Assessment of Clinical Laboratory Safety in Pathology Laboratories in a Tertiary Health Facility in Benin City, Nigeria

Abstract

Background: Clinical pathology laboratories are high-risk occupational environments. Despite the availability of national and international bio-safety frameworks, compliance within Nigerian tertiary health care facilities remains inconsistent. This study assessed the key components of clinical laboratory safety in the pathology laboratories of the University of Benin Teaching Hospital (UBTH), Benin-City, Nigeria.

Methods: A descriptive cross-sectional study conducted across four pathology departments. Total enumeration was employed and 185 valid structured questionnaires were analyzed. The instrument comprised 25 items across five domains: Demography, safety policies and infrastructure, hazard management and risk assessment, standard operating procedures, and safety training and culture. A composite safety score (0–100%) was computed per respondent from 20 scored items; a score ≥60% was classified as satisfactory. Inferential analyses included Kruskal-Wallis tests, chi-square tests of independence, and Spearman rank correlation (α=0.05).

Results: The mean composite safety score was 71.8% (SD±21.4%), with 144 respondents (77.8%) classified as satisfactory. Written safety policy availability was confirmed by 76.2% of the respondents and proficiency testing participation by 84.3%, whilst functional safety equipment was rated adequate by only 56.8%. Hazard awareness was high (93.0% favourable), but PPE was always available to only 38.9% of the respondents, and consistent PPE use was reported by 68.6%. SOP availability was strong for specimen handling (94.6%) and waste disposal (87.0%), but formal safety training in the preceding 12 months was received by only 62.2% of personnel. Composite scores differed significantly by professional cadre (Kruskal-Wallis H=36.53, p<0.001), department (H=9.85, p=0.020), and years of experience (H=10.32, p=0.006). Safety training receipt varied significantly across departments (χ²=11.00, df=3, p=0.012). All four safety domains correlated strongly with the composite score (Spearman ρ range: 0.671–0.814, all p<0.001).

Conclusion: Safety infrastructure at UBTH was partially established but substantive deficiencies persist in equipment adequacy, PPE availability and consistent use, equitable training distribution, and incident reporting. Professional cadre, department, and experience were significantly associated with safety performance. A comprehensive, evidence-based institutional safety improvement programme is urgently required.