Managing pathology specimens safely

Key points

All specimens may contain micro-organisms capable of causing disease, they must be obtained, handled and transported with care to reduce the risk of transmission of infection to all people involved, under the Health and Safety at Work Act (1974) and the Control of Substances Hazardous to Health (Amendment) Regulations 2004.

Hazard group definitions

A biological agent is assigned to one of the following groups according to its level of risk of infection to humans:

• group 1, unlikely to cause human disease
• group 2, can cause human disease and may be a hazard to employees; it is unlikely to spread to the community and there is usually effective prophylaxis or treatment available
• group 3, can cause severe human disease and may be a serious hazard to employees; it may spread to the community, but there is usually effective prophylaxis or treatment available
• group 4, causes severe human disease and is a serious hazard to employees; it is likely to spread to the community and there is usually no effective prophylaxis or treatment available

A list of Hazard group 3 and 4 organisms can be found here (opens in new window).

When dealing with specimens of suspected or confirmed hazard group 3 organisms, additional precautions may be required. These will be detailed in the respective procedures or advised by the consultant microbiologist.

All specimens from patients with known or suspected hazard group 3 organisms must be designated as high risk and a ‘danger of infection’ label must be applied to both the container and the form. Labels can be ordered from the print room, order code DP5697.

Hazard group 4 organisms include viruses that cause haemorrhagic fever, for example, Ebola virus. It is unlikely that group 4 organisms will be encountered within the trust. If this occurs or is suspected then advice must be sought from the consultant microbiologist or the infectious diseases physician (Royal Hallamshire Hospital, Sheffield) before any specimens are obtained, by contacting switchboard at the Royal Hallamshire Hospital (on 0114 271 1900) and asking for the on call infectious diseases registrar. The patient would be transferred to an infectious diseases unit as a priority.

IPC precautions

• Follow standard infection prevention and control precautions including:
  • use of personal protective equipment, aseptic non touch technique, management of blood and body fluid spillages and hand hygiene
• Clinical biochemistry, haematology, immunology, microbiology and virology specimens must be placed in the bag attached to the form and sealed. Several blood samples from an individual patient can be placed in the same bag but virology or serology samples require a separate form and bag. Blood cultures, urines, swabs, fluids, sputum and poo samples must not be mixed with blood samples.
• In instances where patients are requested to collect their own specimens, education on the specimen collection method, instructions on handling the specimen and prompt returning of the specimen to promote accurate results and patient safety is paramount.
• Further information can be found in the pathology handbooks for each locality, including:
  • obtaining, packaging specimens and collecting high risk specimens
  • completing the request form
  • transporting specimens

Pathology handbooks:

• Doncaster (staff access only) (opens in new window)
• Rotherham (opens in new window)
• North Lincolnshire (opens in new window)

Linked to: Transportation of sharps or specimens in quick guides.

Page last reviewed: September 18, 2024
Next review due: September 18, 2025