MAN - Packaging and Transport Manual As of 2019June06-Edited - CCO

MANUAL ONPACKAGINGANDTRANSPORTOFLABORATORY SPECIMENS FORREFERRAL
2018
DEPARTMENT OF HEALTH
REPUBLIC OF THE PHILIPPINES
1
2018
DEPARTMENT OF HEALTH
REPUBLIC OF THE PHILIPPINES
2
MANUAL ON PACKAGING AND TRANSPORT OF LABORATORY
SPECIMENS FOR REFERRAL
©2018 by the Department of Health. All rights reserved. Subject to

the acknowledgment of the Health Facility Development Bureau
(HFDB), Department of Health, the Manual may be freely
abstracted, reproduced or translated in part or in whole for non-
commercial purposes only. If the entire Manual or substantial
portions will be translated or reproduced, permission should be
requested from HFDB. Printed in the Republic of the Philippines.
National Library Cataloging-in-Publication Data

ISBN
Published by
Department of Health
San Lazaro Compound
Rizal Avenue, Sta. Cruz, Manila
1003 PHILIPPINES
Development of this Manual was initiated and completed, and

subsequently published through the Health Facility Development
Bureau, Department of Health, Manila. Contact HFDB for
inquiries: +63 2 6517800 locals 1401, 1403 and 1408.
Email address: [email protected] / [email protected]
3
Republic of the Philippines
Department of Health
OFFICE OF THE SECRETARY
MESSAGE
With the President’s approval of Republic Act No. 11223, or the

Universal Health Care (UHC) Act, the health sector, with the
Department of Health at the helm, is poised to accelerate towards
the realization of health for all Filipinos. Our strategic framework to
boost towards UHC is FOURmula One Plus for Health (F1 Plus),
which is driven to meet our goals in better health outcomes, more
responsive health system, more equitable healthcare financing,
and strategized in pillars focused on governance, financing,
regulations, service delivery and performance accountability.
UHC, simply put, means every Filipino gains equitable access to quality health care
without the financial hardship. Thus, it serves as the health lens for our country’s noble
aspiration for “matatag, maginhawa, at panatag na buhay,” as defined by the Philippines’
long-term vision, AmBisyon Natin 2040. In UHC terms, it envisions the Filipino as one of
the healthiest in Southeast Asia by 2022 and in Asia by 2040.
Much has already been achieved since we began our journey in healthcare reform.
Nevertheless, now is not the time to be complacent in our efforts as stewards of a

progressive healthcare system. The DOH shall ride through R.A. No. 11223’s momentum
and accomplish F1 Plus fueled by the energies of passionate, committed civil servants,
and like-spirited people’s organizations, development partners and private sector.
I commend the Health Facility Development Bureau (HFDB) for this endeavor to update
the manuals of standards and operations of health facilities. With this initiative the HFDB
fulfills its strategic commitments to F1 Plus; to integrate and standardize health facility
operations in the context of the health provider networks; to enhance the Philippine Health
Facility Development Plan; and to incentivize health facilities that institutionalize people-
centered care and patient safety programs.
We trust that these manuals serve as standard references to guide management, service
providers and support staff to instill quality in all aspects of health facility operations and
service delivery. May these references, together with the Bureau’s other sustained
engagements with partners and stakeholders, facilitate health services that are designed
according to the patient’s rights, values and preferences, and delivered to their satisfaction
and delight
FRANCISCO T. DUQUE III, MD, MSc

Secretary of Health
4
FOREWORD
In line with the thrust of the Department of Health on Service Delivery Network
and Good Governance under FOURmula One Plus for Health (F1Plus), the Health
Facility Development Bureau (HFDB) formulates policies and develops standards for
the establishment, development, management and operations of health facilities in the
country. The HFDB assumes the technical leadership and coordinates the health
facility development initiatives of the government and its partners. Efforts to improve
the service delivery network and determine the critical areas for continuing quality
improvement that ensure patient-centered quality care have been our utmost priority.
Health workers and Health Facility/Hospital Administrators have been

continuously confronted with a wide range of issues, new trends and technologies in
various health care settings. The development of more relevant and responsive
policies and guidelines for patient-centered quality care attunes our health systems to
this dynamic environment.
For 2018, the Health Facility Development Bureau (HFDB) proudly endorses a
set of Manuals for the Clinical Laboratory. These Manuals are outputs of the National
Unit for Health Laboratories and the National Technical Working Groups of the
National Health Laboratory Network (NHLN) Program. The authors and contributors in
the conceptualization and completion of these manuals are experts in the various fields
of laboratory medicine. The Manuals are in congruence with Philippine settings while
maintaining consistency with international standards. Each of the following individual
manuals is best used in conjunction with the other Manuals in the set:
1. Manual of Standards on Quality Management System in the Clinical

Laboratory – 2nd edition
2. Manual of Standards and Criteria for Laboratory Action Plan
3. Manual of Standards on Laboratory Biosafety and Biosecurity
4. Manual on Packaging and Transport of Laboratory Specimens for Referral
The above-mentioned Manuals will serve as standard reference materials for

the DOH Clinical Laboratories to aid laboratory administrators and clinical practitioners
in the management and operations of various laboratory services that contribute
directly and indirectly to quality patient care. These Manuals are also recommended
for use in the Clinical Laboratories of Local Government Units, Military, Philippine
National Police, Academe, and the Private sector.
5
PREFACE
The Department of Health’s enactment of Administrative Order No. 2012-0021

