Pathology Transport Procedures BHR 4543

BHR HOSPITALS – PATHOLOGY
PATHOLOGY TRANSPORT PROCEDURES

Paper copy number, when printed:
1.0 PURPOSE / CLINICAL RELEVANCE

This document sets out the safe working practices for all staff involved in the
transportation of clinical samples to and from the pathology department.
This document does not cover the transport of blood/products for transfusion or
the transport of waste. Both topics have dedicated procedures.
This document sets out the procedures for the transportation of patient samples
via vehicle couriers to Pathology from GPs, clinics and outside sources, between
Pathology departments on different sites at Barking, Havering & Redbridge
Pathology, and beyond to other laboratories or reference centres in a manner that
is both safe and ensures that the integrity of the samples is not compromised.
It is intended as a guide for the staff within Pathology and not outside of the
department. Information for users of the service is available on the BHR website
under Pathology. Instructions for porters are produced by Sodexo for their own
staff. Instructions for use of the internal Trust airtube systems are in the
Reception and Handling SOPs listed below and also available on the intranet
2.0 RESPONSIBILITY
Each employee is required to take reasonable care for the health and safety of
themselves and all other persons who may be affected by their acts or omissions
at work.
All managers and senior staff are responsible for ensuring that this policy and
working instructions are adhered to.
Responsibility for the safe collection and packaging of clinical samples shall rest
entirely with the sender, therefore all staff involved with the transportation of
clinical samples must be conversant with current rules, regulations and codes of
practice.
All specimens and accompanying paperwork must be transported in such a way

as to maintain patient confidentiality at all times. They must never be left
unattended in a public area.
The European Agreement concerning the International Carriage of Dangerous

Goods by Road 2015 (ADR) regulates the carriage of dangerous goods in
motorised vehicles throughout the European Union and beyond (UN boundaries).
Implementation of the ADR Framework Directive is achieved in Great Britain

under The Carriage of Dangerous Goods and Use of Transportable Pressure
Equipment Regulations 2009 (carriage regulations) and The Carriage of
Dangerous Goods and Use of Transportable Pressure Equipment (Amendment)
Q Pulse record: Pathology 4543 Revision: 3 Page 1 of 19

Approved / Authorised by: R. Davis Last updated June 2017

Regulations 2011, (CDG), which came into force on 1st July 2009 and 24th
October 2011 respectively.
BHR Hospitals NHS Trust (the Trust) has statutory duties as both a ‘consignor’
and ‘carrier’ under the Carriage of Dangerous Goods and Use of Transportable
Pressure Equipment Regulations (Amendment) 2011 - ‘carriage regulations’ or
‘CDG11’.
The carriage regulations main purpose is to identify dangerous substances and

articles (liquid, solid or gaseous) and to place controls on these dangerous goods
when they are being conveyed by any mode of transport i.e. road, rail, sea or air.
This is to protect the environment and the lives of the public as well as personnel
involved in the transport chain (i.e. the driver) from exposure to the dangerous
goods and ensures in the event of an accident, emergency services personnel
attending the scene can identify contents of the vehicle’s load and take
precautionary action
3.0 REFERENCES
ISO 15189:2012 Medical laboratories – Requirements for quality and
competence Clause 5.4.5
Health and Safety at Work Act 1974
The Carriage of Dangerous Goods and Use of Transportable Pressure Equipment
Regulations 2009
Pathology User Information available on intranet and BHR website
BHRUT: Transportation of Dangerous Goods Policy
WHO Guidance on regulations for the Transport of Infectious Substances 2015–
201
Department of Transport – Transport of Infectious Substances
Transportation of infectious substances - Blood borne viruses (BBV)
Pathology 376: Sending samples to King George Hospital (Haem)

Pathology 456 Sending Specimens to other Laboratories (Haem)
Pathology 469: Pathology Safety Rules
Pathology 485: Procedure for posting pathological specimens by Royal
Mail (excluding microbiology)
Pathology 857: Histology Neuropathology – Policy for sending frozen
tissue away
Pathology1853: Safe working practice for courier / taxi drivers carrying
pathological specimens
Pathology1854: Safe working instructions for phlebotomists transporting
blood samples
Pathology1843: Mortuary Specimen Handling, Storage and Transportation
Pathology 1873: Safe use of air tube transport systems for pathology
specimens - HSE information sheet, 1999
Pathology 1915: Cat 3 Lab – Sending Samples to MRU (Micro)
Pathology2096: Send away by Royal Mail (Micro)


