Approximately 200 of the more than 186,000 laboratories in the United States are classified as state public health laboratories. Included in this number are about 150 regional or branch laboratories that are administered as part of the state public health laboratory. More than 6,500 laboratory professionals are employed by state public health laboratories.
Each state and five territories operate a state public health laboratory. One major function of theses laboratories is to provide diagnostic and analytical services for surveillance of infectious, communicable, genetic, and chronic diseases. State (and local) public health laboratories provide testing to support many public health programs (tuberculosis, sexually transmitted diseases, HIV, immunizations, and newborn screening). Areas of analysis include clinical and environmental chemistry, immunology, pathogenic microbiology, virology, and parasitology. State laboratories serve as reference laboratories, and they provide confirmatory testing of specimens submitted from other laboratories. The state public health laboratories frequently measure toxicants in human samples to document exposures to chemicals found in the diet or environment. This specialized testing requires expensive equipment (mass spectrometers, chromatographs) and well-trained chemists.
The capabilities, responsibilities, and practices of the state public health laboratories vary. During recent years, many of these laboratories have received substantial federal funding to increase staff, equipment, and capabilities to respond to biologic and chemical threats, as part of the DHHS' Cooperative Agreement on Public Health Preparedness and Response for Bioterrorism. A large percentage of the state public health laboratories have used some of the federal funding to build, remodel, and upgrade facilities. Funding for state laboratories is generally a mix of state and federal funds. Many states rely on fees, reimbursements, and service contracts to carry out their mission. Some states have regional or district laboratories to provide the necessary services throughout an entire state. State public health laboratories partner with public health laboratories operated by counties or cities to meet the needs of their communities. State public health laboratories are generally better prepared to respond to an incident requiring biologic testing as opposed to an incident requiring chemical testing.
Although research is not the primary mission of public health laboratories, several state public health laboratories have developed close ties with academic institutions. The opportunity to work on surveillance projects with faculty and students from schools of public health and academic training programs for laboratory professionals has been beneficial to these laboratories.
Arrangements with academic centers afford opportunities to improve laboratory services and surveillance systems. Flexible funding and other resources, such as grants, faculty, and students, help support special research projects and training opportunities within public health laboratories.
State laboratories provide services to health departments; healthcare organizations; local, state, and federal law enforcement; local hazardous materials (hazmat) teams; civil support teams; and other private and governmental laboratories. State laboratories analyze thousands of water and air samples daily. State laboratories involved in the analysis of drinking water and other environmental samples are accredited by the NELAP, certified by EPA Office of Drinking Water Programs, or accredited by state-specific accreditation programs.
State public health laboratories are the backbone of the Laboratory Response Network (LRN), which we discuss below. The LRN also includes laboratories under the jurisdiction of federal agencies discussed in this chapter. At the time of publication, 96 state and local public health laboratories make up the 146 laboratories that are members of the LRN. Of these, 72 state, territorial, and metropolitan public health laboratories are part of the LRN's chemical testing network.
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