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RE: BMP for analytical labs



Am I responding to the email address correctly?  diane

Diane D. Buxbaum, MPH
US Environmental Protection Agency, Region 2
Compliance Assistance and Program Support Branch
290 Broadway, 21st Floor, East
New York, New York 10007
212-637-3919 (fax 212-637-4086)
----- Forwarded by Diane Buxbaum/R2/USEPA/US on 06/06/01 02:44 PM -----
                                                                                                        
                    "Stillman, Marvin"                                                                  
                    <mstillman@facilities.roch        To:     Diane Buxbaum/R2/USEPA/US@EPA, Carl       
                    ester.edu>                        Plossl/R2/USEPA/US@EPA                            
                                                      cc:                                               
                    06/06/01 11:33 AM                 Subject:     RE: BMP for analytical labs          
                                                                                                        
                                                                                                        



Diane,

I spoke with our Clinical Labs administrator to get a lab perspective.
This response may not really answer the question directly, but maybe it
will
give some ideas of things to think about.

A consolidated document for a lab that one could hold in their hand and
call
a BMP is not the usual case.  Instead, there are standards and internal
policies that are periodically reviewed that,if brought together, would
make
a very nice BMP.  I would start there. These would include such things as a
written waste and laboratory management policy that is site-specific,
industry standard practices and accreditation guidelines and requirements.
All analytical processes and procedures are documented and subject to
internal and external oversight.

Our own standards are in the process of being raised. We will be moving out
from under JCAHO laboratory oversight to the College of American
Pathologists oversight in the very near future (as well as remaining under
NYSDOH oversight and standards.)  The reason I bring this up is that I am
told the CAP standards and inspections are much more rigorous and that CAP
may be a good place to go for more information or to lobby for more P2
inclusion into those standards.  Our lab administrator will be emailing the
address of CAP to me soon.

Under JCAHO, inspectors of varying technical background review lab
operations.  CAP inspectors, I am told, are technically more savy and see
way beyond what is looked at under JCAHO.  At least one of our PhD chemists
has participated as part of a CAP inspection in Ohio, so the level of
expertise is high.

I present the following so that maybe one can glean some ideas from what is
going on in a modern clinical lab to include in a BMP.

To improve patient care and overall operations, including waste, we are
currently installing approximately $100,000 worth of robotics that can
prepare blood samples to be analyzer ready.( I was at the meeting this
morning).  This automation will cut down on blood handling, waste, human
error, exposure potential, and so forth.  Another great way to minimize
chemical usage we employ includes Vitros units. (I am not technically savy
on these units, but I am sure I could come up with more information) These
essentially replace a lot of wet chemistry with dry chemistry done on
slides.  The amount of chemcals is greatly reduced. This has even
eliminated
full-time wet chemistry type positions in the labs.  Other  automated
devices that run on chemical kits designed specifically for a particular
machine/process are also usused.  These not only cut down on the amount of
chemicals used in each process, but cut down on waste because the
pre-standardized chemicals that are purchased are sized to match the
machine's usage.  One screws the bottles into the machine and they all get
used up together.  There is no waste from left over reagents or
mis-prepared
standards.  Also, our Special Stains Laboratory Manual has been updated and
the processes reformulated to no longer include any mecury in the stains
formulations, including B-5 fixative.

These things have come about essentially as a result of seeking better ways
to provide high quality patient care, reduce costs, and create a safer
working environment.  These activities just happen to also reduce waste.  A
modern clincal lab is a fine example of how P2, quality, safety concerns
and
economics all come together.  A win win.

Regards,

Marvin Stillman




-----Original Message-----
From: Buxbaum.Diane@epamail.epa.gov
[mailto:Buxbaum.Diane@epamail.epa.gov]
Sent: Wednesday, June 06, 2001 9:13 AM
To: Plossl.Carl@epamail.epa.gov; Stillman, Marvin
Subject: BMP for analytical labs


Diane D. Buxbaum, MPH
US Environmental Protection Agency, Region 2
Compliance Assistance and Program Support Branch
290 Broadway, 21st Floor, East
New York, New York 10007
212-637-3919 (fax 212-637-4086)
----- Forwarded by Diane Buxbaum/R2/USEPA/US on 06/06/01 09:12 AM -----


                    srock@pprc.org

                    Sent by:                  To:
p2tech@great-lakes.net

                    owner-p2tech@great        cc:

                    -lakes.net                Subject:     BMP for
analytical labs




                    06/06/01 08:34 AM

                    Please respond to

                    srock










A client is trying to help their quality assurance person put together a
contract for the state lab to include P2 language in the contract. They are
looking for BMPs for analytical laboratories. Can anyone help with this?
Thanks,


L.B. Sandy Rock, MD, MPH
Environment and Health Research Director
Pacific NW Pollution Prevention Resource Center
513 First Ave. W
Seattle, WA  98119
(206) 352-2050
(206) 352-2049 FAX
srock@pprc.org
www.pprc.org