Public Health Laboratory Services

In the State of Maharashtra, the laboratory network comprises of 34 District Public Health Laboratories, one laboratory at each District Headquarter, (There are two laboratories at Thane District, one at Thane District Public Health Laboratory and other at C. B. D. Belapur, Public Health Laboratory Konkan Bhavan,) and 138 Sub Divisional Laboratories at Block level. In Toto laboratory network comprise of 172 laboratories

The Public Health laboratories have a four tier networking. State Public Health Laboratory, Pune functions as the State level laboratory as well as State referral laboratory. It exercises administrative and technical control all over the Public Health Laboratories in the State. Nagpur and Aurangabad are the Regional Level Laboratories; remaining 31 Laboratories are District level Laboratories. The Public Health Department in collaboration with Water Supply and Sanitation Department of the State Government, have flagged off on the 1st May 2013, 137 Sub-Divisional Laboratories, functioning till date at the block level and located at Rural/Sub-District Hospitals. 337 Mini Laboratories, at the rural level, perform simple “Field Test” to determine bacteriological potability of water. Out of 337 Mini Laboratories, 138 Mini laboratories have been upgraded to Sub-Divisional Laboratories.

Ministry of Health and Family Welfare, New Delhi, vide Resolution No. P 13011/34-76 PHANP (I), dated 08/02/1978, notified State Public Health Laboratory Pune, as Central Food Laboratory, Pune among the Four Central Food Laboratories in the country for analyzing appellate food samples received from Honorable Courts as per the provisions of the Prevention of Food Adulteration Act 1954 & rules 1955. It is also notified as Referral Food Laboratory, as per the Food Safety and Standards Act 2006, Regulations 2011.

All above 172 Laboratories exclusively dedicated for Chemical and Bacteriological anlysis of water out of which 15 notified Food Laboratories dedicated for Food Analysis.

Main Events regarding Public Health Laboratories

  • In 1912, the Laboratory at Pune was established as “Sanitary Board Laboratory”
  • In 1960, World Health Organization recognized the Laboratory at Pune as “District Referral Laboratory”.
  • In 1970, Formal food sample analysis was initiated in Public Health Laboratory, Pune.
  • In 1971, the laboratory was declared as “Regional Referral Laboratory” by World Health Organization.
  • In 1973, the Government of Maharashtra recognized this laboratory as “State Public Health Laboratory”.
  • In 1975, Committee under Urban Development and Public Health Department, recommended and transferred Laboratories of the Water Pollution Board, Maharashtra Prevention of Water Pollution and Investigation Centre, and Public Health Engineering Laboratory under the umbrella of the Directorate of Health Services.
  • Up to the year 1977, 11 Public Health Laboratories were established, including Pune, as follows 1. Aurangabad 2. Nagpur 3. Amaravati 4. Kolhapur 5. Solapur 6. Jalgaon 7. Sangli 8. Nashik 9. Nanded 10. Konkan Bhavan (Navi Mumbai)
  • In 1977, the State Public Health Laboratory, Pune, Regional Public Health Laboratories at Nagpur and Aurangabad were notified by the Government of Maharashtra as Water & Waste Water testing laboratories under the Maharashtra Water (Prevention & Control of Pollution) Act 1974.
  • In 1977, Public Analysts in the Public Health laboratories were declared as Government Analysts.
  • In 1978, Government of India notified State Public Health Laboratory, Pune as "Central Food Laboratory, Pune" for examination of appellate food samples.
  • In the period 1980-90, "Water and Sanitation Decade" was declared. During the period 1984-89, Nineteen more District Public Health Laboratories at remaining District Headquarters in the State of Maharashtra were established, for Bacteriological and Chemical examination of water.
  • During the period 2001 to 2004, the Government of Maharashtra has in passed various Government Resolutions for achieving safe and pure drinking water sources with simple tests throughout the state. As per these Resolutions 351 Mini laboratories were established in a phased manner, at Rural Hospital levels, to carry out simple tests to check the bacteriological quality of drinking water sources.
  • In 2006, District Public Health Laboratories at Ahmednagar, Satara, Jalana, and Bhandara were approved for analysis of food samples under the Prevention of Food Adulteration Act 1954 and Rules 1955 District Public Health Laboratories at Ahmednagar, Satara has been started analysis of food samples.
  • Year 2012, State Public Health Laboratory, Pune celebrated its "Centenary Year."
  • On the 1st of May 2013, 138 Sub- Divisional Laboratories have been established throughout the state.

