It is therefore the responsibility of the requestor to ensure that all samples are sent to GSTS Pathology in accordance with the following instructions.
Packaging requirements
Potentially infectious samples from GPs transported by designated vehicles provided by GSTS Pathology or the local NHS Trust must be carried in compliance with the UK road transport regulations. When being transported infectious substances must be packaged according to the UN standard PI 650 (Packaging Instruction 650) as follows:
Infectious substances include material that is known to contain, or is reasonably expected to contain, pathogens and should therefore be packaged as follows:
- All samples must be placed in individual plastic ‘kangaroo’ type sample bags to avoid cross contamination.
- Individual sample bags should be placed into a large, clear plastic, sample bag that contains absorbent material (eg a sufficient amount of paper towelling to absorb any leakage).
- The large bag should be placed into a rigid sample transport container.
- Only rigid outer containers supplied by GSTS Pathology or the local NHS Trust may be used to transport samples to the laboratory by road.
- There should be sufficient absorbent material lining the outer rigid container to absorb any spillage from samples.
- If samples leak into the box the paper lining should be disposed of as clinical waste.
- If the container becomes contaminated it should be disinfected by wiping out with 1000 ppm chlorine solution or equivalent.
For more information on PI 650 see the guidelines here.
Transport of samples in formalin
Formalin is covered by the Control of Substances Hazardous to Health Regulations 2002 (COSHH). Before formalin is used in the workplace, risk assessments under COSHH must be carried out to ensure that people are not exposed to formaldehyde vapour. Formaldehyde has a short term (15 minutes) workplace exposure limit of two parts per million per mg.m-3 and is a potential carcinogen.
Formalin spillage control granules should be available wherever formalin is used or stored and staff trained in their use. Granules are available here.
Advice on the safe use of formalin may be obtained from the local GSTS Pathology Histopathology department.
Samples in formalin must not be sent in the postal system. Samples for histology, and liquid based cytology, may only be sent via Medical Couriers vehicles organised by GSTS Pathology or the local NHS Trust as follows:
- Ensure the cap of the primary container is securely fastened.
- Wrap the primary container in absorbent material and place into a sample bag.
- Place the sample bag into a large plastic bag or cardboard box and place into the transport box. Ensure the sample remains upright in the transport box.
- The surgery must keep a log of all samples for Cytopathology and Histopathology sent to the laboratory. The patient’s name, type of sample and the date and time the sample was sent to the laboratory must be recorded, as well as the signature of the person who packaged and sent the sample.
Samples sent on dry ice
Samples on dry ice must not be sent in outer containers with a sealed lid as there is a risk of explosion during transport from the build up of carbon dioxide gas.
If dry ice is used to transport samples the outer packaging or over pack shall permit the release of carbon dioxide gas. The primary and the secondary packaging shall maintain their integrity at the temperature of the refrigerant used. For more information see page 57 of the guidelines here.
Samples sent via Royal Mail
Packaging for samples sent via Royal Mail must comply with PI 650 for Category B substances. It is the sender’s responsibility to ensure that samples are packaged according to PI 650.
PI 650 requires that the primary sample container must be leak proof and be wrapped in sufficient absorbent material to absorb any spillage (see information on sample packaging above). The primary container and absorbent material must be placed into a single sample bag with the request form in the pouch.
The sample bag should be placed into a leak-proof. This product must be fully compliant with both Packaging Instruction 650 and UN3373 requirements.
Labelling of packages
Packages containing infectious substances sent by post must be marked with:
- The sender’s name and address.
- The telephone number of a responsible person, with knowledge of the shipment.
- The receiver’s name and address.
- The proper shipping name eg ‘infectious substance, affecting humans’.
- The appropriate UN number (UN 3373).
- Diagnostic samples PI 650 should be labelled as ‘Diagnostic specimens’ or ‘Biological Substance, Category B’.
- The appropriate warning label for infectious substances should be used.
Warning Labels
The HSE recommend the use of ‘high risk’ or ‘danger of infection’ stickers attached to samples and request forms from patients that pose a high risk of exposure to agents such as HIV, HBV, HCV, TB, Typhoid, Brucella, CJD. Care must be taken to protect the confidentiality of the patient when these stickers are used. See HSE Guidance Safe working and the prevention of infection in clinical laboratories and similar facilities ISBN 0-7176-2513-3.
Dispatch address
All samples should be delivered to GSTS Central Specimen Reception;
5th Floor, North Wing
St Thomas' Hospital
Westminster Bridge Road
SE1 7EH
For deliveries to KingsPath, visit the sample dispatch page of their website.
For more information on Quality and Governance at GSTS at Guy's and St Thomas' Hospital, please contact Ann Newman or for general queries, contact GSTS Head of Quality Mike Langford.
