Wisconsin’s Local Laboratories

A publication of the Wisconsin Public Health Laboratory Network

Questions and Answers for Community Leaders If you have ever wondered what your public health laboratory does to protect your commu- nity, this publication will help answer your questions. Want to know more? Call your local laboratory and schedule a visit!

Q: What do local Q: What advantages do public health public health laboratories bring to Wisconsin commu- laboratories do? nities?

A: Local public A: There are several advantages that a local public health laboratories health laboratory brings to its community: offer testing, refer- • Monitoring programs that prevent or detect prob- ral, interpretation lems early of results and follow • Quick response and rapid testing turn around up investigations for many different environmental times and human health problems. Health department staff • Professionals that assist in-person with commu- work not just in the laboratory but also in the field nity education, assessment and sample collection applying science to real life situations. • Connections to other laboratory resources through Public health laboratory professionals and the Wisconsin Local Public Health Laboratory other health department staff also provide monitor- Network, the Wisconsin State Laboratory of Hy- ing programs in an effort to prevent human expo- giene, the Department of Natural Resources, the sure to pathogens and chemicals. They see their role Wisconsin Division of Public Health, the Depart- as proactive – understanding and monitoring their ment of Agriculture, Trade and Consumer Protec- communities to detect and prevent health hazards. tion, even the Centers for Disease Control and Pre- This approach distinguishes a public health labora- vention – to bring state-of-the-art service to your tory from laboratories whose mission is focused only community. on sample testing.

1 Q: What specific services clinical and environmental services from blood lead do Wisconsin’s local testing to communicable . The public health laborato- majority of Wisconsin’s public health laboratories ries offer? fall somewhere in between those two examples. But what’s important to note is that most lo- A: That varies quite a bit. A cal public health laboratories offer on-site service, local laboratory might focus on counseling, education and thorough follow-up in a specific program such as well addition to the actual laboratory tests. These water testing, outreach and services make local public health laboratories education. By contrast, the City unique. of Milwaukee Health Depart- Here are some examples of how public health ment is home to our state’s largest local public health laboratories have played a role in protecting Wiscon- laboratory, and personnel there provide a range of sin communities. Schools Real Estate Tourism

Much of what local public health About one third of Wisconsin’s Most of us know how important laboratories do grows out of ongo- residents are served by private wa- tourism is to Wisconsin’s eco- ing protection programs rather ter supplies. But routine safety nomic health. But did you know than high profile events. As part of testing of private well water is not that health department laboratories a school safety assessment, the required in our state. This be- are partners in assuring healthy Eau Claire City-County Health comes a special concern for pro- tourism? Before the Ironman Tri- Department laboratory tested the spective home buyers. What can athlon came to Wisconsin, event treated lumber used in a school they do to assure that they are organizers wanted to assure the playground and found it contained buying a safe water supply along safety of entrants who would be arsenic. The school district took with a home? The Marathon swimming in Lake Monona. The quick remedial action and addi- County Health Department has Madison Department of Public tional local public health labora- created a publication to guide Health Laboratory completed a tory testing confirmed the poten- home buyers entitled Buying a series of tests and communicated tial hazard had been eliminated. House in the Country. The labora- the results to the organizers, assur- Throughout this process, the tory processes well water tests ing the safety of the swimmers. health department worked with the upon request and keeps a database The estimated economic impact of school system to educate the of well test histories which is ac- the Ironman in 2006 was $2.23 community. cessible to prospective home buy- million. ers.

2

Q: How many local public health labora- Q: Why are local public health laborato- tories are there in Wisconsin? ries needed when commercial laborato- ries are available?

A: Commercial laboratories play an important role in our communities. These laboratories focus on achieving a test result to meet the needs of their cus- tomers as individuals. Local public health laboratories focus on how test results affect both the individual and the community. A local public health laboratory’s primary mission is to protect the public and staff members respond around the clock if there is a public health emergency. They also directly advise and assist health departments and other governmental agencies in prevention, detection and abatement of environ- mental hazards that threaten communities, and when needed, provide information to enforce laws. Though appropriate protections for individual privacy are A: In 2006, 13 of Wisconsin’s 93 health jurisdic- assured, the work of public health laboratories is tions (city, county, and city-county health depart- public record. ments) provided laboratory services as part of their local operations. These laboratories often provide services for neighboring jurisdictions so their actual To illustrate the difference between public and private “reach” extends well beyond the 13 areas. laboratory services, let’s pose another question…

Q: Why don’t all jurisdictions have public Q: What does a publicly supported po- health laboratories? lice force offer that a private security firm does not? A: Two reasons – local priorities and sample vol- A: A private security firm might contract to pro- ume. Some communities have placed a high priority vide crowd control at a concert. But, if a distur- on quick, thorough and local response to public bance occurs on the street outside of the venue, the security firm has no obligation or authority to health problems such as food and waterborne out- respond, and would likely incur liability if it did. The breaks and environmental hazards. These communi- public police force however, because it is driven by ties support public health laboratory services as a its charge to protect the public, will engage on the way to assure these protections. And laboratories street, in the venue, anywhere where the need regular test volume so that personnel can need to protect the public presents it- maintain skills necessary to operate effectively and self – and at any time of day or night. efficiently. That is why some local laboratories co- That is how a public health laboratory responds. operate to provide services for neighboring health departments on a fee or contractual basis. 3 Q: Why should a local health department personnel know their communities community either pro- and can translate test results into information for de- vide or assure laboratory cision making in real time. While they might not be services are provided? able to provide every test or piece of advice needed, they are connected with those who can, and their job is to assure that the best laboratory science is A: Because local laboratories brought to bear in any particular situation. can respond quickly and in person when a community Here are more examples of the value of public health member needs a test, has a question or a crisis. Local laboratory services in your community... Restaurants Public Buildings Beaches and Pools