This periodical development has helped to accomplish an all encompassing state wide laboratory network.

CENTRAL FOOD LABORATORY, PUNE

In the year 1976, Government of India had decided to establish four Central Food Laboratories, one Central Food Laboratory, for each zone. Hence in addition to Central Food Laboratory, Calcutta, three more Central Food Laboratories, were created at Ghaziabad, Mysore and Pune. The State Public Health Laboratory, Pune was notified as Central Food Laboratory, from 1st April 1978, by the Central Government.

Central/ Referral Food Laboratory, Pune carries out various functions as follows

  • Examine statutory appellate food samples received from various courts of different States as per the jurisdiction declared in the Act.
  • Generate data by research for fixing standards for various Food commodities under the provisions of Prevention of Food Adulteration Act 1954 and Rules 1955 and Food Safety and Standards Act 2006, Rules and Regulations 2011.
  • Active participation in various collaborative projects pertaining to food commodities sponsored by Indian Council of Medical Reasearch, New Delhi, Food Agriculture Organization, New Delhi, and World Health Organization etc.

Objectives for establishment of Public Health Laboratories

To analyze bacteriologically and chemically - samples of various drinking water sources and food commodities throughout the State. To submit reports of analysis in standard formats, within stipulated time, to the concerned authorities for further necessary action.

The analysis of Food, Water and water treatment chemicals is carried out as per the following standards.

  • The Food Safety and Standards Act 2006, Rules & Regulations 2011.
  • Various Bureau of Indian Standards (BIS) specifications eg. IS 10500:2012, 11673:1992, 1065:1989 & 299:1989.
  • The Water (Prevention and Control of Pollution) Act 1974

Strategies

  • To analyze food and water samples so as to enable safe and pure water and food supply to the grass root level of the community at large through Public Health Laboratory networking

Different sections and their functioning

Work is carried out through three sub sections within the laboratory

  • A) Bacteriology Section.
  • B) Water Chemical Section.
  • C) Food Section.

Details of the working of each sub-section is as follows-

A)Bacteriological Section

  • Bacteriological examination of drinking water as per the standards of IS 10500:2012.
  • Examination of stool samples under the prevention and control of waterborne diseases, for the presence of disease causing bacteria.
  • Ascertaining the antibiotic sensitivity of the isolates disease causing bacteria.
  • Bacteriological examination of Government, Private and Informal Food samples.
  • Bacteriological examination of samples related to Food Poisoning or other poisoning incidents.
  • Bacteriological examination of Food Samples prepared for the consumption of VIP and VVIP dignitaries.

I) Water samples

Method of Sampling

For effective and quality analysis of water, it is important that the water sampling should fulfill the following requirements.

  • Sampling should be properly planned.
  • Sampling points should be representative of water source.
  • Number of sampling points should be in proportion to population served.
  • Approximately 200 ml samples should be collected, stored, dispatched in suitable sterilized glass bottles, with properly fitting stoppers or caps.
  • Samples should be sent to the nearest District Public Health Laboratory or Sub-divisional laboratory within 24 hrs from the time of collection.

Storage and Transportation

The shorter the time that elapses between collection of sample and its analysis the more reliable will be the analytical results. Therefore send the sample to the destination at the earliest. Where it is not possible to send samples within 24 hours, then the samples should be stored and sent in a cold chain.

Concerned Laboratories: List of concerned District Public Health Laboratory with telephone numbers is given at Annexure - I, and the list of newly established Sub-Divisional laboratories is given at Annexure - II

II) Stool sample

Method of Sampling:

Reliability of test results for detecting disease causing bacteria, depend largely on the care taken in collection and transportation of samples. Stool samples are collected for various different tests as follows.

