It's time we tested our labs

If you check your blood sugar or urea creatinin levels in three different laboratories in the city, chances are you will get three different results. While street corner labs offering simple tests for as little as 30 may be a cheap option for diabetics, experts say unmonitored proliferation of laboratories could be counter-productive.
Health officials say they are aware of thousands of laboratories functioning across the state, many without proper equipment or technicians, but they can do little in the absence of strict norms.All one needs to open such a lab is a trade licence from Chennai Corporation. Many such labs don't have proper ventilation, quality water supply, cold storage facility or waste disposal facility. Neither the state health department nor the civic body conducts inspection at these places.
Certification by agencies like National Accreditation Board for Testing and Calibration Laboratories (NABL) or National Accreditation Board for Hospitals and Healthcare Providers (NABH) provide a formal recognition to the quality and technical competence of a lab. But these certificates are yet to be made mandatory for laboratories and less than 100 have applied for NABL accreditation in the country so far.
P Kalidasan, president of Paramedical Lab Education and Welfare Association, said the absence of a monitoring body poses a risk to patients. "Anybody can start a lab without following standards. There are no checks on chemicals or equipment used or qualifications of lab technicians. Despite several representations to the government to form a regulatory body to restrict illegal labs, nothing has been done so far," he said. He added that the process of getting NABL certificate is cumbersome and costly.
Many laboratories employ under-qualified people as lab technicians to save money. "It's difficult to get a lab assistant for anything less than 7,000 a month. It is tough to compete with modern labs. How do you expect us to employ a postgraduate diploma or degree holder in the lab?" said a lab owner in north Chennai.
Dr S Elango, former director of public health, said the absence of monitoring has led to inaccuracies in lab reports. "Like in the US, Japan and China, India needs a regulatory body on the lines of drugs control administration to monitor labs," he said. Officials in the drugs control administration said they are not monitoring labs, and they have records of only 17 labs which are attached to pharmacies.
Ideally, an accredited lab should have two pathologists, two microbiologists and two histopathologists, but a majority of small and medium labs has just one pathologist. Accredited labs are bound to give reports within a prescribed time. For instance, reports of haemoglobin and sugar need to be handed over to the patient in an hour, while the other reports must be done in three hours. These norms are seldom followed.