realised, but remains a serious risk. Many countries such as the UK, USA, and Australia have introduced measures for the control, transportation, and health and safety aspects of handling and distribution of infectious materials. The national postal services of many countries do not accept infectious materials by mail. There are a limited number of courier services willing to transport dangerous goods, especially 6.2 (infectious substances) and these services are costly. Measures can be implemented by scheme organisers to ensure best practice; for instance, by having sufficient and trained staff, with knowledge, expertise and use of computerised systems in the shipping/export department. Ensuring compliance with national and international health and safety legislation by providing safety data sheets and by carrying out product risk assessments is required to ensure transparency and to demonstrate duty of care. Organisers of microbiology EQA face uncertainty about the future survival of schemes in the current climate. It is imperative that practices and procedures are put into place that meet with the legislation and enable us to continue to support quality in laboratory medicine.