  • Collect stool samples before the patient is administered with any antibiotic dose.
  • Use clean sterile cotton tipped swab and introduce well into rectum. When this is done the swab becomes faecally stained and moist.
  • Send the sample to the laboratory in a tightly sealed screw capped sterile bottle.
  • In case of samples of suspected Bacillary dysentery the fresh stool sample is preferred. If it will take more than 2 hrs to reach laboratory send the sample in a Cary Blair transport medium.
  • List of concerned District Public Health Laboratories with telephone numbers, supplying Cary Blair transport medium is given at Annexure I

Storage of Media containing sample

Each sample should be properly & appropriately labeled. Detailed information should be given in the letter sent along with each sample as follows:

  • Name of Patient.
  • Name of Mother and Father.
  • Address of Patient.
  • Sex and age.
  • Date of Onset of Symptoms.
  • Symptoms & Provisional Diagnosis.
  • Treatment received by the patient in short

Transportation

Transport the specimens at the earliest. If delay is anticipated, send in cold chain (2o - 8o C) to nearest District Public Health Laboratory. (Annexure I)

III) Blood Samples

Collection of Blood Sample for detection of pathogens causing Enteric fever:

  • For detection of Salmonella typhi, Salmonella Para-typhi A and B collect blood sample in 5 % bile broth medium.
  • Collect blood sample in the first week of illness.
  • Collect sample before antibiotics are administered to the patient.
  • 5 ml of blood to be taken in 50 ml of Bile Broth.
  • If bile broth is unavailable, collect blood sample in sterile plain bulb and send to District Public Health Laboratory at an earliest.
  • Labeling, Storage and transportation of blood samples is same as in stool samples.
  • List of concerned District Public Health Laboratories with telephone numbers, supplying Bile Broth transport medium is given at Annexure I

IV) Food poisoning samples

Besides food poisoning caused by the bacterial contamination of food, it is also caused due to toxins produced by microorganisms Food borne outbreaks are very common in our country, and are due to carelessness during big events, community and religious gatherings etc.

Collection of food Samples for Food poisoning outbreaks:

  • Collect sample in a clean, dry, sterile, leak proof container such as glass or plastic jar. If unavailable, collect in a disposable new unused plastic bag. Do not add any preservative.
  • Collect minimum 250 gms or ml of sample depending upon whether it is solid or liquid.
  • If product is in big container representative sample should be collected in sterile container under aseptic conditions.
  • Sample should be labeled immediately after collection.
  • Collect patient's stool / vomit sample and water sample, which is used for drinking and raw material used for food preparation purpose, simultaneously label properly and send along with food sample to the nearest Food Testing Laboratory.
  • Samples should be sent immediately along with duly filled standard Proforma. (Standard proforma is given in Annexure III)

Transportation

The collected samples are to be sent at the earliest to the nearest food testing laboratory. If delay is anticipated then send in cold chain (2o - 8o C) to nearest food testing Laboratory.

V) Operation theatre swabs

It is of utmost importance to see if the operation theatre is properly sterilized before operation commences.

Collection of swabs for'' sterilization testing'' of Operation theatre swabs:

  • Collect swabs in Robertson's cooked meat medium.
  • Collect samples from following points.
    • Operation table surface.
    • Instrument trolley.
    • Overhead lamp.
    • Boyle's apparatus.
    • Floor near table.
    • Alternate walls of the theatre.

(Robertson’s cooked meat media will be made available at State Public Health Laboratory, Pune)

Storage and Transportation: Store the collected swab at ambient temperature and not at freezing temperature.

Transport swab to the laboratory at an earliest, preferably within 24 hrs of collection.

Concerned Laboratories

Send operation theatre swabs to State Public Health Laboratory Pune.

B) Chemical Section (Water)

Following functions are carried out in this section

  • Chemical analysis of water to ascertain its potability as per BIS specifications IS 10500:2012.
  • Chemical analysis of Effluents, Treated waste, sewage as per the provisions of the Maharashtra (Prevention and Control of Pollution) Act 1974.
  • Analysis of water samples collected in connection with Food Poisoning incidents, and natural calamities for chemical toxicants including pesticide residue, metals etc.
  • Chemical analysis of water disinfectants like Bleaching Powder (IS 1065 : 1989), Liquid Chlorine (IS 11673:1992), and Chlorine tablets etc. as per BIS Specifications mentioned.
  • Chemical Analysis of other water treatment chemicals as per BIS specifications.
  • Dose determination of water treatment chemical.
  • Analysis of water for construction purposes, swimming pools as per BIS.
  • Examination of various Kits made available in the market for the determination of various chemical parameter of water for assessing their quality and technical feasibility.

