Strong laboratory capacity is essential for detecting and responding to emerging and re-emerging global health threats. We conducted a quantitative laboratory assessment during 2014–2015 in two resource-limited provinces in southern China, Guangxi and Guizhou in order to guide strategies for strengthening core capacities as required by the International Health Regulations (IHR 2005). We selected 28 public health and clinical laboratories from the provincial, prefecture and county levels through a quasi-random sampling approach. The 11-module World Health Organization (WHO) laboratory assessment tool was adapted to the local context in China. At each laboratory, modules were scored 0–100% through a combination of paper surveys, in-person interviews, and visual inspections. We defined module scores as strong (> = 85%), good (70–84%), weak (50–69%), and very weak (< 50%). We estimated overall capacity and compared module scores across the provincial, prefecture, and county levels. Overall, laboratories in both provinces received strong or good scores for 10 of the 11 modules. These findings were primarily driven by strong and good scores from the two provincial level laboratories; prefecture and county laboratories were strong or good for only 8 and 6 modules, respectively. County laboratories received weak scores in 4 modules. The module, ‘Public Health Functions’ (e.g., surveillance and reporting practices) lagged far behind all other modules (mean score = 46%) across all three administrative levels. Findings across the two provinces were similar. Laboratories in Guangxi and Guizhou are generally performing well in laboratory capacity as required by IHR. However, we recommend targeted interventions particularly for county-level laboratories, where we identified a number of gaps. Given the importance of surveillance and reporting, addressing gaps in public health functions is likely to have the greatest positive impact for IHR requirements. The quantitative WHO laboratory assessment tool was useful in identifying both comparative strengths and weaknesses. However, prior to future assessments, the tool may need to be aligned with the new WHO IHR monitoring and evaluation framework.

This paper provides a comprehensive review of the history of laboratory-acquired infections (LAIs) from a scientific perspective on biosafety risks. It analyzes cases from the late 19th century to the 2020s, whereas the previous research on this topic has primarily focused on social factors. By combining real case studies, this study elucidates the mechanisms of LAI occurrence and development, compares the attribution of risks and mitigation measures, and establishes the scientific patterns of LAIs’ historical evolution. The details of LAI cases are compared to the biosafety risk assessment indices of the World Health Organization (WHO), the United States, and China. These real cases of LAI occurrence risks are now incorporated into biosafety standards and assessments in the modern era. Additionally, factors that pose potential risks of LAIs, even if they have not yet manifested, are also highlighted.

Background: To understand the biosafety awareness of hospital laboratory staff in seven provinces of China, and to provide a basis for medical staff to carry out laboratory biosafety education. Methods: By using a stratified random sampling method, 188 laboratory staff from 41 hospitals in seven provinces were selected for a face-to-face questionnaire survey. In this survey, the biosafety awareness of the respondents was scored, and the biosafety awareness among hospital laboratory staff were evaluated based on the score. Results: The overall average score of laboratory staff in the surveyed hospitals was 81.64 points, and the average score of the biosafety awareness in the laboratory was 95.57 points, while the average score of biosafety awareness in risk assessment and control was only 44.68 points. Among the respondents, 57.22% of the staff identified a lack of special funds relating to biosafety activities. Conclusion: Biosafety awareness of laboratory staff is low, with laboratory funding, education level and years of laboratory work affecting the biosafety awareness of hospital laboratory staff. Biosafety training needs to be improved by paying attention to the biosafety training content, plus adding training effect evaluation and feedback loops, as well as exploring new training modes and increasing the support through special hospital biosafety funds.