title: Cerebrospinal fluid protein and glucose examinations and tuberculosis: Will laboratory safety regulations force a change of practice?
abstract: Cerebrospinal fluid (CSF) protein and glucose examinations are usually performed in chemical pathology departments on autoanalysers. Tuberculosis (TB) is a group 3 biological agent under Directive 2000/54/EC of the European Parliament but in the biochemistry laboratory, no extra precautions are taken in its analysis in possible TB cases. The issue of laboratory practice and safety in the biochemical analyses of CSF specimens, when tuberculosis infection is in question is addressed in the context of ambiguity in the implementation of current national and international health and safety regulations. Additional protective measures for laboratory staff during the analysis of CSF TB samples should force a change in current laboratory practice and become a regulatory issue under ISO 15189. Annual Mantoux skin test or an interferon-γ release assay for TB should be mandatory for relevant staff. This manuscript addresses the issue of biochemistry laboratory practice and safety in the biochemical analyses of CSF specimens when tuberculosis infection is in question in the context of the ambiguity of statutory health and safety regulations.
authors.affiliation: Department of Chemical Pathology, Beaumont Hospital, Dublin, Ireland ; Athlone Institute of Technology, Athlone, Ireland ; Biomedical Sciences, University of Ulster, Coleraine, Northern Ireland.
authors.forename: William P
authors.initials: WP
authors.lastname: Tormey
authors.affiliation: Department of Chemical Pathology, Beaumont Hospital, Dublin, Ireland.
authors.forename: Christopher
authors.initials: C
authors.lastname: O'Hagan
mesh_terms: D001322:Autoanalysis / Q000295:instrumentation; D057205:Automation, Laboratory / Q000295:instrumentation; D002555:Cerebrospinal Fluid / Q000737:chemistry / Q000382:microbiology; D002556:Cerebrospinal Fluid Proteins / Q000032:analysis*; D003264:Containment of Biohazards / Q000592:standards*; D005947:Glucose / Q000134:cerebrospinal fluid*; D006801:Humans; D017053:Infection Control / Q000592:standards; D007494:Ireland; D007757:Laboratory Infection / Q000453:epidemiology / Q000517:prevention & control* / Q000635:transmission; D017056:Medical Laboratory Personnel; D016272:Occupational Health / Q000331:legislation & jurisprudence* / Q000592:standards; D011364:Professional Practice / Q000592:standards* / Q000639:trends; D017751:Safety Management / Q000331:legislation & jurisprudence* / Q000592:standards; D013048:Specimen Handling / Q000592:standards; D014376:Tuberculosis / Q000134:cerebrospinal fluid* / Q000453:epidemiology / Q000517:prevention & control / Q000635:transmission; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D002556:Cerebrospinal Fluid Proteins; D005947:Glucose
keywords: accreditation; cerebrospinal fluid; glucose; proteins; safety; tuberculosis