Collection of Water Sample for Chemical Examination

  • Collect the water sample in a clean plastic can of 5 liter capacity.
  • Ideally a new container should be used.
  • But if it is unavailable, wash the used containers with detergent, carefully rinse thoroughly with water to make it detergent free. Cans previously containing any chemicals should not be used.
  • Sample should be representative of the supply.
  • Avoid surface scum during sample collection.
  • Before filling, rinse sample container two or three times with the water being collected for testing.
  • Collect minimum 2.5 liters sample.

Transportation

List of concerned District Public Health Laboratory with telephone numbers is given at Annexure I. Analysis is also carried out at the newly established Sub-Divisional laboratories, their list is given at Annexure II.

Collection of Bleaching powder Sample for Chemical Examination

  • Sample shall not be exposed to atmosphere for longer time than necessary and sampling shall be done as rapidly and thoroughly as possible.
  • Sampling instrument should be clean and dry when used.
  • To draw a representative sample, and take the central portion
  • Sample shall be placed in clean, dry and airtight polythene bag
  • Each sample container shall be sealed airtight immediately after filling.
  • Care should be taken to avoid direct contact of bleaching powder with skin. Face should be kept at a safe distance from the container when it is opened.
  • Sample should be packed in double packing system. Following information should be given on a label which is to be kept between the two bags
    • The Date of Sampling
    • The month and year of manufacture
    • Manufacturer’s name.
    • Company’s name
    • Brand name
    • Batch number & grade.

Storage and Transportation

After the sample is collected, it should be sent to the laboratory. If delay in sending is anticipated then the Bleaching Powder must be stored in a cool and dry place and away from sunlight, at ambient temperature.

C) Food Section

The functioning of the 15 notified food laboratories in the state is as follows

  • Analysis of food samples as per the Food Safety Standards Act 2006, Rules & Regulations 2011.
  • Analysis of food samples related to various incidents like Food Poisoning
  • Collection and testing of food samples during the visits of VIP and VVIP dignitaries.
  • Analysis of food samples received from Government and Private Agencies.
  • Information regarding food safety and adulteration with demonstration is given to visitors with prior appointment.
  • To conduct exhibitions regarding food safety and adulteration for the public at large.
  • To give training to the technical staff concerning any new methods of food analysis.

Implementation of Food laws.

From ancient times food adulteration has been a problem for mankind. The Central Government passed the Prevention of Food Adulteration Act 1954, and Rules 1955 to control the menace of adulteration. In the beginning this act was enforced within the Municipal council and corporation areas. In the year 1970 the act was further extended to the rural areas also. In the same year the implementation was handed over to independent department- Food and Drugs Administration of Maharashtra State. The Commissioner- an IAS Officer- of the FDA is notified as the “Food Safety Commissioner” for the entire State of Maharashtra. Apart from Food and Drug Administration, Municipal Corporations, Councils and Cantonment Boards in their respective areas also implement the Act. Recently to align Indian Food laws with International Food laws for smooth / convenient international food trade, the Government of India has passed the Food Safety and Standards Act 2006, Rules and Regulations 2011.

The Aim and Objects of the Food Laws

  • To ensure Food safety.
  • To protect Food Consumer’s Interest.
  • To ensure safe and wholesome food for human consumption.

Various Authorities responsible for implementation of the Food Safety and Standards Act 2006.

Food Safety and Standards Authority of India.

  • Central and State Food Safety and Standards Authority
  • Food Safety Officers of Food and Drug Administration, and Railway Authorities
  • Adjucating Officer, Designated Officers of Food and Drug Administration
  • Food Analyst.
  • Licensing Authorities.
  • Consenting Authorities.
  • Consumer Councils
  • Courts of Law

National Iodine Deficiency Disorder Control Program

This program is sponsored by the Central Government. Under this program samples of salt are analyzed for Iodine content at State Public Health Laboratory, Pune and all District Public Health Laboratories and Sub-Divisional Laboratories. Samples of salt and urine are analyzed for Iodine content at State Public Health Laboratory, Pune and Regional Public Health Laboratory Nagpur.

Monthly information report is sent every month to the Food and Drug Administration, Salt Commissioner and to the concerned desk of the Directorate of Health of the State and Central Governments.

Analysis of Iodised Salt.

