Impacts and Adaptations to Extreme Weather Events on Pathology Laboratories: A Scoping Review

Pathology laboratories are a critical dependency across almost every diagnostic and treatment pathway. Pathology laboratories support healthcare delivery through analysing blood, urine, faecal and tissue samples, informing clinical diagnosis and tailoring patient treatment. However, laboratories have unique vulnerabilities to extreme weather events. To analyse samples and provide timely results, laboratories need highly-controlled environments and timelines. EWE can disrupt these and, when pathology laboratories fail or slow down during EWE, many healthcare services are disrupted simultaneously. In this study we have reviewed the impacts of heatwaves and flooding on pathology laboratories in G20 and European Union countries and any adaptation strategies that laboratories have put in place to mitigate those impacts. The PRISMA guidance was followed for a systematic search strategy that identified 1,133 articles for screening. Seven of these were included after full-text screening. Together with an additional two articles from backward citation searches, a total of nine articles were included in this review. Three reviewers were involved in this process. We found reports of widespread impacts of heatwaves and flooding on pathology laboratory staff, equipment, operations and internal and external supply chains. The perspectives of patients were mostly absent. While there were examples of adaptations deployed, we found little evidence of systematic evaluation to determine the cost-benefit of these adaptations, their health consequences or their impacts on health inequalities. Climate change will lead to more intense, frequent, volatile and unpredictable extreme weather events in most countries, which will increase pathology laboratory disruptions and subsequent impacts on healthcare pathways and patients. This should be a call for further action and the development of frameworks to enable pathology laboratories to implement and evaluate adaptations to extreme weather events-related disruptions that minimise disruption and deliver resilient pathology service provision to support patient care.