Pathology2097: Send away by London Van (Micro)
Pathology2106: Office: Sending Cases to an External Pathology (Cell Path)
Pathology 2490: Pneumatic air tube operating instructions
Pathology2517: Sending away Specimens (BT)
Pathology2709: Send Away by the London Van (Micro)
Pathology3479: Sending Samples to Referral Labs (Biochem QH)
Pathology3922: Procedure for sending Samples Away (Biochem KGH)
Pathology4229 Front Bench Send Away QH (Biochem)
Pathology4471: Working with Substances Hazardous to Health - Control
of Substances Hazardous to Health Regulations 2002 (HSE)
4.0 DEFINITIONS
ADR: The European Agreement concerning the international carriage of
dangerous goods by road
BHR: Barking, Havering and Redbridge
COSHH: Control of Substances Hazardous to Health
NVF: Non-viable foetus
Clinical Sample/Specimen
A patient specimen of human material including, but not limited to, excreta,
secreta, blood and its components, tissue and tissue fluid swabs, and body parts
being submitted for purposes such as research, diagnosis, investigational
activities, disease treatment or prevention.
Biohazard
A sample from a patient infected with a Hazard Group 3 or 4 biological agent
(known or suspected)
UN3373 packaging
Approved sample packaging (triple-pack) that meets the standard required for
safe transport by road & rail.
5.0 DOCUMENTATION
6.0 ACTIONS AND METHODS

6.1 Health & Safety / COSHH / Risk Assessment
The Pathology Department will take all necessary steps to meet legal
requirements and eliminate risks associated with the transport of any articles
which are potentially dangerous or injurious to health. It will provide such
information, instruction, training and supervision as is necessary to foster an
awareness, understanding and acceptance of health and safety rules and an
appreciation by employees of the need to co-operate with the Pathology


Department by taking reasonable care of their own health and safety as well as
that of their colleagues and members of the public.
Each department must prepare risk assessments and control the risks in the areas
for which they hold responsibility.
6.2 Personnel to do the task / level of training required

All staff involved with the transportation of any article must receive appropriate
training and be competent in the duties they perform.
6.3 TRANSPORT OF SPECIMENS WITHIN THE HOSPITAL

• Clinical samples include any substance, solid or liquid, removed from the
patient for the purpose of analysis.
• Care must be taken when handling clinical samples to ensure that they are
transported as quickly and as safely as possible, and that the risk of infection
is kept to a minimum at all times. The trust adopts universal precautions and
all specimens must be treated as high risk.
• Samples must never be carried unprotected in the open hand or given to
other members of staff in this way.
• Patient confidentiality must be observed at all times.
• Samples must never be left unattended in a public area.
• Specimens for Histology may also contain formalin which is a chemical
hazard.
• Staff should be aware of samples that may contain radioactive isotopes or
cytotoxic drugs and take additional precautions as required.
• Clinical samples are most likely to be delivered to the laboratory by
portering / clinical staff or by the pneumatic tube system
6.3.1 Transport of specimens to the laboratory by hospital staff

1. The majority of routine specimens being sent to pathology will fit into the
dedicated plastic specimen transport bags. These bags have two pockets, one
for the specimen and one for the request form. The specimen pocket must be
sealed.
2. For transporting multiple specimens, the sealed bags should be transported
in a dedicated box which has been approved by pathology.
3. Blood and tissue slides must be treated as ‘sharps’ and be placed in an
appropriate slide transport box for transportation.
4. Blood Gas specimens must be transported immediately in the syringe. The
needle must be removed before transporting and the specimens placed in a
routine transport bag as in item 1. above.
5. Large Histology Specimens sealed in plastic containers provided for the
purpose must be placed in a large plastic outer bag which is tied at the top to
render it leak proof. The request form must be attached to the outside of the
bag.


6.3.2 Transport of specimens by Pneumatic Tube System
The Law
All pathology specimens may contain substances that are ‘hazardous to health’.
Many may contain harmful biological agents, including those samples not
necessarily sent for microbiological identification; others may contain hazardous
chemicals e.g. formalin
Employers are required to
• assess the risks to employees, the self-employed and the public from use of
the system and from exposure to hazardous substances.
• take action to prevent or adequately control that exposure.
Risks are likely to arise from

Leaking / broken samples and aerosols
Using the system inappropriately
Using the system to transport inappropriate samples
Blockages caused by not using the transport pods
Instruction for the operation of the pneumatic tube systems at Queen’s and King
George Hospitals is also included in the Pathology User Information which is
displayed on the Trust’s Intranet.
6.4 TRANSPORT OF SPECIMENS OUTSIDE THE HOSPITAL (by transport

or Royal Mail)
Specimen Classification
The classification of infectious substances for carriage by road was subject to
change in July 2005 when new terminology for identification purposes became
effective. For transport, (not clinical assessment), the Risk Groups 1 to 4 (in
descending order of risk), that had been used for many years to identify levels of
pathogenicity, were replaced by the expressions Category A and Category B.
These two transport categories of diagnostic specimens are specified within ADR
- Category A and Category B. There is no direct relationship between Risk
Groups and the transport categories.
Note that all infectious diagnostic specimens (Category A or Category B) are

assigned to Class 6.2 (infectious substances) within ADR and that infectious
substances cannot be packaged using the Limited Quantity relaxations.
Category A: An infectious substance which is transported in a form that when

exposure to it occurs, it is capable of causing permanent disability, life
threatening or fatal disease in otherwise healthy humans or animals. A list of
Category A substances is given in Appendix 2.
Category A specimens or cultures are assigned to UN 2814 (Infectious
Substances Affecting Humans) and are covered by Packing Instruction 620.


