Climate change and medical laboratory operations: Impacts, challenges, and adaptation strategies: A narrative review

Climate change is increasingly disrupting medical laboratory operations worldwide, affecting diagnostic accuracy, infrastructure integrity, and supply chain stability. Hurricane Maria in 2017 devastated Puerto Rico, a major hub for medical supply manufacturing, leading to critical shortages of blood bags and reagents in U.S. hospitals. Rising global temperatures have also challenged the stability of temperature-sensitive reagents and biological samples, with studies indicating that a mere 2°C increase in ambient temperature can significantly reduce enzyme activity in diagnostic assays. Laboratories, particularly in low-resource settings, are struggling to maintain optimal storage conditions, raising concerns about the reliability of test results in disease diagnosis and monitoring. Extreme weather events and shifting disease patterns further compound these challenges. Flooding in South Asia has repeatedly disrupted microbiology laboratories, causing waterborne pathogen contamination and delays in infectious disease testing. In Sub-Saharan Africa, rising temperatures have expanded the range of malaria-carrying mosquitoes, increasing the demand for diagnostic services beyond the capacity of many laboratories. Supply chain disruptions due to climate-related disasters have led to prolonged shortages of essential testing materials, as seen during the COVID-19 pandemic when heatwaves affected the production and transportation of medical reagents. These disruptions highlight the urgent need for climate-adaptive strategies to ensure laboratory resilience and continuity in healthcare services. To mitigate these impacts, laboratories must adopt sustainable infrastructure and operational practices. Key recommendations include transitioning to solar-powered refrigeration to prevent sample degradation during power outages, investing in climate-resilient laboratory buildings, and enhancing digital diagnostic capabilities to reduce reliance on physical sample transportation.