Occupational and environmental laboratory medicine: A network of EQAS organisers

Most people in any community come into contact with chemicals that are potentially harmful to their health. Some elements are essential to health and inadequate amounts in food may also lead to ill health. Measurement of chemicals in blood, urine or other specimens is a fundamental feature of studies undertaken in the field of Occupational and Environmental Laboratory Medicine (OELM). Results are used to assess the risk for either overexposure or deficiency of essential nutrients. External Quality Assessment Schemes (EQAS) aid laboratories to achieve accurate and consistent data and 11 organisers of EQAS in Europe and North America are working to improve the effectiveness of their activities.The aims of the Network of EQAS Organisers in OELM are to stimulate improvements in analytical results, establish equivalence of assessment among Schemes, collaborate to enhance the practice of EQA including whenever possible to warrant traceability of EQAS to primary standards.Presented at the Eurachem PT Workshop September 2005, Portorož, Slovenia.     

Quality specifications for evaluation and comparison of performance among external quality assessment schemes in occupational and environmental laboratory medicine

Quality specifications (QS) are proposed for lead in blood and for aluminium, copper, selenium and zinc in serum as part of the aim to set standards of performance for laboratories so that results can be demonstrated to be fit for the purpose to which they are applied. The QS were established taking account of the analytical state-of-the-art, physiological variations in the concentrations of the analyte and the clinical purpose for which the assay is to be used. A procedure was devised that uses these QS to give equivalence of assessment among external quality assessment schemes (EQAS), thus avoiding conflicting information which has been demonstrated in the past. Advantages of this procedure are: to provide direct comparison of performance of laboratories taking part in different schemes, to provide equivalence of assessment of laboratory performance necessary to establish mutual recognition agreements, and to demonstrate the fitness for purpose of results from participants.Presented at the Eurachem PT Workshop September 2005, Portorož, Slovenia     

Considering uncertainty of measurement when assessing compliance or non-compliance with reference values given in compositional specifications and statutory limits: a proposal

Considering the uncertainty of measurement (UOM) is mandatory when assessing compliance with reference values given in compositional specifications and statutory limits, but the matter is still open to question. Working in the signal or concentration domains and considering false negative together with false positive errors are the main points of debate. Frequently, the available approaches look too simplified for being accurate or too complex (since more rigorously formulated from a theoretical point of view) for being largely acceptable. In the Authors opinion, assessing compliance with reference values given in compositional specifications and statutory limits is a problem similar to that of estimating the limit of detection. This allows proposing a simple operational approach based on well-known and accepted assumptions and approximations. This proposal, described in the light of the most recent literature information, is aimed to stimulate a critical discussion in view of evaluating possible corrections to the generally accepted approach.Papers published in this section do not necessarily reflect the opinion of the Editors, the Editorial Board and the Publisher.