Category B: An infectious substance which does not meet the criteria for
inclusion in Category A.
They are assigned to UN 3373 (Diagnostic Specimens) and covered by
Packaging Instruction 650.
The majority of specimens and cultures transported around the Trust or
dispatched to reference centres are expected to fall within Category B.
The Transport of Category A is described below after the section on
Category B.
Specimen packing
It is the sender’s responsibility to correctly package specimens. However, if
specimens are received inappropriately packaged, the receiver has a duty of care
to inform senders of the type of packaging required.
Any specimens received by the laboratory inadequately packaged from other
hospitals or clinics should be referred to a Senior BMS.
The Senior should contact a senior member of staff from the other hospital and
explain the situation and arrange for a copy of these instructions to be sent.
Take the details of the person you have spoken with and submit an incident
report if packaging is unacceptable.
1. Category B Diagnostic Specimens

Category B diagnostic specimens are assigned to “UN3373 Biological
Substance, Category B” and are subject to Packing Instruction 650 (P650) when
a road transit is involved.
Category B Specimen Packaging

To meet the requirements of P650, there are 3 levels of packaging for diagnostic
liquid and solid samples;
a. The primary receptacle – containing the sample (e.g. specimen tube/pot).
b. The secondary packaging – this will contain the primary/primaries
packaging, at BHR that is a sealable specimen bag.
c. Specimens in sealable specimen bags should be placed in groups together, or
singly, within a large bag with sufficient absorbent material to absorb the
contents if there were a leak.
d. The outer packaging i.e. that seen by the delivery driver, red large and small
Daniels Transport boxes, DX boxes. This must be rigid with at least one
surface having a minimum dimension of 100x100 mm. They must pass a
“drop test” of 1.2 meters when containing primary and secondary packaging.
See Appendix 3.
e. The specimen forms MUST not be placed inside the secondary container
with the specimen(s).Use the pocket of the plastic bag or use a separate
plastic bag.
f. Blood samples may be placed in racks and then the rack placed inside a
large plastic sealable bag. This bag must contain absorbent material to


absorb all of the specimens if broken. Alternatively they must be
individually wrapped. The idea is to ensure there is no contact between
them.
Liquids:
For liquid specimens, both primary receptacles and secondary packaging are
required to be leakproof.
Where the specimen is a liquid. absorbent material must be placed between the
primary receptacle(s) and the secondary packaging and must be present in
quantity sufficient to absorb the entire contents of the primary receptacle(s) so
that any release of the liquid substance will not compromise the integrity of the
cushioning material or of the outer packaging.
For liquid specimens, where multiple secondary packagings are used, absorbent
materials must either be placed within each small specimen bag next to the
primary packaging or within the larger “outer” bag (s) (sometimes labelled with
the words “pathology specimens” that are often used to contain multiple small
specimen bags) which is/are then placed into the outer package. Whichever
option is taken, the absorbent material shall be in quantity sufficient to absorb the
entire contents of all of the primary receptacles so that any release of the liquid
substance will not compromise the integrity of the cushioning material or of the
outer packaging.
If there is any doubt as to whether or not residual liquid may be present in the
primary receptacle during transport then a packaging suitable for liquids,
including absorbent materials, shall be used.
Solids:
For solid specimens the primary receptacle(s) and secondary packaging shall be
siftproof. Siftproof means impermeable to dry contents.
Outer Package:
The primary and secondary packaging then needs to be placed into an outer
package with the outer package correctly marked and labelled as shown below.
The completed package (primary, secondary and outer with absorbents and
cushioning material as required) must be capable of meeting the drop test
requirements of ADR 2015.
This could be evidenced by obtaining a Certificate of Conformity for the

packaging from the manufacturer, where one exists (although the manufacturer is
not required to have such packaging formally tested so there may be no
Certificate of Conformity),


