This is a text-only web adaptation of a brochure produced by the Association of Public Health Laboratories.

ON THE FRONT LINE:

• Monitoring the environments in which we live, work and play
• Investigating and Containing emerging infectious diseases and outbreaks
• Preventing disease and disability in vulnerable populations, including women and children
• Developing new methods to combat infectious diseases
• Preparing for and responding to local, state, and national emergencies, such as bioterrorism and natural disasters
• Informing communities and government about threats or risks to health
• Formulating policies that assure the health and safety of communities

"Public Health Laboratories are an important national resource for safeguarding the health of our citizens." 

Dr C. Everett Koop
Former U.S.Surgeon General

The following are just a few examples of how public health laboratories protect the health of our nation.
  

Safe Drinking Water - by testing for bacteria and parasites that pose serious threats to U.S. water supplies, as well as testing for pesticides, and other harmful substances.

Food Safety - through participation in PulseNet, a national network based on DNA finger printing of bacteria that cause food-borne disease, Public Health Laboratories can quickly identify outbreaks such as Escherichia coli, commonly referred to as E.coli, and Salmonella.

Safe Air and Habitats - by testing for radon, asbestos, lead, mercury, and hazardous waste in or near our homes, work sites, and recreational areas.

Cancer Prevention - by testing for and identifying carcinogens in the environment, Public Health Laboratories help reduce the incidence of cancer in our communities.

Quality Laboratory Practices - by regulating clinical laboratories, including those in physician offices, and by training private and public laboratory personnel.

Rapid Reporting - as part of our national surveillance system, by providing crucial data and information used to assess the health of communities and to diagnose and contain outbreaks.

Public Policy - through participation in policy formulation processes, advocating for and assuring that appropriate legislation and resources exist to protect the public's health and safety.

"In many communities, Public Health Laboratories are the safety net between the local water plant and your kitchen tap." 
 

Antibiotic Resistant Organisms - using advanced testing methods, Public Health Laboratories can detect the emergence of resistant organisms so that more effective therapies can be administered to prevent the spread of infection and save lives.

E. coli - Public Health Laboratories were the first to identify E. coli O157:H7 in hamburger meat as the cause of outbreaks in several states. As a result, hundreds, if not thousands, of children and adults were protected from severe illness and even death caused by these bacteria.

Hantavirus - caused by exposure to rodent excretions, there is no cure or vaccine for this deadly virus. In 1993, during the first outbreak in the U.S., our federal public health laboratories quickly identified the virus as the cause of several deaths. New testing technology to identify the virus was rapidly developed and provided to state and local public health laboratories. Additionally, guidelines for protecting against exposure to the virus were developed and implemented to protect visitors to our national parks and recreational areas.

Rabies - in one year alone, it has been estimated that animal testing conducted by Public Health Laboratories prevented the pain, trauma, and expense of rabies shots in more than 71 thousand people, and saved over $100 million.¹
       

Over 2.6 million women in the U.S. have undiagnosed chlamydia. Left untreated, this disease may progress to pelvic inflammatory disease (PID) which can result in infertility. Laboratory screening coupled with appropriate treatment of chlamydia can reduce the incidence of infertility by as much as 56%.^{2, 3}

It is estimated that early detection and treatment of chlamydia saves $100 - $400 million per year over the cost of treating complications later.⁴

Over 14,000 new cases of cervical cancer are diagnosed each year, and over one-third of all women with this disease die within five years. Pap smear screening every three years, carried out by public health and other laboratories, can reduce cervical cancer by 91%.² 

Each year in the U.S., 20,000 to 30,000 infants and young children are infected with hepatitis B. Early testing in mothers, combined with a single dose vaccine for the infant within 12 hours of birth, can prevent chronic infection in up to 95% of cases.⁴ 

Public Health Laboratories conduct screening tests to determine if a newborn has an inborn error of metabolism associated with phenylketonuria (PKU), sickle cell disease, cystic fibrosis, hypothyroidism, and other disorders.

Screening and testing newborns for sickle cell anemia can reduce deaths from this disease by up to 84%.⁴ 

Newborn screening coupled with rapid diagnosis and treatment prevents mental retardation, illness, and death in newborns. It also saves millions in treatment, home and institutional costs.

For every $1 spent on newborn screening, $9 in medical care and treatment costs are saved - resulting in a national savings of $36 million every year.⁵ 

"Routinely, Public Health Laboratories provide screenings for diseases such as hepatitis B and chlamydia."

Public Health Laboratories developed the original step-wise method for HIV testing. Because of the test to detect HIV status, infected individuals can now be treated early and expect to live longer, healthier, and more productive lives.

Public Health Laboratories are leaders in detecting and diagnosing drug resistant strains of tuberculosis (TB). These life protecting detection methods coupled with rapid physician notification have contributed to significant decreases in multi-drug resistant deaths and related disabilities.

During the influenza epidemics that occurred between 1972 and 1991, more than 18,000 people aged 65 years and older died.⁵ Each year Public Health Laboratories, working in concert with a network of physicians and the Centers for Disease Control and Prevention, collect and test specimens from influenza patients. The findings from these tests determine the type of vaccine that will be needed to protect the elderly and others at risk for influenza in the upcoming year. Between 1990-1993, for every $1 spent on vaccinations of older adults, $30 to $60 in hospitalization costs were saved and deaths related to influenza were reduced by up to 54%.⁶

Investigations carried out in our nation's Public Health Laboratories resulted in the identification of the organisms that cause diphtheria, cholera, tuberculosis, leprosy, and typhoid fever. Their findings paved the way for development of antitoxins and other therapies used to prevent and control these diseases.⁷

"Public Health Laboratories are leaders in prevention and control of disease."
 

 

Rapid detection and diagnosis of biological threats such as the bacteria that cause anthrax, plague, tularemia, and other deadly agents.

Identification of chemical threats such as ricin, sarin, and mustard gas, among others.

Development of new rapid tests for detecting and identifying biological agents and transferring testing technology quickly for use at the state and local levels.

Triaging water samples and using rapid screening methods to identify coliforms, nitrates, petroleum, and pesticides in drinking water caused by flooding.

Partnering with the Centers for Disease Control and Prevention, the Federal Bureau of Investigation, and the Department of Defense, to establish a nationwide network capable of:

• Identifying and diagnosing chemical and biological threats
   
• Alerting local authorities and emergency medical programs of necessary actions to be taken
   
• Training local hospital laboratory and health care workers to recognize biological agents and to treat patients appropriately.
   

Assess the health of their communities 

Assure safe and disease-free communities 

Investigate, identify, report, and control threats to health

Screen for infectious and chronic diseases to prevent death and disability

Research and develop new methods to detect chemical and biological threats

Inform and educate the public and community officials about risks to health

Regulate private and clinical laboratories to assure quality laboratory practices

Train laboratory professionals

Participate in formulation of policies that assure the health and safety of our citizens

Public Health Laboratories are integral to our nation's health system. They are uniquely qualified to support surveillance activities, conduct outbreak investigations, and monitor for new or emerging infectious diseases. They are among our first line of defense against bioterrorism. The health and safety of our nation depends on Public Health Laboratories. 

"Public Health Laboratories are as essential to our health and safety as police and fire departments."

To fulfill its mission, APHL works collaboratively with a diverse array of national, international, public and private sector partners in formulating and advocating sound public health and environmental health policies, preparing future generations of scientists and laboratory leaders through fellowship and traineeship programs, and improving public health laboratory practices nationally and internationally through technical assistance and training.

APHL is recognized nationally and internationally for its excellence in the provision of cost-effective training and continuing education programs offered through its National Laboratory Training Network (NLTN), a collaborative training system with the Centers for Disease Control and Prevention.

For more information on APHL, its members, and programs visit our web site at: http://www.aphl.org  or contact us at:

Association of Public Health Laboratories
1211 Connecticut Avenue, NW
Suite 608
Washington, DC 20036

Phone: 202-822-5227
Fax: 202-887-5098
Email: info@aphl.org

The support of the Division of Laboratory Systems, Public Health Practice Program Office, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services is gratefully acknowledged.

References :

1. Cordts JR. The Laboratory as a Model Public Health Function. CDC/NCID Focus. March 1995; 6-9.
    
2. Centers for Disease Control and Prevention. An Ounce of Prevention, What Are The Returns? 2nd ed., 1999, U.S. Department of Health and Human Services.
    
3. Washington AE, Johnson RE, Sanders LL Jr. Chlamydia trachomatis infections in the United States: What are they costing us? JAMA 1987; 257:2070-72.
    
4. U.S. Preventive Services Task Force. Guide to Clinical Preventive Services. 2nd ed.,1996 , Baltimore: Williams & Wilkins.
    
5. Centers for Disease Control and Prevention. Prevention and Control of Influenza: Recommendations of the Advisory Committee on Immunization Practice (ACIP). MMWR 1995; 44(RR 3):1-22.
    
6. Nichol KL, Margolis KL, Wuorenma J, Van Sternberg T. The efficacy and cost effectiveness of vaccination against influenza among elderly persons living in the community. New England Journal of Medicine 1994; 331:778-84.
    
7. Valdiserri R. Temples of the future; an historical overview of the laboratory's role in public health practice. Annual Review of Public Health 1993; 14:635-48.