Thought Leader Interviews

René J. Buesa on Histology Research & Safety in the Histology Laboratory

René J. Buesa on Histology Research & Safety in the Histology Laboratory

Rene’s passion for safety and process improvements in histology is very apparent. I’m excited to share some excerpts from our interview about his research process, and why he is so interested in safety. You can read our previous interviews here and here. I hope you enjoy!

You’ve done an incredible amount of research and writing about the field of histology. What inspired you to produce so many publications?
I always wanted to share my results with my colleagues so I started publishing before I retired. After retirement, with time to spare, I embarked in a program to divulgate my experiences in managing a histology lab because I became aware that there were no “quantified standards of performance.” While some labs demanded unreal work outputs from their techs, others did not used the allotted times efficiently. I felt the need to divulgate MY vision of how a histology lab should be operated. But since the decisions to improve the situation could not come from “the base” (the rank and file histotech or supervisor), I decided to publish my work in a pathologist’s forum so those with the power to make changes would be aware of how the histology work should be done. Consequently, I presented a proposal of 12 articles to the Editor-in-Chief of Annals of Diagnostic Pathology (Saul Suster, MD). Between 2007 and 2012, I completed the series and became a member of the Editorial Board of the Journal. My articles have been requested by 1,852 colleagues worldwide and I have obliged them with electronic copies.

Many of your articles include massive surveys of histology labs around the world! How do you conduct surveys of so many histology laboratories?
HistoNet has thousands of subscribers, many of whom are really interested in histology work and have been my fundamental source for information. I prepared 2 basic questionnaires, one for productivity and work volume, and the other for security aspects. Every time a colleague wrote me with a consult, I took the opportunity to ask if s/he would be interested in participating in a productivity and a security survey. They usually accepted. and then I sent them the 2 questionnaires.

Those 2 questionnaires were translated to Spanish and to Russian by my colleague Maxim Peshkov who distributed the surveys amongst his Russian colleagues, translated their results, and sent them to me. He also completed a series of experiments on processing with mineral oil and the amount of formalin really needed to fix tissues. I also used information posted in HistoNet and in the few publications on the subject. During my trips abroad to dictate conferences on the subject (to Australia, Italy, México, and Spain) I took copies of the questionnaires with me and distributed them amongst the participants. All those answering my surveys received a free evaluation of their lab operations along with advice on how to improve them. I always received great cooperation from the colleagues I contacted.

After the productivity study was published I kept receiving unsolicited information. In general, the volume of data I have published is larger than in any other individual survey and permitted me to conclude that, with tiny variations, the productivity in histology is quite uniform all around the world.

Safety in the histology laboratory is something you’ve written a lot about. Why is this issue so important to you?
When I began working in histology, my manual processing protocol was: graded ethanol → aniline oil → benzene → paraffin. I just cannot imagine a more dangerous protocol given that aniline oil and benzene are both carcinogens affecting the bone marrow! Staining used xylene as a clearing agent before and after staining, making it no safer. The wide and unprotected use of formalin was and sometimes still is a safety issue. Even today, formalin is used in excess and xylene has not been totally abandoned. Often, the substitutes for these chemicals may not be “healthier”, as I discuss in my article about “Histology without Xylene.” So yes, and not only for me but for everybody working in histology, chemical safety is paramount and something that still needs a lot of work.

Do you think safety is improving?
Yes, it has improved, especially due to the universal precautions developed because of the AIDS epidemic. There is a graph in my safety article showing the improvement changes along the years. Safety has improved but not as much as it could because only a minority of labs have done what is required to assure the proper environment to the histotechs.

Thank you so much, René! Stay tuned next week for more questions and answers from René Buesa! Also, keep in touch by signing up for our newsletter, contacting us, or following us on Twitter, Facebook, LinkedIn, or Google+.