The gap of psychological perspective in high-containment lab training — An exploratory systematic review and meta-analysis

High-containment laboratories (HCLs) depend on sustained human performance to maintain biosafety and biosecurity, yet training primarily emphasizes technical competence and regulatory compliance while giving limited attention to human factors. We conducted an exploratory systematic review and meta -analysis to examine how laboratory personnel (LP) psychology can inform HCL training. Following PRISMA guidelines, we searched PubMed, Embase, Web of Science, Scopus, and Ovid MEDLINE from inception to June 15, 2026. Two evidence streams were synthesized separately: HCL training studies and studies reporting psychological outcomes in LP. Risk of bias was assessed using the Joanna Briggs Institute checklist. Prevalence and odds ratios were pooled using random-effects meta -analysis (REML with Knapp–Hartung adjustment). Sixty-five studies met the inclusion criteria (38 HCL training; 27 psychology). Training literature was dominated by institution-specific programs, with limited international harmonization, inconsistent certification, infrequent incident-reporting frameworks, and minimal integration of psychological human factors. Leadership emerged as a recurring organizational factor influencing safety and well-being. Pooled prevalence estimates were 73% for stress (95% CI 51–88%), 45% for depression (27–65%), 44% for anxiety (22–68%), and 56% for burnout (31–78%). Compared with other healthcare workers, LP had higher odds of depression (OR 2.63, 95% CI 1.62–4.28) and anxiety (OR 2.57, 95% CI 1.73–3.83), whereas stress and burnout did not differ significantly. Current HCL training underrepresents psychological and organizational factors relevant to safe laboratory performance. Integrating evidence-based human factors, leadership, and mental health literacy into competency-based training and biosafety management may strengthen workforce resilience, operational reliability, and biosafety.