The test must be of a complete package as prepared for transport in accordance
with P650: i.e. the primary receptacles must be filled with a substance that
represents the infectious substance (e.g. water) and absorbent/cushioning
material must be in place, where required. Following the appropriate drop
sequence, there must be no leakage from the primary receptacle(s), which must
remain protected by absorbent material in the secondary packaging.
A record must be kept. This might include a photograph of the before, during
and after stages of the testing process. The use of accredited testing facilities is
not required.
Safety Precautions
• Samples must always be carried in closed boxes, which are clearly marked
with a Biological Substance Category B label. This outer package must
display a diamond warning symbol (size 50 mm) containing the text
“UN3373” in letters 6mm high.
• Samples must be individually bagged, or placed in a rack and bagged, placed
in a secondary bag containing absorbent material, sealed and carefully
placed in the transport container.
• Blood and tissue slides should be regarded as ‘sharps’ and placed in an
appropriate plastic slide transport box before packaging
• Handle specimen containers gently at all times.
• Safe working practices shall be observed at all times.
• Samples must never be carried unprotected in the open hand or given to
other members of staff in this way.
• Samples must not be left unattended when not secured in the van. Patient
confidentiality must be preserved at all times.
• The containment of samples within motor vehicles, used to transport
samples, must be such as to restrain, retain and protect the contents in the
event of an accident. In the event of a spillage drivers are trained to deal
with it but they are advised to return to the nearest BHR Pathology
Reception and obtain assistance. Reception staff should seek advice from
senior staff on how to deal with the situation. Out of hours, if there are no
staff in Reception the driver should seek help from the Blood Sciences staff
on duty.
• Decontamination materials are carried in each vehicle to enable small
spillages to be contained. In the event of major contamination the Pathology
Central Reception or, in the event of Formalin spillage the Cellular
Pathology Laboratory, must be contacted before any material is touched.
• In the event of a vehicle breakdown or a road traffic accident, do not allow
persons other than courier staff or Trust staff to handle specimens.
• Any spillage must be reported immediately to a designated senior member
of the department concerned.
• The response by the Pathology laboratory staff will depend upon the size
and extent of the spillage and upon the level of contamination. All


decontamination shall be in accordance with the current Pathology Health
and Safety Policy.
• Always wash hands thoroughly before rest breaks and at the end of a work
period.
Category B Specimen Marking & labelling

The outer packaging must always be suitably marked/labelled as follows -
UN3373 contained within a diamond shape with minimum dimensions of 50 mm
by 50 mm; the width of the line shall be at least 2 mm and the letters at least 6
mm high. The Proper shipping name ‘’Biological Substance, Category B’’ must
be marked adjacent to the diamond shaped mark in letters at least 6 mm high, as
shown below.
BIOLOGICAL SUBSTANCE,
UN3373 CATEGORY B.
Labels shall be displayed on a background of contrasting colour, or shall have

either a dotted or solid outer boundary line. The dotted outer boundary is not
required when the label is applied on a background of contrasting colour
The label must be affixed to the surface of the package and, if the dimensions
allow, must be placed on the package so that it is not covered or obscured by any
part or attachment to the packaging or any other label or marking. Where the
package is of such an irregular size or small shape that the label cannot be
satisfactorily affixed, the label may be attached to the package by a securely
affixed tag or other suitable means.
If the size of the package so requires, the dimensions of the labels may be
reduced, provided that they remain clearly visible.
All labels shall be able to withstand open weather exposure without a substantial
reduction in effectiveness.
Category B Specimens and the Carrier

The carrier of UN3373 assigned diagnostic specimens i.e. Trust transport or
contracted courier, is subject to a number of relaxations from the ‘on the road
rules’.
There is no limit to the amount of diagnostic specimens assigned to UN3373 that
can be transported, provided specimens are contained in packaging that meets the
requirement of packing instruction 650 (P650).
Vehicles do not need to display placards (i.e., orange plates or class warning
diamonds etc.)

Category B Specimens and Training

Staff who package Category B diagnostic specimens for transport on the road are
required to receive training on Dangerous Goods awareness. This training
should take the form of face to face training or of reading procedures on
appropriate packaging.
Category B Diagnostic Specimen Waste

The hospital’s clinical waste outputs including spent diagnostic specimens, are
assigned to Category B and therefore for disposal fall under UN3291 Clinical
waste, unspecified, n.o.s.
Where wastes have been autoclaved they may be suitable for disposal as
offensive waste depending on there being no chemical or pharmaceutical
contamination.
Any histopathology samples destined for final disposal should be incinerated in
line with the Human Tissue Act.
Waste is tagged and the number recorded by Sodexo for tracking purposes
Category B Diagnostic Specimen Documentation

Diagnostic specimens assigned to UN3373 and packaged in accordance with
P650 are subject to a rule relaxation and therefore there is no requirement for the
hospital to provide any documentation under ADR 2015.
Exemptions
The following are deemed not to be Class 6.2 infectious for carriage:
• Substances which do not contain infectious substances. This specifically
includes offensive waste (EWC code: 18 01 04)
• Substances containing microorganisms which are non-pathogenic to humans
or animals; unless they also have characteristics which meet the criteria for
another classification;
• Substances which have been treated so that the pathogens have been
neutralised or deactivated;
• Medical equipment which has been drained of free liquid. (the term
“equipment” does not include constructed devices such as endoscopes for
example);
• Substances where the concentration level of pathogens is at a level naturally
encountered, (foodstuffs, water samples) and which are not considered to
pose a significant risk of infection;
• Dried blood spots, collected by applying a drop of blood onto absorbent
material;
• Faecal occult blood screening samples;
• Blood or blood components which have been collected for the purpose of
transfusion or for the preparation of blood products to be used for
transfusion or transplantation, tissues or organs intended for use in
transplantation as well as samples drawn in connection with such purposes

• Human specimens for which there is minimal likelihood that pathogens are
present, provided that the specimen is carried in a packaging which will
prevent any leakage and which is marked “Exempt (Human) Specimen”.
The Trust is advised that under section 2.2.62.1.5.8 of ADR 2015 which
details this exemption, the following is still required.
The packaging must consist of three components:

1. a leak-proof primary receptacle(s);
2. a leak-proof secondary packaging; and
3. an outer packaging of adequate strength for its capacity, mass and intended
use, and with at least one surface having minimum dimensions of 100 mm x
100 mm;
For liquids, absorbent material in sufficient quantity to absorb the entire contents
is be placed so that, during transport, any release or leak of a liquid substance
will not reach the outer packaging and will not compromise the integrity of the
cushioning material;
When multiple fragile primary receptacles are placed in a single secondary

packaging, they are either individually wrapped or separated to prevent contact
between them.
Category B Refrigerated or frozen specimens: Ice and dry ice

When dry ice is used as a coolant/conditioner to keep specimens cold, the
following requirements must be met: If ice is used, the outside packaging or
overpack must be leakproof.
• When used, ice or dry ice must be placed outside the secondary packagings
or in the outer packaging or an overpack.
• Interior supports must be provided to secure the secondary packagings in the
original position after the ice or dry ice has dissipated.
• If solid carbon dioxide (dry ice) is used, the packaging must be designed and
constructed to permit the release of carbon dioxide gas to prevent a build-up
of pressure that could rupture the packagings.
• The primary receptacle and the secondary packaging must maintain their
integrity at the temperature of the refrigerant used as well as the
temperatures and the pressures which could result if refrigeration were lost.
• Packages containing dry ice for cooling shall be marked with the following
wording:
CARBON DIOXIDE, SOLID, AS COOLANT
• The markings shall be durable, legible and placed in such a location and of
such a size relative to the package as to be readily visible.
Receiving Samples


Where the laboratory receives specimens from GPs surgeries or external clinics
and these specimens are sent by road, they are required to meet the P650
packaging instruction requirements as detailed above.
While the responsibility for the correct packaging (including the use of absorbent
materials for liquid specimens) rests with the consignor (i.e. the GP’s practice), it
is advisable to identify facilities that are not compliant and instruct them of the
relevant packaging requirements in order to protect the health and well-being of
the Trust’s own staff.
Moreover, where these specimens are received at Trust sites and then sent by
road to other Trust laboratories for analysis, the laboratory will need to
repackage these non-compliant specimens because the laboratory is now acting
as the consignor of the diagnostic specimens so it must ensure that UN3373
diagnostic specimens are packaged in accordance with P650 requirements.
2. Category A diagnostic specimens

Category A samples are rare but senior staff, laboratory or reception managers,
should always be informed if any are to be transported. Category A is an
infectious substance which is carried in a form that, when exposure to it occurs,
is capable of causing permanent disability, life threatening or fatal disease in
otherwise healthy humans or animals.
The exception is cultures of Escherichia coli, Shigella dysenteriae and

Mycobacterium tuberculosis which although Category A are permitted to be
classified as Category B provided the cultures are intended for diagnostic or
clinical purposes.
Category A specimens are assigned to UN2814 and have the proper shipping
name “Infectious Substance Affecting Humans”. Specimens falling into this
category are rare and are usually sent to the Rare & Imported Pathogens
Laboratory at Porton Down. Their staff will provide advice to technical staff in
the referring hospital on request
Imported Fever Service

0844 7788990
This number automatically routes to the clinician’s mobile phone. Please allow
time for the connection to be made and the doctor to answer it!
RIPL on call clinician
07789 031672
This also re-routes to the on-call person’s phone so allow time.
If all else fails or to contact laboratory technician
01980 612100
PHE Porton switchboard, who will ensure someone gets back to you.


This laboratory uses approved specialist couriers for Category A samples, these
couriers will pack specimens for transport.
Approved category A carriers include:

• PDP: 01784 420 466
• DGI : 0208 814 0404
Category A Specimens - Packaging

UN2814 assigned Category A diagnostic specimens must be placed into
packaging meeting the United Nations standard Packing Instruction 620 (P620)
as follows:
a) Inner packagings comprising:
i) leakproof primary receptacle(s) made of glass, metal or plastic (with a
positive means of securing a leakproof seal e.g. heat seal, skirt stopper,
or a metal crimp seal. If screw caps are to be used, they must be
secured by positive means, e.g. tape, paraffin sealing tape or
manufactured locking closure).
ii) a leakproof secondary package
iii)Where liquid specimens are transported, absorbent material must be
placed between the primary and secondary packaging sufficient to
absorb the entire contents of the primary.
b) A rigid outer packaging, with smallest external dimensions of not less than
100mm, correctly marked and labelled as shown in the next section.
The packaging used for Category A specimens must be UN approved i.e. with
UN markings and a certificate of conformity available and held by the Trust.
All packaging must be strong enough to withstand the shocks and loadings
normally encountered during transport, including trans-shipment.
Primary receptacles shall be placed in secondary packages in such a way that,

under normal conditions of transport, they cannot break, be punctured or leak
their contents into the secondary packaging.
If multiple fragile primary receptacles are placed in a single secondary
packaging, they shall be either individually wrapped or separated (e.g. in
specimen racks) to prevent contact between them.
Secondary packages shall be secured in outer packaging with suitable cushioning
material.
Category A Specimens - Marking and Labelling

In accordance with Packing Instruction P620, the rigid outer packaging used to
transport Category A specimens must display the UN2814 number, the Proper
Shipping Name and the Class 6.2 danger label on the outer packaging (see
below, either type sufficient). The Class 6.2 label must be affixed to the surface


of the package and the dimensions of the label may be reduced to not less than
50 mm square provided that it remains clear.
Class 6.2 Danger Label
Details of the consignor/consignee (name, address and phone number) and a

responsible person contact, ideally 24 hour (if different to the
consignee/consignor), must be displayed on the outer packaging.
The outer packaging shall bear the United Nations packaging specification
marking (code) which indicates that the packaging has passed the performance
tests to the satisfaction of the competent authority.
High Consequence Dangerous Goods and Notification Procedures

Category A diagnostic specimens are considered to be High Consequence
Dangerous Goods under the Carriage Regulations as detailed earlier in this
report. Prior to a Category A specimen being transported the DGSA must be
contacted, who will liaise with Police Counter Terrorism Officer and the
appointed Courier as appropriate. The Trust should have written procedures that
reflect this requirement.
Category A Specimens Paperwork

There is no rule relaxation for the carriage of Category A specimens on the road.
As such, a transport document is required to be completed and retained by the
Trust for at least 3 months for every Category A specimen package that is
consigned.
In reality, it is often a specialist courier firm that will supply the transport
document but the Trust is responsible for providing the courier with the correct
information to put on the Transport Document and for ensuring that the
document is correctly completed.
The transport document must include the information detailed earlier in this
report together with the following information:
For known Category A infections substances:

• UN2814, INFECTIOUS SUBSTANCES, AFFECTING HUMANS (name
of micro-organism), 6.2 ,(E)


For unknown or suspected Category A infections substances:
• UN2814, INFECTIOUS SUBSTANCES, AFFECTING HUMANS
(Suspected Category A Infectious Substance), 6.2, (E)
Category A Specimens and Training

Staff who package Category A diagnostic specimens for transport on the road
MUST receive training on Dangerous Goods awareness.
This training must be face to face.
Category A Specimen Couriers and Courier Checks

Designated carriers are used. They carry out the necessary training, precautions
and checks on staff.
Category A Waste
Clinical wastes containing Category A infectious substances shall be assigned to
UN2814 for road transport as appropriate unless it has been rendered safe by
autoclave or chemical disinfection.
If Category A waste that has not been rendered safe is required to be moved on
the road then there are specialist packaging and notification requirements for
this.
1. Transport Routes for Pathology Specimens.

These are summarised in Appendix 1.
2. Urgent Specimens
The majority of specimens being transported between sites are not urgent but
should be sent on a transport run at the earliest opportunity.
Urgent samples should be dealt with immediately and given priority. Urgent
specimens include the following;
Blood Sciences Samples deemed to be urgent by Biomedical Scientists at any
time.
All CSFs, (Cerebro Spinal Fluid), at any time.
Paediatric blood cultures for Microbiology should be sent to QH within 2 hours
of receipt, and so are deemed to be urgent at night.
Transport of samples using the Courier / Taxi services

The Trust manages its transport courier service from King George Hospital.
If a Taxi is required for transporting specimens, use the company that has a
contract with the Trust. Taxis should be requested via the Trust switchboard. The
BHRU Transport Department is responsible for liaising with the Taxi firm
regarding training and best practice.

