Field Instrument Proficiency Testing Discussion

There has been significant concern regarding the use of hand-held "field" devices for risk assessment, identification, and testing of potential exposure materials. With the increase in availability of hand-held instrumentation for chemical, biological, radiological, and other analyses, it is often difficult to evaluate and compare results from different manufacturers, analysis algorithms, and methodologies. To better protect responders, receiving laboratory staff, and the community, a proficiency-testing program needs to be implemented.

Why Proficiency Testing?

Laboratories participate in proficiency testing at scheduled and non-scheduled intervals to test instrument responsiveness, sensitivity, and specificity. Analysts perform the tests to remain proficient, that is able to reproduce accurate and precise results sample-to-sample, day in, day out. Proficiency testing also provides a common benchmark across differing staff, physical instruments and instrument types, and organizations. Most laboratories use a certified laboratory or vendor to provide a specific number of samples at pre-arranged intervals. These specimens are treated in the same manner and run as a regular specimen. Analysis and results are reported in a standardized predetermined format based on the limits of detection. Differing programs have varying windows for analysis, ranging from 3 days to 3 or more weeks. Once the results are received, the data is compared versus the known or pre-arranged concentration then evaluated statistically against all participants. Results are then compiled. Participants performing less than satisfactorily are then given a certain timeframe to perform corrective actions. In some cases, the samples may be run again and the results resubmitted for further review. By maintaining the satisfactory level of performance, the lab maintains its proficiency in practice and in certification.

How Often is Good Enough?

Each program establishes the frequency of the proficiency testing. This is usually based on criteria set forth by the governing regulations, certification agency, or established laboratory practices. Monthly and quarterly are most common in laboratories. For the hand-held instruments, a quarterly to semi-annual evaluation is most practical as part of a training session or group meeting. This also allows multiple individuals to attempt the analysis, not just one or two individuals. A schedule will need to be developed based on the instruments types and quantities available throughout the partner organizations.

What Types of Specimens Do We Want to Consider?

Instrumentation sensitivity, response, and specificity will be investigated as part of this project. While some instruments are only geared towards specific types of analysis or analytes, initially the selected analyses will need to be specific. As organizations become more comfortable with the process, matrices that are more exotic should be considered (food, sludge, etc.) to evaluate what are the limits of the equipment. In addition, laboratories with mobile or fixed instrument can also participate in the analysis, bringing another dimension to better integration.

How Do We Do Participate?

An organization associated with a Hazardous Materials Team, potential exposure response, or healthcare based organization with hand-held equipment is eligible to participate. During the spring 2007 Laboratory Preparedness Advisory Committee (LPAC) meeting, the 31st Civil Support Team was identified as the lead organization for coordination. Members of the LPAC will work to develop the proficiency testing criteria as well as an enrollment and participation process. This will be discussed in further detail during the fall LPAC meeting (15 November 2007).

Once criteria are established, a reporting mechanism identified, and an instrument inventory compiled, specimens will need to be ordered and/or generated.

What Happens if There is a Failure?

Corrective action criteria will be established as part of the participation criteria. Organizations will work with vendors, LPAC members, and other partners to determine the source of the failure. Once corrected, additional specimens may be provided for evaluation. As this is a committee driven mechanism, additional consequences must be discussed prior to full implementation. The overall goal is to strengthen the best safety practices for responders, laboratory personnel, and the community, not to assign blame.

When Do We Want to Start?

Once the participation criteria, instrument inventory, and materials are identified, a start date can be identified. With this in mind, a start date of February to May 2008 is not unreasonable. Whether the proficiency tests are done as part of a training exercise within each organization or as an overall large, scale training session must be determined. SO, the best question:  WHEN DO YOU WANT TO START?