or the “National Framework of the National Health Laboratory Network” that shall
support the achievement of quality laboratory service through Service Delivery
Network, as one of the strategic pillars of FOURmula 1 Plus for Health (F1 Plus). The
measures to improve the quality of laboratory services are provided in the Strategic
Plan for National Health Laboratory Network (NHLN). To ensure quality and take
advances of economies of scale, the service capabilities of various health laboratories
differ. The lower category laboratories perform the simpler and more common
laboratory examinations while the higher category laboratories perform the less
common and more complex laboratory procedures.
To make the more complex laboratory examinations accessible to the lower

category laboratories, a referral system has been devised. Within the Regional Health
Laboratory Network, referral laboratories are identified for various types of special
laboratory examinations. Further, the special examinations are available from National
Reference Laboratories and other tertiary category laboratories.
This Manual is designed to give proper packaging and transport of the

laboratory specimens in consideration of regional health laboratory network system

that aims towards time, resource and cost efficiency. The Manual will help protect the
public and environment from the potential harmful effects due to improper handling of
the laboratory specimens.
6
ACKNOWLEDGEMENT
The formulation of the Manual on Packaging and Transport of Laboratory

Specimens for Referral has been made possible through the contributions of the
following whose expertise is gratefully appreciated.
Health Facility Development

Dr. Criselda G. Abesamis Director IV
Bureau
Victor R. Potenciano Medical
Dr. Tomas P. Maramba, Jr. Pathologist
Center
Chairman, National TWG for the

Dr. Marissa A. Orillaza Pathologist Implementation of Strategies of
the Strategic Plan for NHLN
San Lazaro Hospital-STD/AIDS
Dr. Elizabeth O. Telan Pathologist Central Cooperative Laboratory
NRL
Philippine Association of Medical
Dr. Leila M. Florento Past President
Technologists
Quality
Research Institute for Tropical
Ms. Josefina Geronimo Assurance
Medicine
Officer
Biological Risk Association of the

Dr. Miguel Martin Moreno President
Philippines
Philippine Association of Medical
Mr. Ronaldo E. Puno President
Technologists
Supervising
Science Research Institute for Tropical
Mr. Plebeian B. Medina
Research Medicine
Specialist
Associate
Mr. Oliver Shane Dumaoal Lyceum of the Philippines
Professor
Dr. Razel L. Kawano Professor Angeles University Foundation

Medical Health Facilities and Services
Ms. Marieta T. Go
Technologist Regulatory Bureau
Medical Health Facility Development
Ms. Minda C. Quitoriano
Technologist Bureau
Medical
Ms. Nenita S. Cañafranca Lung Center of the Philippines
Technologist
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Developmental
Ms. Angelita O. Jimenez Management
Bureau
Officer IV
Mr. Richard Albert J. Medical Health Facility Development

Ramones Technologist Bureau
Mr. Henry Ryan Dominic G. Administrative Health Facility Development

Cajandig Assistant Bureau
Development
Mr. Glenn A. Cruz Management
Bureau
Officer III
Senior
Ms. Camille Ann C. Ople Administrative
Bureau
Assistant II
National Reference Laboratory - East Avenue Medical Center
National Reference Laboratory - Lung Center of the Philippines
National Reference Laboratory - Philippine Heart Center
National Reference Laboratory - National Kidney and Transplant Institute
National Reference Laboratory - Philippine Heart Center
National Reference Laboratory - Research Institute for Tropical Medicine
8
LIST OF ACRONYMS
ARSRL – Antimicrobial Resistance Surveillance Reference Laboratories
EAMC – East Avenue Medical Center
ICAO – International Civil Aviation Organization
IATA – International Air Transport Association
LCP – Lung Center of the Philippines
NHLN – National Health Laboratory Network
NKTI – National Kidney and Transplant Institute
NRL – National Reference Laboratories
NTRL – National Tuberculosis Reference Laboratory
PHC – Philippine Heart Center

RITM – Research Institute for Tropical Medicine
SLH-SACCL – San Lazaro Hospital-STD/AIDS Central Cooperative Laboratory
VRD – Veterinary Research Department
WHO – World Health Organization
9
DEFINITION OF TERMS
Air waybill tracking – is a receipt issued by an international airline for goods and an
evidence of the contract of carriage, but it is not a document of title to the goods.
Carrier – company that transports goods and/or people by air, land or sea, in its own
or chartered vessels or equipment, and is named as the carrier in the contract of
carriage.
Courier – is a person or company that delivers messages, packages and mails.
Designated Referral Laboratory – is a DOH-licensed laboratory and a member of

the Regional Health Laboratory Network that is designated to receive specimens from
other referring laboratories for testing.
Environmental specimen – a sample taken from the environment e.g. air, water, soil,
sediments, vegetation and foods intended for laboratory examinations.
Outer shipping package – a sturdy container used to hold the secondary receptacle
to protect it and its contents from outside influences such as physical damage and
water while in transit.
Overpack – is an enclosure by a single shipper to contain one or more packages and

to form one handling unit for convenience of handling and stowage.
Patient specimen – is a clinical sample collected directly from a human and intended
for laboratory examinations.
Preservative – is a chemical substance that is used to preserve the specimen’s

viability (e.g. formaldehyde).
Primary receptacle – is a labelled primary leak-proof receptacle containing the

specimen. The receptacle is wrapped in enough absorbent material to absorb all fluid
in case of breakage.
Referring Laboratory /Sender– is a laboratory that sends specimen to a referral

laboratory for testing and/or further examinations.
Regional Health Laboratory Network – is a group of laboratories that belongs to

laboratory network in a designated region.
Secondary container – is a second durable, leak-proof receptacle to enclose and

protect the primary receptacle. Several wrapped primary receptacles may be placed
in one secondary receptacle. Sufficient additional absorbent material must be used to
cushion multiple primary receptacles.
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Shipper’s Declaration – is a specific form prepared by sender certifying that the
specimen has been packed, labelled, and declared according to IATA Dangerous
Goods Regulations.
Triple packaging - a recommended packing of laboratory specimen using two (2)

inner layers of leak-proof containers and one (1) sturdy outer container to prevent any
spillage of its contents.
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TABLE OF CONTENTS
Message …………………………………………………………………… 4
Foreword …………………………………………………………………… 5
Preface …………………………………………………………… 6
Acknowledgement ……………………………………………………………. 7
List of Acronyms ……………………………………………………………. 9
Definition of Terms ……………………………………………………………. 10
CHAPTER 1
Specimen for Referral …………………………………………………… 14
Regulated and Unregulated Biological Materials Subject to IATA
Shipping Regulations …………………………………...……… 14
Means of Specimen Transport …………………………………………… 16
General Steps in Handling All Specimens for Referral ………………… 17
Procedure for Local Land and Water Transport …………………………... 18
Procedure for Air Transport …………………………………………… 25
Roles and Responsibilities in Specimen Packaging and Transport …... 28
Spill Decontamination …………………………………………………… 29
Appendices
A: Triple Packaging System …………………………………………… 31
B: Classification of Dangerous Goods ……………………………….…… 34
C-1: Classification of Biological Materials for Transport …………… 35
C-2: Flowchart for the Classification of Infectious Substances and Patient
Specimens ………………………………………………..…………. 38
C-3: Examples of Infectious Substances Included in Category A ….... 39
D: Shipper’s Declaration Form …………………………………… 41
E: Marking and Labelling …………………………………………………... 42
CHAPTER 2
List of National Reference Laboratories and Their Specific Requirements
for Referral, Services, and Contact Information …………………………... 46
References …………………………………………………………… 123
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CHAPTER 1
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SPECIMEN FOR REFERRAL
The great majority of the specimens come from patients. They may be
categorized into:
1. Whole Blood, Serum or Plasma
2. Urine
3. Body fluids, e.g., Pleural, Peritoneal, Cerebrospinal, or joint fluid
4. Stool or fecal smear
5. Oropharyngeal and nasopharyngeal swabs
6. Microbiological culture or smear
7. Surgical specimen for Surgical Pathology
8. Smear or fluid for Cytology
9. Water, waste and other environmental specimens
A. Regulated and Unregulated Biological Materials Subject to IATA

Shipping Regulations
1. Regulated Biological Materials
The materials presented below are subject to IATA shipping regulations for
infectious substances:
Infectious substances are materials regulated for shipping. These

materials are known to be, or are reasonably suspected to contain, an
animal or human pathogen. A pathogen is a virus, microorganism (including
bacteria, plasmids, or other genetic elements), proteinaceous infectious

particle (prion), or a recombinant microorganism (hybrid or mutant) that is
known or reasonably expected to cause disease in humans or animals.
Microorganisms that are unlikely to cause human or animal diseases are
not subject to biological shipping regulations.
 Category A infectious substances are materials capable of causing

permanent disability, or a life-threatening or fatal disease in humans or
animals when exposure to them occurs. Category A infectious
substances are shipped as infectious substances affecting humans
(UN2814) or infectious substances affecting animals (UN2900).
Examples of Category A infectious substances are listed in Appendix
C3.
 Category B infectious substances are materials that do not meet

Category A criteria. Category B infectious substances are shipped as
UN3373.
Patient specimens or diagnostic specimens are any human or animal

materials including but not limited to excreta, secreta, blood, blood
components, tissue, and tissue fluids being shipped for the purpose of
diagnosis. Patient specimens that have a minimal likelihood of containing
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pathogens are regulated materials, but they are also exempt from many
shipping requirements. Professional judgment is used to determine if a
specimen contains pathogens and should be based on the patient’s medical
history, symptoms, local conditions, and individual circumstances. The
outer package must be marked “Exempt human specimen” or “Exempt
animal specimen.” If there is more than a “minimal likelihood” that a patient
specimen contains pathogens, it must be shipped as a Category A or
Category B infectious substance.
Biological products are materials that are derived from living organisms
and manufactured for use in the prevention, diagnosis, treatment, or cure
of disease in humans or animals. Examples of biological products include
certain viruses, therapeutic serums, toxins, antitoxins, vaccines, blood, and
blood products. Biological products transported for final packaging,
distribution, or use by medical professionals is not subject to biological
shipping regulations. Biological products that do not meet these criteria
must be shipped as UN2814, UN2900, or UN3373 when appropriate.
2. Unregulated Biological Materials
The following materials are not subject to IATA infectious substance

shipping regulations:
 Substances that do not contain infectious substances or that are

unlikely to cause disease in humans or animals.
 Noninfectious biological materials from humans, animals, or plants.

Examples include noninfectious cells, tissue culture, blood, or plasma
from individuals not suspected of having an infectious disease, DNA,
RNA, or other genetic elements.
 Substances containing microorganisms that are nonpathogenic to
humans or animals.
 Substances that have been neutralized or inactivated so that they no
longer pose a health risk.
 Environmental samples that are not considered to pose a significant risk
of infection (e.g., food and water samples).
 Dried blood spots.
 Fecal occult blood screening tests.
 An infectious substance (other than a Category A infectious substance)
contained in a patient sample being transported for research, diagnosis,
investigational activities, or disease treatment and prevention; or a
biological product when such materials are being transported by a
private carrier in a motor vehicle used exclusively to transport such
materials.
 Blood or blood components that have been collected for the purpose of
transfusion or the preparation of blood products to be used for
transfusion or transplantation.
 Tissues or organs intended for use in transplantation.
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 A material with a low probability of containing an infectious disease, or
where the concentration of the infectious substance is at a level that
naturally occurs in the environment and cannot cause disease when
exposure to it occurs. Examples of these materials include foodstuffs
and environmental samples (e.g., samples of water, dust, or mold).
 A biological product, including an experimental or investigational
product or component of a product, subject to regulations approval,
permit, review, or licensing requirements.
B. MEANS OF SPECIMEN TRANSPORT
The means of transport will depend on the destination and other specific
requirements of specimens to be referred (Part 2 List of National Reference
Laboratories and their specific requirements for referring samples). Specimens
are generally referred to:
I. Identified Laboratories in the Regional Health Laboratory Referral

Network.
II. National Reference Laboratories (NRLs) located in Metro Manila
(Supplemental)
The means of transport can be generally classified into personal transportation

and transport by a licensed courier.
The means of transport include:

1. Personal Transportation by Land
1.1 Hand-carry transport between laboratories
There are specimens that are hand carried from one laboratory to
another by a trained health facility staff. Hand-carry transport
between laboratories generally means an employee is hand-
carrying the biological material in a container and walking between
laboratories in the same building or buildings that are closely
connected and designed for pedestrian traffic.
1.2 Personal Transportation in a Motor Vehicle
Transportation of biological material using a private or government

passenger vehicle such as a car, bus taxi, motor bike tricycle,
bicycle or pickup truck also required that the samples are triple-
packed and transported by a trained personnel.
1.3 Transport by Boat
The laboratory specimens should be transported triple packed by

a trained person.
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Biological materials transported by this means are not subject to
IATA regulations; however, biological materials transported by this
means must at least be triple packed.
2. Delivery by courier
The courier companies that are transporting laboratory specimens are

required to have undergone training and should be duly accredited in order
to maintain the viability of samples and to implement the safety transport
guidelines.
2.1 Transport by Land
The couriers/cargo companies that are transporting laboratory

specimens via land are required to have undergone training and
should be duly accredited in order to maintain the viability of
samples and to implement the safety transport guidelines.
2.2 Transport by Air
Delivery by courier or carrier with airline: It is required that

appropriate trainings are provided to persons and organizations
processing laboratory specimens to be transported by air [2,3].
2.3 Transport by Ship
2.3.1 Transport by ship/ ship cargo
The ship/ ship cargo companies that are transporting

laboratory specimens are required to have undergone
training and should be duly accredited in order to maintain
the viability of samples and to implement the safety
transport guidelines.
C. GENERAL STEPS IN HANDLING ALL SPECIMENS FOR REFERRAL
Step 1: Determine the referral laboratory network system and their

requirements:
1.1 Regional (Sub-national/Referral)
1.2 NRLs
1.3 Others
Step 2: Classify specimens to be transported.
Step 3: Plan the transport
Step 4: Pack the specimen using triple packaging system with proper
labelling in each receptacle.
Step 5: Document and label the outer container box
Step 6: Transport only properly packed specimens
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Step 7: Document received specimens
D. PROCEDURE FOR LOCAL LAND AND WATER TRANSPORT
Step 1: Determine the Referral Health Laboratory Network System

and their requirements
1.1 Refer to the list of Referral Laboratories in the network to

identify where to refer in the regional networking system and
to verify the availability of the desired laboratory examination.
1.2 Check specific requirements of the identified referral

laboratory for specimen referral.
Step 2: Classify Specimens to be Transported
2.1 Determine the type of the specimens to be transported (e.g.

whole blood, serum, plasma, urine, body fluids,
microbiological, surgical specimens, etc.) and the added
chemical preservatives for anatomic specimens (e.g. alcohol
or formalin).
2.2 Specify the amount of the specimen to be transported. Use

plastic cryotubes (e.g. screw-capped cryovials) for the primary
container or receptacle for small (1-2 ml) quantity of liquid
specimens; use thick plastic (e.g. resealable plastic

containers) for larger volume specimens of not more than 500
ml liquid diagnostic specimen and not more than 500g.
2.3 Determine the medical diagnosis, history and clinical

symptoms of the patient source.
2.4 Determine the classification according to guidelines (refer to

Appendix C1 Classification of Biological Materials for
Transport)
Step 3: Plan the Transport
3.1 Coordinate specimen referral. Fill-out appropriate request

forms, referral documents and specimen status monitoring
form. Call up to inform the referral laboratory to inform them
about the specimen referral. Document the name of the
person who received the coordination call, date and time of
the referral.
3.2 Choose and contact the appropriate specimen carrier (i.e.

personnel, courier company or transportation vehicles). It is
recommended that carriers have undergone proper training
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for transport of diagnostic specimens [2,3] and to have a
memorandum of agreement with couriers or transportation
companies (e.g. bus, taxis, etc.) if their services are utilized in
order to maintain integrity, viability security and avoid delay or
theft during the transport for solid diagnostic specimen.
Step 4: Triple Pack the Sample Specimens
4.1 Pack all specimens following the basic triple packaging

(Figure 1) requirement to ensure that the laboratory
specimens will reach their destinations in good condition and
that no risk of leakage and subsequent hazard to the public
and handlers will be caused. Refer to Appendix A for further
specific illustration of packaging of specimens for transport.
Figure 1: Basic triple packing
4.2 Use primary receptacles that are leak-proof and watertight. In

general, screw cap cryovials (Figure 2) are recommended for
the usual clinical laboratory specimens in chemistry, serology,
immunology or hematology; clean sterile conical tubes (Figure
3) for urine and thick resealable plastic containers (Figure 4)
for small anatomic specimens. Label the primary container
with the patient’s name, type of specimen and laterality (e.g.
right or left foot) when appropriate.
Figure 2: Screw cap cryovials
19
Figure 3: Clean sterile conical tubes
Figure 4: Resealable plastic container
4.3 Use primary containers with sturdy, leak-proof plastic containers

with screw cap (Figure 5) for small anatomic or representative
tissue specimens in formalin. For large anatomic specimens,
place and seal in large plastic bags before putting into large
sturdy, leak-proof plastic containers (Figure 6). Use of glass
containers is not recommended. Microscopic slides are

recommended to be individually packed in plastic slide holders
(Figure 7) with outside padding to prevent breakage during
transport. Pack paraffin blocks in plastic bags (Figure 8) with
refrigerants to avoid melting in hot temperatures during
shipment.
Figure 5 Leak-proof plastic containers with screw cap
20
Figure 6 Leak-proof container for large anatomic specimen
Figure 7 Plastic slide holder

Figure 8 Resealable plastic bag for paraffin blocks
4.4 Use secondary containers that are leak-proof and then place
absorbent material, such as paper towels or cotton,
appropriate for the size of the specimen being transported.
Examples of secondary containers are screw-capped jars
(Figure 9) or resealable plastic bags (Figure 10).
21
Figure 9 Screw-capped jars
Figure 10 Secondary containers (jar, conical tube, resealable

plastic bag, lock and lock airtight container)
4.5 Secure the specimen request with identification data and

monitoring record of status of specimen in a separate
resealable plastic bag and place outside the secondary
container.
4.6 Use solid, sturdy and durable container for the outer
container/box such as thick durable carton box (Figure 11) or
styrofoam box (Figure 12) or insulated cooler (Figure 13) that
withstand ordinary humid environment as well as forces during
regular dropping of cargo. Please refer to Appendix A for the
specific packaging requirements.
22
Figure 11 Thick durable carton box
Figure 12 Styrofoam box
Figure 13. Insulated cooler
4.7 Securely position the specimen transport container in the

transport vehicle.
4.8 Regulate the temperature for the specimen transport

container that ranges from 5oC-25oC and/or under conditions
indicated for the examination as recommended by the Referral
/ Receiving Laboratory.
23
4.9 Keep a spill kit (Figure 14) containing absorbent material, a
disinfectant, a leak-proof waste disposal container and heavy
duty gloves in the transport vehicle.
4.10 Transport all specimens to the laboratory for examination as

quickly or as reasonably possible. It is expected that
specimens will not remain in transit for longer periods than
recommended by the referral laboratory.
Figure 14. Spill kit
Step 5: Document and labelling the outer container box
5.1 Secure the necessary documents required for the referral and
transport of specimens inside a plastic bag and place or paste

outside the secondary container. Prepare a duplicate copy of
all documents for file by the sender.
5.2 Label the outer container clearly and legibly with the following
information: complete address and emergency contact
numbers of both referring (sender) laboratory and the referral
(receiver) laboratory.
5.3 Label appropriately each specimen transport container

consistent with its contents e.g. diagnostic specimens.
5.4 If used, properly label the preservative substance such as in

‘Formaldehyde’.
5.5 For packages with dry ice allow the release of carbon dioxide
gas to prevent pressure build-up and subsequent explosion.
Step 6: Transport only properly packed specimens.
6.1 Check and strictly follow the requirements of the referral

laboratory to avoid rejection of specimens being referred.
24
Observe the criteria for specimen rejection and acceptance of
the referral laboratory meticulously.
6.2 Comply and observe the guidelines of the regional referral

system
6.3 Fill-out the specimen status monitoring form
Step 7: Document Received Specimens
7.1 For the referral laboratory: document the status of the

specimen received from the referring laboratory/sender.
7.2 Indicate in the specimen monitoring form and receiving

logbook the time, date and conditions of the specimens.
7.3 Fully document and file comments in case of rejection of

specimen.
Note: For the receiving or referral laboratory: periodically review

sample transport time periods and temperatures to verify
compliance with the standard policy guidelines. Record and analyse
results of these reviews/ checks.
E. PROCEDURE FOR AIR TRANSPORT

Step 1: Determine the Referral Laboratory and their requirements.
Step 2: Classify Specimens to be transported according to the UN

class.
2.1 Classify specimens according to their specific class so they

are properly packed and transported appropriately. Chemicals
may be necessary for the preservation of the materials to be
transported. It is essential to include information about the
classification of both materials included in the shipment and
identified in the labels and data sheets.
2.2 It is recommended that agencies and individuals involved in

the transport of specimens undergo training for packaging and
transport/shipping of specimens or infectious substances.
Step 3: Plan the Transport
3.1 Plan the transport following Step 3 of procedure for land and
water transport.
25
Step 4: Pack patients’ specimens according to their corresponding
categories, as specified in the IATA Packaging Instructions
[1,4,5]
4.1 Pack, mark and label all infectious substances using the triple
packaging system (Figure 15). Although, there are slight
differences in the packaging guidelines, the basic triple
packaging is fundamental to all specimens. Refer to Appendix
A for further illustration of triple packaging system.
Figure 15. Basic triple packaging (IATA packaging

instruction)
4.2 Pack category A specimens according to IATA Packaging

Instructions (PI) 620 while Category B specimens according
to PI 650. Refer to Appendix A for proper packaging
instructions.
4.3 Use leak-proof, screw-capped primary and secondary

containers. Primary container should be individually labelled
and secured for any possibility of leakage.
4.4 Use plastic bags as primary receptacle for tissue specimens

with preservative. Pack paraffin blocks appropriately to avoid
melting and crushing during transport.
4.5 Secure and pack microscopic slides to prevent breakage.

Individual wrapping and padding should be sufficient to
withstand damage during shipment.
26
4.6 Insert enough absorbent materials in between the primary and
secondary containers. These absorbents should be able to
absorb all the liquid contents in case of leakage.
4.7 Place outside the secondary container the request, monitoring

status of specimens and other records which are placed in
separate plastic zip lock bags.
4.8 Use rigid outer container of adequate sturdiness and strength

for its expected capacity and intended purpose.
4.9 For shipping with dry ice, allow the release of carbon dioxide
gas during sublimation. Place the dry ice outside the
secondary container.
4.10 For overpack, several triple packages are combined into one
larger package, each combined package inside the overpack
are marked and labelled including hazard labels, proper
shipping names and quantities (net). Indicate the mark
“Overpack” in the outermost container.
Step 5: Documentation
Complete all the necessary shipping forms and make a copy for
record file.
5.1 Properly fill-out the Shipper’s Declaration Form for

Dangerous Goods (for category A) with complete information
provided for emergency response
5.2 Track the document which includes the name and telephone
number of the person responsible for the shipment by Air
Waybill tracking.
Step 6: Markings and Labelling in the Outermost Container
6.1 Mark and label the outer container with the name, address and
telephone number of the shipper, as well as the name,
address and telephone number of the receiver/consignee.
6.2 Write in words the UN label with the appropriate content (e.g.
UN 3373 Biological Substances, Category B) next to the
diamond sign (Appendix E).
6.3 Category B shipments DO NOT REQUIRE an Infectious

Substance label, Shipper’s Declaration form for Dangerous
Goods or emergency response information.
27
F. ROLES AND RESPONSIBILITIES IN SPECIMEN PACKAGING AND
TRANSPORT
It is the responsibility of the sender to ensure the correct designation,

packaging, labelling and documentation of all diagnostic specimens for
transport including the monitoring record of status of specimens. The efficient
transport and transfer of diagnostic specimens requires good coordination
between the sender, the carrier and the receiver (receiving laboratory), to
ensure that the material is transported safely and arrives on time and in good
condition. Such coordination depends upon well-established communication
and a partnership among the three parties. All have specific responsibilities to
carry out in order to achieve an effective and successful transport.
1. The Referring Agency/Sender
1.1 Makes advance arrangements with the receiver of the specimens.

Calls the recipient to verify the shipping address and obtain the name
and phone number of the contact person. Finds out when the contact
person will be able to receive the shipment.
1.2 Makes advance arrangements with the carrier/courier to ensure that

the shipment will be accepted for appropriate transport and that the
shipment (direct transport, if possible) is undertaken by the most direct
routing, avoiding arrival at weekends/holidays. Shipments should not
go out on Thursdays or Fridays unless the recipient agrees that the
recipient will be there to receive the package during the weekend or

holiday.
1.3 Prepares necessary documentation including request forms,

specimen status for specimen monitoring, permits if necessary,
dispatch and shipping documents;
1.4 Notifies the receiver of transportation arrangements once these have

been made, well in advance of expected arrival time.
2. The Carrier/Courier
2.1 Provides the sender with the necessary shipping documents and
instructions for their completion;
2.2 Provides advice to the sender about correct packaging;
2.3 Assists the sender in arranging the most direct routing and then
confirms the routing;
2.4 Maintains and archives the documentation for shipment and transport;
2.5 Monitors required holding conditions of the shipment while in transit;
28
2.6 Notifies the sender of any anticipated (or actual) delays in transit.
2.7 Notifies the sender of the completed or uncompleted delivery of the

package.
3. The Receiver
3.1 Arranges for the timeliest and efficient collection on arrival;
3.2 Immediately acknowledges receipt and records the date and time of
receipt of specimen.
3.3 Returns a copy of the monitoring record of specimen status to the

sender.
Shipments should not be dispatched until:
a. Advance arrangements have been made between the sender,

carrier and receiver
b. Receiver has confirmed that there will be no delay incurred in the
delivery of the package to its destination.
G. SPILL DECONTAMINATION
The following general procedure shall be used as a guideline for cleanup of a

damaged, or leaking package.
1. Preparation
1.1 Wear PPE such as reusable or disposable rubber gloves and safety
glasses when handling decontaminant solutions or when cleaning up
contaminated materials. Use double disposable gloves if possible and
appropriate.
2. Clean-up
2.1 Clean the package by first pouring or soaking the package with an
appropriate disinfectant such as 10% household bleach, Lysol®, or
other appropriate disinfectant. Allow the disinfectant sufficient time to
decontaminate the item (e.g., 10 minutes).
2.2 If possible and appropriate, pick up the decontaminated item with an

impervious barrier such as a plastic bag placed over the item. Place
the decontaminated item into a plastic bag, tie the bag shut, place the
bag into a second bag, and tie the second bag shut.
29
2.3 Clean up localized gross surface contamination as needed by pouring
or soaking with disinfectant and using disposable paper towels. Place
waste materials in a plastic bag, remove outer contaminated
disposable gloves, and double bag the waste materials.
3. Decontamination
3.1 Clean contaminated surfaces or floors as needed. Use a solution of

water, detergent, and disinfectant to mop floors or wipe surfaces.
Steam clean or shampoo carpets and upholstered furniture. Do not
vacuum or dry sweep surfaces before wet cleaning. Pour mop or
cleaning wastewater into a drain that is connected to the building’s
sanitary sewer system.
3.2 Remove any potentially contaminated clothing and launder with

detergent and hot water separately.
3.3 Decontaminate Re-Useable Equipment
3.3.1 Decontaminate with the bleach solution all potentially

contaminated re-useable tools or protective equipment used
in the clean-up.
3.3.2 Autoclave the material in the laboratory before disposal.
4. Disposal
4.1 Dispose of the bags of waste in the general trash. Use an outside
dumpster, as needed, to prevent odor problems.
4.2 Remove PPE, and then clean it (if reusable) or dispose of it.
5. Washing of hands
5.1 Wash hands with soap and water.
5.2 If hand-washing facilities are not available at the job site, use 70%
alcohol and then wash your hands as soon as possible.
30
APPENDICES:
APPENDIX A: TRIPLE PACKAGING SYSTEM [5]
Packing Instruction 620 and 650 [1]
This instruction applies to substance marked as UN 2814 and UN 2900.
31
The following packagings are authorized provided the special packing provisions
described below are met. Packagings meeting the requirements and approved
accordingly consisting of:
1. Inner packagings comprised of:
a. Leak-proof primary receptacle(s);

b. A leak-proof secondary packaging;
c. Other than for solid infectious substances, an absorbent material in sufficient
quantity to absorb the entire contents placed between the primary
receptacle(s) and the secondary packaging; if multiple fragile primary
receptacles are placed in a single secondary packaging, they shall be either
individually wrapped or separated so as to prevent contact between them;
2. A rigid outer packaging:
a. Drums (1A1, 1A2, 1B1, 1B2, 1N1, 1N2, 1H1, 1H2, 1D, 1G);
b. Boxes (4A, 4B, 4N, 4C1, 4C2, 4D, 4F, 4G, 4H1, 4H2);
c. Jerricans (3A1, 3A2, 3B1, 3B2, 3H1, 3H2).
The smallest external dimension shall be not less than 100 mm (4 in).
Additional requirements:
1. Inner packagings containing infectious substances shall not be consolidated with

inner packagings containing unrelated types of goods. Complete packages may

be overpacked in accordance with the provisions of 1.2.1 and 5.1.2; such an
overpack may contain dry ice.
2. Other than for exceptional consignments, e.g. whole organs that require special
packaging, the following additional requirements shall apply:
a. Substances consigned at ambient temperatures or at a higher temperature.

Primary receptacles shall be of glass, metal or plastics. Positive means of
ensuring a leak-proof seal shall be provided, e.g. a heat seal, a skirted
stopper or a metal crimp seal. If screw caps are used, they shall be secured
by positive means, e.g., tape, paraffin sealing tape or manufactured locking
closure;
b. Substances consigned refrigerated or frozen. Ice, dry ice or other refrigerant
shall be placed around the secondary packaging(s) or alternatively in an
overpack with one or more complete packages marked. Interior supports
shall be provided to secure secondary packaging(s) or packages in position
after the ice or dry ice has dissipated. If ice is used, the outer packaging or
overpack shall be leak-proof. If dry ice is used, the outer packaging or
overpack shall permit the release of carbon dioxide gas. The primary
receptacle and the secondary packaging shall maintain their integrity at the
temperature of the refrigerant used;
32
c. Substances consigned in liquid nitrogen. Plastics primary receptacles
capable of withstanding very low temperature shall be used. The secondary
packaging shall also be capable of withstanding very low temperatures, and
in most cases will need to be fitted over the primary receptacle individually.
Provisions for the consignment of liquid nitrogen shall also be fulfilled. The
primary receptacle and the secondary packaging shall maintain their integrity
at the temperature of the liquid nitrogen;
d. Lyophilized substances may also be transported in primary receptacles that
are flame-sealed glass ampoules or rubber-stoppered glass vials fitted with
metal seals.
3. Whatever the intended temperature of the consignment, the primary receptacle

or the secondary packaging shall be capable of withstanding without leakage an
internal pressure producing a pressure differential of not less than 95 kPa and
temperatures in the range -40 °C to +55 °C (-40 °F to +130 °F).
4. Other dangerous goods shall not be packed in the same packaging as Division
6.2 infectious substances unless they are necessary for maintaining the viability,
stabilizing or preventing degradation or neutralizing the hazards of the infectious
substances. A quantity of 30 ml or less of dangerous goods included in Classes
3 (flammable liquids), 8 (corrosive substances) or 9 (miscellaneous dangerous
substances and articles, including environmentally hazardous substances) may
be packed in each primary receptacle containing infectious substances. These
small quantities of dangerous goods of Classes 3, 8 or 9 are not subject to any
additional requirements of these Regulations when packed in accordance with
this packing instruction.
5. Alternative packagings for the transport of animal material may be authorized by

the competent authority.
33
APPENDIX B: CLASSIFICATION LIST OF DANGEROUS GOODS [1, 2, 4, 5]
Class 1 - Explosives
Class 2 - Gases
Class 3 - Flammable Liquids
Class 4 - Flammable Solids
Class 5 - Oxidizing Agents and Organic Peroxides
Class 6 - Toxic and Infectious Substances
6.1 Toxic Agents
6.2 Biohazard substances (Category A or B)
Class 7 - Radioactive Materials
Class 8 - Corrosive Agents
Class 9 - Miscellaneous
34
APPENDIX C-1: CLASSIFICATION OF BIOLOGICAL MATERIALS FOR TRANSPORT [5]
Dangerous goods are assigned UN numbers and proper shipping names according to their
hazard classification and their composition. Proper shipping names are used to clearly
identify the dangerous article or substance.
Infectious substances are classified in Division 6.2 and assigned to UN 2814, UN 2900,
UN 3291 or UN 3373, as appropriate. Infectious substances are divided into the following
categories:

CATEGORY A:
An infectious substance which is transported 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.
NOTE: An exposure occurs when an infectious substance is released outside of

the protective packaging, resulting in physical contact with humans or animals.
1. Infectious substances meeting these criteria which cause disease in humans

or both in humans and animals shall be assigned to United Nations number UN
2814. Infectious substances which cause disease only in animals shall be
assigned to UN 2900.
2. Assignment to UN 2814 or UN 2900 shall be based on the known medical

history and symptoms of the source human or animal, endemic local
conditions, or professional judgement concerning individual circumstances of
the source human or animal.

