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Laboratory services and training in support of the Year 2000 national health objectives.

In October 1989, the Association of State and Territorial Public Health Laboratory Directors (ASTPHLD) conducted a survey regarding laboratory services training needs required to support the Year 2000 Health Objectives for the Nation (1 ). ASTPHLD distributed questionnaires through the seven regional offices of the National Laboratory Training Network (NLTN), a cooperative program jointly sponsored by ASTPHLD and CDC, to 54 state and territorial laboratory directors and 48 state laboratory training coordinators. Thirty-eight (70%) of the laboratory directors and 44 (92%) of the training coordinators responded.

For eight health objective areas that will require substantial laboratory support, CDC identified 83 specific laboratory tests and procedures that are considered critical for achieving these objectives (Table 1). Survey participants were asked to rate the training needs of both public and private sector laboratorians in their states in the 83 specific test areas as "high priority ... .. moderate priority," "low priority," "training not needed," or "don't know." High-priority laboratory training needs were identified for tests associated with each of the eight objective areas (Table 2). The greatest perceived need was for laboratory training related to the Papanicolaou test.

In addition to rating the priority of training needs, respondents were asked to identify potential sources for training within their states for each of the listed laboratory procedures. For high-priority training items, 18%-72% of the respondents indicated either that training was not available or that they were uncertain whether training was available. Reported by: Association of State and Territorial Public Health Laboratory Directors. Div of Laboratory Systems, Public Health Practice Program Office, CDC.

Editorial Note: Accessible, high-quality laboratory services are critical to public health program efforts because they provide support for disease surveillance activities, assessment of the adequacy of treatment for infectious and chronic diseases, and development of more sensitive methods for the detection of preventable illnesses. For example, the 1990 health objective that recommended that all newborns be provided neonatal screening for treatable metabolic disorders could not have been achieved without adequate laboratory support to diagnose these disorders. Therefore, success in achieving the year 2000 health objectives will require that public and private health laboratories be prepared to support new, ongoing, and expanded programs to prevent, detect, and control disease. This is especially important for the year 2000 objectives, which, when compared to the 1990 objectives, include more screening interventions to detect asymptomatic diseases (1 ).

The results of this survey suggest that laboratorians may require ongoing training for a variety of test procedures critical to achieving the objectives. Although some training may be available through existing public and private sources, this survey suggests that there may be gaps in the availability of, or in the access to, training for certain laboratory procedures.

The role of training as an essential component of laboratory quality assurance is critical when planning for new or expanded programs. Moreover, training should not be restricted to laboratorians in the public sector, since private sector laboratories also perform testing that supports public health objectives.

Many states and professional organizations have already developed excellent laboratory training programs. in addition, the NLTN will continue to support laboratory training based on regional needs. A major objective of NLTN is to improve access to existing laboratory training opportunities by acting as an information clearinghouse. Laboratorians who request information about specific training opportunities* will be placed in touch with state, federal, and private sector organizations providing this training. When regional assessments indicate training needs, NLTN will work with laboratorians from the public and private sectors to address these needs in a timely and cost-effective manner.

The participation of public and private organizations was essential for developing the draft year 2000 national health objectives. Similarly, laboratorians in both the public and private sectors will need to collaborate in identifying and addressing the training essential to ensure the quality of laboratory services needed to support the year 2000 objectives.


1. CDC. Year 2000 national health objectives. MMWR 1989;38:629-33. Notice to Readers

Implementation of Quarterly AIDS Map

The following map provides information on the reported number of acquired immunodeficiency syndrome (AIDS) cases per 100,000 population by state of residence for April 1989 through March 1990. The map will appear quarterly in MMWR. More detailed information on AIDS cases is provided in the monthly HIV/AIDS Surveillance Report, single copies of which are available free from the National AIDS information Clearinghouse, P.O. Box 6003, Rockville, MD 20850; telephone (800) 458-5231.

Erratum: Vol. 39, No. 14

In "Statewide Prevalence of Illicit Drug Use by Pregnant Women - Rhode Island," the toxicology screen cutoff measurements were incorrectly listed in the third paragraph of the article (page 225). The second and third sentences of that paragraph should read: Toxicology screen cutoffs were: cocaine, 300 ng/ml; amphetamines, 1000 ng/ml; opiates, 300 ng/ml; and cannabinoids, 100 ng/mL.* Positive results were confirmed with thin-layer chromatography for cocaine (150 ng/mL), opiates (300 ng/mL), and cannabinoids (50 ng/mL); gas chromatography was used to confirm positive results for amphetamines (300 ng/mL).
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Publication:Morbidity and Mortality Weekly Report
Date:Apr 27, 1991
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