The Howie code: is the price of safety too high?

The code of practice for the prevention of infection in clinical laboratories and postmortem rooms (the "Howie code") was produced in order to standardise laboratory safety procedures at a level which would minimise risks to laboratory workers. The costs of implementing this code, which were not given proper consideration when the code was drawn up, are seen to be very high. This paper questions whether the benefits of risk reduction resulting from the code can justify the high cost of its implementation. Beginning with an examination of the incidence in recent years of laboratory-acquired infections, the paper looks at the perceptions of risk by laboratory workers and the feasibility of low cost alternatives to those of the Howie code. The potential benefits of the code are then viewed against the cost of upgrading the laboratories of two Scottish hospitals to Howie standards. The fact of high costs relative to benefits reinforces the paper's call for the proper consideration of economic issues to be given at the development rather than the implementation stage of any regulatory codes.