Only specimens classified as Biological Substance Category B shall be

transported by the routine courier / taxi services.
Refer to Safe working practice for courier / taxi drivers carrying pathological
specimens – Pathology1853. These instructions are issued to the transport
managers and should be incorporated into working instructions issued to courier
and taxi drivers.
Transporting cases for MDMs

The cases for MDT meetings (specifically breast MDT) are transported to KGH
(and returned) via designated courier. Date, time and signature of courier is
recorded.
Transport of samples by patients

Patients transporting their own samples are exempt from transport regulations,
however local labelling and packing instructions must be followed.
Transport of blood samples by phlebotomists

Phlebotomists attending outreach / community clinics must comply with ADR
regulations and package samples according to P650 packaging instructions as
explained in section 6.4.1.
Refer to Safe working practice for phlebotomists transporting blood samples –

Pathology1854.
6.5 TRANSPORTATION TIMES

The sender must ensure that personnel transporting specimens are made aware of
any special requirements so that specimens arrive within a time frame
appropriate to the nature of the requested examination and are transported in a
way that protects the specimens from deterioration. Refer to appendix 1 for the
courier run transport schedule.
6.6 INCIDENT REPORTING

All incidents and near misses regarding the transportation of pathology
specimens must be reported for investigation and root cause analysis. Within the
Trust, these must be reported using the electronic IR1 form. The laboratory
should be informed as part of the reporting process. Incidents involving external
couriers / taxis must be reported to the trust’s transport department and also to
pathology.


Appendix 1: Courier run transport schedule:
LOCATION SERVICE Courier Specimens Blood Current

Mail collections collections collection
time
1 Grosvenor Raod Dagenham GP 1 1 0 10:20
1 Queens Road (Victoria
health center) GP 1 1 0 10:55
10 Bennets Castle Lane GP 1 1 0 11:45
12 Movers Lane (The White
House) GP 1 1 0 11:35
130 Upney Lane GP 1 1 0 10:30
14 Clayhall Ave. GP 1 1 0 10:30
145-207 Bevan Ave. GP 1 1 0 13:50
167 Eastern Ave. GP 1 1 0 10:50
188 Ripple Rd. GP 1 1 0 11:30
19 Castleton Road GP 1 1 0 09:25
199 Reede Road GP 1 1 0 09:30
2 First Ave Dagenham GP 1 1 0 09:10
2 Halbutt Road Dagenham GP 1 1 0 09:50
200 Chadwell Heath Lane GP 1 1 0 12:10
26 Wanstead High street E11
2AQ MH & GP 0 1 0 12:00
272 Fullwell Avenue GP 1 1 0 11:30
281 Ilford Lane GP 1 1 0 14:50
3 Broadway Gdns. GP 1 1 1 13:30
300 Fencepiece Road GP 1 1 0 11:50
34 New North Road GP 1 1 0 12:00
35 Maplestead Rd. GP 1 1 0 13:40
36 Dewwy Road GP 1 1 0 09:40
11:00
364-370 Ripple Rd. GP 1 2 2 &14:30
36-65 Ethelbert Gdns. GP 1 1 0 11:20
37 Cavendish Gdns. GP 1 1 0 10:25
374 Parsloes Ave. GP 1 1 0 10:50
38 Bathurst Rd. GP 1 1 0 11:10
4 Eastwood Road GP 1 1 0 09:15
4 Granville Road GP 1 1 0 14:20
40 Cameron Road GP 1 1 0 09:35
45 Wanstead Place Clinic E11
2SW MH & GP 0 1 0 12:05
465 Cranbrook Road GP 1 1 0 14:10
49 Windermere Gdns. GP 1 1 0 10:40
51 Upney Lane (Faircross
health center) GP 1 1 0 10:35


time
55 York Road GP 1 1 0 14:00
561-563 Valence Ave. GP 1 1 0 11:40
595 Green Lane GP 1 1 0 16:20
60 Victoria Rd. GP 1 1 0 10:50
61 Cleveland Rd. GP 1 1 0 14:40
62 Courtland Ave. GP 1 1 0 11:00
620 Longbridge Rd. GP 1 1 0 11:10
641-645 Becontree Ave. GP 1 1 0 11:20
68 The Drive GP 1 1 0 13:50
69 Oval Road Dagenham GP 1 1 0 09:20
7 Salisbury Ave. GP 1 1 0 10:40
700 Cranbrook Road GP 1 1 0 09:45
72 Chadwell Heath Lane GP 1 1 0 12:15
83 Fencepiece Road GP 1 1 0 11:45
872 Green Lane GP 1 1 0 11:30
92 Balfour Road GP 1 1 0 14:30
92 Hedgemans Road GP 1 1 0 09:40
Abbey M.C. GP 1 1 0 10:45
Aldersbrook Road GP 1 1 0 14:00
08:30 ,
10:30,
12:30,
14:30
Barking C. H. MH & GP 1 5 5 &16:00
09:40 &
Broad Street Resource Centre MH & GP 1 2 2 14:30
10:00
,12:00,
14:45, &
Chadwell Heath H.C. MH & GP 1 4 4 16:20
Child & Family Centre Axe
Street MH & GP 1 1 0 11:20
11:00,
14:15
Church Elm Lane H.C. MH & GP 1 3 3 &15:55
Diabetic Center Bunting
Bridge Road MH & GP 1 1 0 14:50
Five Elms H.C. MH & GP 1 1 0 10:40
Forest Edge & The Willows 12:30 &
(Hainualt HC) MH & GP 1 2 2 15:30
11:35 &
Fullwell Cross H.C. MH & GP 1 2 2 15:30
11:05,
14:20
Grays Court MH & GP 1 3 3 &16:00


