Acknowledgements

7. Way forward

86 Quality Control in Laboratory

Training of staff running the urinary iodine assays ought to have these goals:

• Achieve competency to do laboratory work

• Aware of sensitiveness of urinary iodine test

• Implement correct waste handling system

• Abide by reagent expiry dates.

8. Conclusion

control in urinary iodine estimation.

• Understand aspects in the laboratory Quality Plan

• Aware of possibility of contamination from iodized salt

7.2. Way forward for small/medium-scaled urinary iodine laboratories

ment and ensures quality in the results produced by the laboratory.

The current reference method for urinary iodine testing is the Inductively Coupled Plasma-Mass Spectrometry (ICP-MS). However, this instrument is most likely unaffordable by small/medium-scaled laboratories due to its high purchasing and maintenance costs. Even though there is high tendency of getting higher bias and deviation when using Sandell-Kolthoff method as compared to using ICP-MS, the small/medium laboratories can still obtain excellent performance by applying a closely-monitored quality management system in the laboratories as discussed in previous sections in this chapter. Decision to participate in the International Organization for Standardization (ISO) 15189 for Quality and Competence for Medical Laboratory will be a plus-point since it consists of all the elements of quality manage-

Even though UIMM, a spectrophotometrical method, is less sensitive compared to the sophisticated methods such as the ICP-MS, the same process of quality system applies to the latter as well. Since urinary iodine is easily evaporated, careful measures have to be made in all preanalytical and analytical procedures to minimize it. The quality system is supported by detailed documentation and glassware cleaning in the post-analytical procedures. IQC and EQA programs are very important to enhance validity of respondent results to be released to the IDD program managers in monitoring the population iodine status. Urinary iodine estimation is vital to maintain effectiveness of the USI program in eliminating IDD worldwide. This chapter is hoped to be a guide to all urinary iodine laboratories in understanding quality

7.1. Training

Utmost appreciation to the Director General of Health Malaysia and the Director of the Institute for Medical Research (IMR) for approving this manuscript to be published as a book chapter. Special gratitude to the Nutrition Division, Ministry of Health Malaysia for annually funding the activities of the IDD laboratory at the Nutrition Unit, IMR and to all staff of Nutrition Unit, IMR for their continuous support. Special thanks to Dr. Gary Ma from TUIQP EQA Program who supplied us with the EQA samples for the 2008 National IDD Survey.