Restaurant closures or food prod- What does a community do in the In communities with active moni- uct recalls as a result of outbreaks case of possible lead contamina- toring programs and public health make the news. But what most tion in an aging school building? laboratories, beach and pool sam- people don’t understand is the If that community has local public ples are tested regularly. (Sadly work that goes on every day as health laboratory capacity, the this does not include all Wisconsin public health laboratory profes- laboratory staff would work with communities.) With local laborato- sionals work with health depart- other public health and community ries, the samples can be processed ment sanitarians and business leaders. The team would deter- on the same day that they are col- owners to perform microbiological mine what type of samples should lected, assuring the most accurate tests to assess and be taken, assure proper sample and timely results. And health de- practices. By doing this collection, analyze the samples partments do more than testing - routinely, a working relationship (or when needed, send for further they work with the pool or beach is developed and through training, analysis at another laboratory), manager to identify potential the knowledge of the managers and then interpret the results so sources of with the goal and workers in the establishment that informed decisions can be of solving the problem, not just increases - all for the benefit of made. reporting a result. One such suc- business, customer and commu- cess story is that of Racine’s North nity. Beach, once a place that was too contaminated for swimming, and now Wisconsin's only "Blue Wave Beach."

4 Q: The Wisconsin State Laboratory of the public. is one of the best state public health laboratories in the nation. Can’t it Q: What are some common tests done in provide local services? public health laboratories and why?

A: The tests done “in house” vary by laboratory but A: Yes and no. There is no this simple table describes a few types of tests that doubt that the WSLH is are a common part of public health laboratory prac- available to and actively serv- tice. ing all 93 health jurisdictions and 11 tribal health units in the state. As just one ex- Sample Tests Benefit ample, WSLH offers an extensive panel of newborn Public water Bacteria and met- Safe drinking screening tests to every baby born in Wisconsin. supplies als water But, WSLH is a high level laboratory located in Madison and it relies on local health department Private wells Bacteria, fluoride, Safe drinking nitrate water partners to be the eyes, ears and hands in each community. In fact, in times of emergency such as Recreational Bacteria Safe swimming the anthrax crises of 2001, many local public health water laboratories assisted in collecting samples which Groundwater Metals, nutrients Prevent and de- were sent to WSLH for testing, while the Milwaukee near landfills and general water tect leaching Health Department Laboratory provided additional quality into groundwa- testing support. The WSLH offers technical assis- ter tance and training, and is a key referral source for Paint chips Lead Minimizes poi- testing requested by local laboratories, but its mis- soning risk es- sion is to serve the whole state and it cannot be “on Drinking water pecially in chil- the scene” and understand a community like a local dren laboratory can. There is no substitute for a health Food Bacteria Assures safety department professional who understands and and improves lives in the community they serve. sanitation

Q: What should citizens be looking for in Q: What if I want to know more? a local public health laboratory? A: For general information on public health labora- A: While there is much variation in local laboratory tory science, visit: capacity and services, there are some guidelines that • The Association of Public Health Laboratories at can be applied to all: www.aphl.org Laboratory certifications - Granted by • The Centers for Disease Control and Prevention’s regulatory agencies, these certifications require on- Division of Laboratory Systems at: site audits and performance evaluation testing. This www.phppo.cdc.gov/dls/default.aspx helps assure competent laboratory staff and results • The Wisconsin State Laboratory of Hygiene at: that reflect a high level of confidence. www.slh.wisc.edu/ Quality assurance - Local public health Contact information for Wisconsin’s public health laboratories typically incorporate tight quality assur- laboratories is listed on the next page. ance measures in their practices, and laboratory leaders can share the features of their program with

5 Wisconsin’s Local Public Health Laboratories April 2007

Contact your public health laboratory • City of Milwaukee Health Dept. 414-286-3526 www.milwaukee.gov/healthlab • Brown County Health Dept. 920-448-6400 www.co.brown.wi.us/Health/index.html • City of Oshkosh Health Services Division 920-236-5030 www.ci.oshkosh.wi.us/Health/Health.htm • Douglas County Dept. of Health and 715-395-1304 www.douglascountywi.org • City of Racine Health Dept. 262-636-9201 www.cityofracine.org • Eau Claire City County Health Dept. 715-839-4718 www.co.eau-claire.wi.us/health/index.htm • Rock County Health Dept. 608-757-5441 www.co.rock.wi.us • Fond du Lac County Health Dept. 920-929-3085 www.co.fond-du-lac.wi.us/Dept/Health/health.html • Waukesha County Dept. of Parks and Land Use Environ- Division 262-896-8300 • Kenosha County Division of Health 262-605-6700 www.waukeshacounty.gov/eh www.co.kenosha.wi.us/dhs/Divisions/Health • Wisconsin Dept. of Agriculture Trade and Consumer Pro- • LaCrosse County Health Dept. 608-785-9872 tection, Food Safety Division 608-224-4700 www.co.la-crosse.wi.us/Health/index.htm www.datcp.state.wi.us/core/food/food.jsp

• Public Health Madison Dane County 608-266-4821 • Wisconsin State Laboratory of Hygiene 608-262-1293 www.publichealthmdc.com www.slh.wisc.edu

• Marathon County Health Dept. 715-261-1900 Funding for this publication was provided by the University of www.co.marathon.wi.us/infosite.asp?dep=20 Wisconsin School of Medicine and Public Health from the Wis- consin Partnership Fund for a Healthy Future.

Return address:

To: