[MCOH-EH] Using staff as "controls" for esoteric hematology labs?

[Angelique Ramirez]

The response from our lab management ... apparently this is the norm ...

Yes, we do; as a matter of fact, I have been the control for a couple of the neutrophil oxidative burst tests over the years.  Additionally, we have certain special coagulation tests where there are no commercial controls available, so the techs in the lab routinely draw each other for QC purposes.  This is a common issue for labs across the nation in these circumstances.  We do offer a small donation incentive for each draw to employees that volunteer, and thankfully we've never had to turn any test away for lack of a normal control.


Angelique Ramirez, MD
Medical Director
Parkland Occupational Health Services
Office of Talent Management
214-590-4842 - office
angelique.ramirez at phhs.org





From: MCOH-EH [mailto:mcoh-eh-bounces at mylist.net] On Behalf Of Swift, Melanie
Sent: Tuesday, September 02, 2014 2:49 PM
To: MCOH/EH
Subject: [MCOH-EH] Using staff as "controls" for esoteric hematology labs?

Wondering if anyone else has a facility that uses reference labs for esoteric hematology tests that require a "healthy, unrelated donor" to submit a blood specimen that is drawn at the same time and shipped along with the patient's?

The reference labs requiring this include ARUP and Quest - one example lab is the "neutrophil oxidative burst test."

The purpose of the control is to ensure that normal cellular function was not adversely affected in transit. Without a control specimen, the labs typically report a caveat "cannot confirm these findings due to lack of a control" with any abnormally functioning cells. Temperature is one factor but not the only factor, so it's not as simple as enclosing a hi/lo thermometer with the package.

Seems a common practice is for lab staff to just draw one another's blood to send with the patient's as the "control." Lots of issues with that as you can imagine - who determines whether the employee is "healthy" or has taken any of the forbidden meds? Should employees be compensated for volunteering to do this? Would compensation have the unintended consequence of coercing employees to donate blood? Is repeated request for donation a form of coercion?

Our lab has queried their university health center list serv and gotten very few responses, all from academic medical centers who say their lab staff is their "donor pool." However all express concerns about this practice.

We are reaching out to the clinics who typically order these tests (often pediatric heme/onc) to find out if such tests can be anticipated in advance and the family encouraged to bring an unrelated eligible donor. However there will still be times when a control is needed and none is available.

Do any of your facilities have a solution to this? (If, like me, you were unaware this was happening, you might want to call your reference lab manager and find out - though it might open a can of worms!)

Melanie Swift, MD
Director, Vanderbilt Occupational Health Clinic
http://occupationalhealth.vanderbilt.edu

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