As per the Central Government’s guidelines, at least 50 salt samples per month are to be analyzed at the Public Health Laboratories in each district.

Each Primary Health Centre should send 5 salt samples per month collected from house / Anganwadi / shop / Primary school / hotel / function halls / mess and send for analysis to the concerned Public Health Laboratory.

The salt sample should be sealed immediately on collection, to avoid loss of Iodine content which occurs due to temperature, humidity, water and prolonged storage.

The sample should be at least 100gm. It should be placed in a polythene bag and sealed immediately

After proper collection of salt samples, it should not be kept for more than one day. It should be sent to the concerned Public Health Laboratory or Sub-Divisional Laboratory labeled with the following information.

  • Name of responsible person from whom sample is collected.
  • Address
  • Type of salt: Whether Iodized or not.
  • Date of purchase of salt (Storage/duration)
  • Location of Purchase (Manufacturer address, distribution information, brand name and Date of Manufacture

Place all labeled samples of salt in another polythene bag, seal it and send to laboratory for testing.

Give the following information on the outer polythene bag.

  • Name of PHC / Rural Hospital ……………..Taluka ………………..District ………………..
  • Sample number
  • Total number of salt samples
  • Date of sending samples for testing
  • Before sending the samples to the Public Health Laboratory/Sub-Divisional Laboratory, make sure that the forwarding letter contains the necessary information filled in the format below, and then duly signed by the Medical Officer.
Sr. No. Name of Sender Place of collection and address Name and address of Manufacturer Brand name / Packing / Price Batch No./ Date of Manufacture Date of collection

Iodine content in the Iodised Salt samples is expected to be as follows

  • Minimum 30 milligrams/Kg (ppm) at the Manufacturer’s level
  • Minimum 15 milligrams/Kg (ppm) at the Vendor’s level.

Testing of Iodine content in urine samples.

As per the Central Government’s guidelines, at least 25 urine samples of suspected patients are to be sent for analysis at the Public Health Laboratories.

Sr. No. Public Health Laboratory Circle
1 State Public Health Laboratory, Pune Pune
2 Regional Public Health Laboratory, Nagpur Nagpur

The responsibility of sending 6 urine samples per month, from the Rural Hospitals/Sub-District Hospitals / District Civil Hospital lies on the Laboratory technicians

  • Pregnant mothers – 2 samples
  • Lactating mothers – 2 samples
  • Students – 2 samples

Collected urine samples to be sent to the above mentioned laboratories along with the information below.

Sr. No. Name of Patient Sex Age Patient’s address Date & sample of collection Date of sending sample for analysis
  • Send the urine sample in a 100 ml capacity glass or plastic bottle, thoroughly wash with water and finally with hot distilled water. The bottle should be clean and Iodine free. Collect about 50 to 70 ml of the urine sample. Ensure that the cap fits tightly and there is no leakage.
  • Add 4 to 5 drops of Sulphur free Toluene as preservative

Training and Health Education

  • In service training to the technical staff.
  • Training to the technical staff.
  • Participation in International training programs
  • Training to the Medical students
  • Interstate training for members of consumer forum
  • Health education through demonstration and exhibition to
    • Medical students
    • Local Semi-Govt. officers and staff
    • College students
    • Nursing staff
    • Sanitary Inspectors.
    • The Common Public

Other special activities

  • To protect the interest of common people by using a tool of quality monitoring, whether they are provided pure and clean drinking water and wholesome food to the implementation of respective Statutory provisions. The common people can also avail the facility of testing water, food articles by paying fees.
  • To create awareness regarding drinking water quality and wholesome food through exhibitions for common people.

Special Features other than routine activities

  • Apart from the routine functions of Water and Food Quality monitoring, the Public Health Laboratories - especially State and Regional—are engaged in various Research Projects pertaining to the Food / Water sponsored by Different Organizations such as ICMR/ WHO/ FAO etc.
  • State Public Health Laboratory, Pune has been identified as a State Referral Center for Bacterial Culture.
  • State Public Health Laboratory, Pune has also been identified as the State Referral Institute for Water Quality Monitoring and Surveillance Program of Water Supply and Sanitary Department in the State.

Important Health Education Messages Clean, Pure Water and Wholesome Food is “ Wealth” and it is the mother of “Health”.