time
Heathcoat Clinic MH & GP 1 1 0 10:15
Julia Engwell H.C. MH & GP 1 1 0 13:30
King Edward M.C. GP 1 1 0 11:25
Laburnum Health Center
RM10 7YU (Valence Avenue) GP 1 1 0 10:10
11:00,
12:30
Loxford Polyclinic GP 1 3 3 &16:00
Makyate Surgery GP 1 1 0 10:15
10:25 &
Marks Gate H.C. MH & GP 1 2 2 12:25
10:00
Newbury Park H.C. MH & GP 1 2 2 &14:45
Oak Tree M.C. GP 1 1 0 16:30
Orchard H.C. MH & GP 1 1 0 11:05
Oxlow Lane Clinic MH & GP 1 1 0 10:00
Palms M.C. GP 1 1 0 09:55
09:45,11:0
0,12:30,14:
Porters Avenue H.C. MH & GP 1 4 4 30
Rydal Surgery GP 1 1 1 13:00
12:00 &
Seven Kings H.C. MH & GP 1 2 2 15:00
11:00 &
South Woodford H.C. MH & GP 2 2 2 13:50
10:00,
12:00,
14:05 &
Thames View H.C. MH & GP 1 4 4 15:40
Urswick M.C. GP 1 1 0 13:25
10:30,
11:15
,13:45
Vicarage Field H.C. MH & GP 1 4 4 &15:30
Whipps Cross Hospital MH & GP 1 0 0
11:00,
14:00 &
Fanshaw 1 3 3 15:30
09:30 &
1600 (2
further
collection
via
Havering
Brentwood Community 1 4 4 Couriers)


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BHR HOSPITALS – PATHOLOGY

PATHOLOGY TRANSPORT PROCEDURES

1.0 PURPOSE / CLINICAL RELEVANCE

All specimens and accompanying paperwork must be transported in such a way

The European Agreement concerning the International Carriage of Dangerous

Implementation of the ADR Framework Directive is achieved in Great Britain

Q Pulse record: Pathology 4543 Revision: 3 Page 1 of 19

PATHOLOGY TRANSPORT PROCEDURES

The carriage regulations main purpose is to identify dangerous substances and

Pathology 376: Sending samples to King George Hospital (Haem)

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PATHOLOGY TRANSPORT PROCEDURES

6.0 ACTIONS AND METHODS

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PATHOLOGY TRANSPORT PROCEDURES

6.2 Personnel to do the task / level of training required

6.3 TRANSPORT OF SPECIMENS WITHIN THE HOSPITAL

6.3.1 Transport of specimens to the laboratory by hospital staff

Q Pulse record: Pathology 4543 Revision: 3 Page 4 of 19

PATHOLOGY TRANSPORT PROCEDURES

Risks are likely to arise from

6.4 TRANSPORT OF SPECIMENS OUTSIDE THE HOSPITAL (by transport

Note that all infectious diagnostic specimens (Category A or Category B) are

Category A: An infectious substance which is transported in a form that when

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PATHOLOGY TRANSPORT PROCEDURES

1. Category B Diagnostic Specimens

Category B Specimen Packaging

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PATHOLOGY TRANSPORT PROCEDURES

This could be evidenced by obtaining a Certificate of Conformity for the

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PATHOLOGY TRANSPORT PROCEDURES

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PATHOLOGY TRANSPORT PROCEDURES

Category B Specimen Marking & labelling

Labels shall be displayed on a background of contrasting colour, or shall have

Category B Specimens and the Carrier

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PATHOLOGY TRANSPORT PROCEDURES

Category B Specimens and Training

Category B Diagnostic Specimen Waste

Category B Diagnostic Specimen Documentation

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PATHOLOGY TRANSPORT PROCEDURES

The packaging must consist of three components:

When multiple fragile primary receptacles are placed in a single secondary

Category B Refrigerated or frozen specimens: Ice and dry ice

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PATHOLOGY TRANSPORT PROCEDURES

2. Category A diagnostic specimens

The exception is cultures of Escherichia coli, Shigella dysenteriae and

Imported Fever Service

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PATHOLOGY TRANSPORT PROCEDURES

Approved category A carriers include:

Category A Specimens - Packaging

Primary receptacles shall be placed in secondary packages in such a way that,

Category A Specimens - Marking and Labelling

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PATHOLOGY TRANSPORT PROCEDURES

Class 6.2 Danger Label

Details of the consignor/consignee (name, address and phone number) and a

High Consequence Dangerous Goods and Notification Procedures