气候变化和诊断样本——打开潘多拉(邮筒)

IF 3.2 3区 医学 Q1 PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH
Paul Klapper , Raghavendran Kulasegaran-Shylini , Andrew Dodgson , Malur Sudhanva , Edward Blandford , Sarah Tunkel , Sue Hill , Susan Hopkins , Tom Fowler
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引用次数: 0

摘要

以英国COVID-19家庭检测项目为例,反思气候变化如何重塑诊断检测的实用性,并呼吁紧急审查管理生物样本运输的国际标准。研究设计:根据英国国家检测计划应对COVID-19期间的操作经验进行基于叙述的分析。方法采用常规邮政服务将生物样本从家中运送到实验室的新型冠状病毒肺炎大规模家庭检测模型的设计和实施。这些样品在没有温度控制的情况下运输,在各种不同的环境条件下运输。这种方法测试了现有后勤假设的局限性,暴露了关键的监管漏洞。结果尽管缺乏温控物流,英国的家庭测试程序在规模上运行,内部验证确保了样品在冬季和夏季极端情况下的稳定性。然而,这一成功是在没有任何适用的国际标准的情况下发生的,例如ISO准则,这些标准考虑了生物样品邮政运输中的环境因素。这一经验突出了监管框架中的一个重大盲点,即目前监管框架所假定的受控条件不能反映紧急情况或气候影响情况下的实际做法。气候的变化和医疗服务模式的发展——特别是向近病人和家庭诊断的转变——要求我们重新思考如何保证运输中生物样本的质量和可靠性。现有的国际标准已不再适用于这方面的目的。迫切需要承认,环境复原力是诊断物流的核心要求,并制定新的标准,以适应气候变化和分散医疗保健的现实。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Climate change and diagnostic samples - Opening Pandora's (post) box

Objectives

To reflect on how climate change is reshaping the practicalities of diagnostic testing, using the UK's COVID-19 home-based testing programme as a case study, and to call for an urgent review of international standards governing the transport of biological samples.

Study design

Narrative-based analysis drawing on operational experience during the UK National Testing Programme's response to COVID-19.

Methods

We examine the design and implementation of a large-scale home testing model for COVID-19, which relied on the routine postal service to transport biological samples from homes to laboratories. These samples were transported without temperature control, across widely varying environmental conditions. This approach tested the limits of existing logistical assumptions and exposed critical regulatory gaps.

Results

Despite the lack of temperature-controlled logistics, the UK's home testing programme functioned at scale, with internal validation assuring sample stability during both winter and summer extremes. However, this success occurred in the absence of any applicable international standards—such as ISO guidelines—that account for environmental factors in postal transport of biological samples. The experience highlighted a significant blind spot in regulatory frameworks, which currently assume controlled conditions that do not reflect real-world practice in emergency or climate-affected contexts.

Conclusions

The changing climate and evolving models of healthcare delivery—particularly the move toward near-patient and home-based diagnostics—require a rethinking of how we assure the quality and reliability of biological samples in transit. Existing international standards are no longer fit for purpose in this regard. There is an urgent need to acknowledge environmental resilience as a core requirement in diagnostic logistics, and to develop new standards that are robust to the realities of climate variability and decentralised healthcare.
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来源期刊
Public Health
Public Health 医学-公共卫生、环境卫生与职业卫生
CiteScore
7.60
自引率
0.00%
发文量
280
审稿时长
37 days
期刊介绍: Public Health is an international, multidisciplinary peer-reviewed journal. It publishes original papers, reviews and short reports on all aspects of the science, philosophy, and practice of public health.
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