Guidance

Appendix 1: sample submission safety considerations

Updated 28 November 2024

Health and safety

The specimen containers and mail transport systems provided by the laboratory should be used. The individual who requests or takes specimens from patients known to be infectious must ensure that both the form and specimen bag are appropriately labelled.

It is essential, where the requester knows or strongly suspects that the patient may be infected with a dangerous pathogen, that this specific information is provided with every specimen or request form.

Where clinical or epidemiological information indicate the possibility of a hazard group 4 pathogen (for example recent return with fever from West Africa) it is essential that sample submission, patient referral, and so on, is discussed immediately with a consultant microbiologist or virologist.

Packaging of specimens

Specimens should be placed in the appropriate specimen container, which must be securely fastened, and any accidental spillage cleaned immediately, with an appropriate chlorine-containing appropriate chlorine-containing disinfectant (see below for details).

Each specimen should be placed in a clear plastic, double (‘marsupial’), self-sealing bag with one compartment containing the request form and the other the specimen.

See Infectious substances transport regulations and Guidance on regulations for the transport of infectious substances 2021 to 2022.

Any specimens sent by post must comply with Infectious substances transport regulations.

Where a needle has been used to obtain the specimen, the needle should be disposed of safely into an approved sharps container at the point of use, and not included in the packet transported to the laboratory.

 Packaging of high-risk specimens

Specimens from patients in the ‘infection risk from blood’ category should be placed in the appropriate specimen container, which must be securely fastened, and any accidental spillage cleaned immediately with an appropriate chlorine-containing disinfectant: 10,000ppm available chlorine for blood spillage (do not use on urine spills), 1,000ppm for surface disinfection.

Note: Undiluted domestic bleach contains 100,000ppm available chlorine.

This should be placed in a clear plastic, double (‘marsupial’), self-sealing bag with one compartment containing the request form and the other the specimen. The specimens should then be placed in a second (outer) plastic bag and appropriately labelled. All specimens and forms should be clearly labelled with an ‘Infection risk from blood’ label.

Transport of specimens

Specimens packaged as above must be transported to the laboratory in a robust, lidded, washable transport box. Do not use ordinary envelopes or ‘jiffy’ bags for transportation. Do not staple or puncture polythene bags.

High-risk incidents and safety

Universal precautions should be observed, and appropriate personal protective equipment should be worn when specimens are collected. (Sterile gloves to take blood, masks, protective eyewear, and a plastic apron if splashing of blood or other body fluids is likely to occur.) Any inoculation incidents (needlesticks or contamination of conjunctiva, mucous membranes, or broken skin, with blood or body fluids), must be reported as soon as possible – within 2 hours – to your occupational health service so that any action required can be instituted promptly.

This procedure must be followed whether or not the patient is perceived to be high risk.