CATEGORY B:
An infectious substance which does not meet the criteria for inclusion in Category
A Infectious substances in Category B shall be assigned to UN 3373.
NOTE: The proper shipping name of UN 3373 is “BIOLOGICAL SUBSTANCE,

CATEGORY B”.
Exemptions:
Substances that do not contain infectious substances or that are unlikely to cause disease
in humans or animals are not subject to dangerous goods regulations, unless they meet
the criteria for inclusion in another class.
Substances containing microorganisms that are non-pathogenic to humans or animals are

not subject to dangerous goods regulations, unless they meet the criteria for inclusion in
another class.[7] WHO/WHE/CPI/2017.[8] Guidance on regulations for the transport of
infectious substances 2017–2018 Substances in a form that any present pathogens have
been neutralized or inactivated such that they no longer pose a health risk are not subject
to dangerous goods regulations, unless they meet the criteria for inclusion in another class.
NOTE: Medical equipment that has been drained free of liquid is deemed to meet the
requirements of this paragraph and is not subject to dangerous goods regulations.
35
Environmental samples (including food and water samples) which are not considered to
pose a significant risk of infection are not subject to dangerous goods regulations, unless
they meet the criteria for inclusion in another class.
Dried blood spots, collected by applying a drop of blood onto absorbent material are not
subject to dangerous goods regulations.
Fecal occult blood screening samples are not subject to dangerous goods regulations.
Blood or blood components which have been collected for the purposes of transfusion or
for the preparation of blood products to be used for transfusion or transplantation and any
tissues or organs intended for use in transplantation as well as samples drawn in
connection with such purposes are not subject to dangerous goods regulations.
Human or animal specimens (patient specimens) for which there is minimal likelihood that
pathogens are present are not subject to dangerous goods regulations if the specimen is
transported in a packaging which will prevent any leakage and which is marked with the
words “Exempt human specimen” or “Exempt animal specimen”, as appropriate. The
packaging should meet the following conditions:
1. The packaging should consist of three components:

a. a leak-proof primary receptacle(s);
b. a leak-proof secondary packaging; and
c. 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 × 100 mm;
2. For liquids, absorbent material in sufficient quantity to absorb the entire

contents should be placed between the primary receptacle(s) and the
secondary packaging 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;
3. When multiple fragile primary receptacles are placed in a single secondary

packaging, they should be either individually wrapped or separated to prevent
contact between them.
NOTE 1: An element of professional judgment is required to determine if a

substance is exempt under this paragraph. That judgment should be based on the
known medical history, symptoms and individual circumstances of the source,
human or animal, and endemic local conditions. Examples of specimens which
may be transported under this paragraph include the blood or urine tests to monitor
cholesterol levels, blood glucose levels, hormone levels, or prostate specific
antigen (PSA); those required to monitor organ function such as heart, liver or
kidney function for humans or animals with non-infectious diseases, or therapeutic
drug monitoring; those conducted for insurance or employment purposes and are
intended to determine the presence of drugs or alcohol; pregnancy test; biopsies
to detect cancer; and antibody detection in humans or animals in the absence of
36
any concern for infection (e.g. evaluation of vaccine induced immunity, diagnosis
of autoimmune disease, etc.).
NOTE 2: For air transport, packaging for specimens exempted under this
paragraph shall meet the conditions in (a) to (c). 8 WHO/WHE/CPI/2017.8
Guidance on regulations for the transport of infectious substances 2017–2018
Except for:
a. Medical waste (UN 3291);

b. Medical devices or equipment contaminated with or containing infectious
substances in Category A (UN 2814 or UN 2900); and
c. Medical devices or equipment contaminated with or containing other
dangerous goods that meet the definition of another hazard class, medical
devices or equipment potentially contaminated with or containing infectious
substances which are being transported for disinfection, cleaning, sterilization,
repair, or equipment evaluation are not subject to the provisions of dangerous
goods regulations if packed in packagings designed and constructed in such a
way that, under normal conditions of transport, they cannot break, be punctured
or leak their contents. Packaging shall be designed to meet specific
construction requirements – this is not considered further in these guidelines.
These packaging shall meet general packaging requirements not considered

further in these guidelines, and be capable of retaining the medical devices and
equipment when dropped from a height of 1.2 m. For air transport, additional
requirements may apply.
The packaging shall be marked “USED MEDICAL DEVICE” or “USED MEDICAL

EQUIPMENT”. When using overpacks, these shall be marked in the same way,
except when the inscription remains visible.
37
APPENDIX C-2: FLOWCHART FOR THE CLASSIFICATION OF INFECTIOUS
SUBSTANCES AND PATIENT SPECIMENS [1]
38
APPENDIX C-3: EXAMPLES OF INFECTIOUS SUBSTANCES INCLUDED IN
CATEGORY A [1, 10]
39
40
APPENDIX D: SHIPPER’S DECLARATION FORM [1, 10]
41
APPENDIX E: MARKING AND LABELLING [1, 10]
Appendix E Figure 1. Hazard label for Category A infectious substances and for
genetically modified microorganisms and organisms that meet the definition of an
infectious substance, Category A.
Appendix E Figure 2. Hazard label for certain non-infectious genetically modified

microorganisms and organisms (UN 3245) and for carbon dioxide, solid (dry ice) (UN
1845); substances packed in dry ice shall bear this label in addition to the primary
risk label.
42
Appendix E Figure 3. Hazard label for liquid nitrogen; substances packed using
liquid nitrogen shall bear this label in addition to the primary risk label (for Category
A infectious substances, and for Category B infectious substances)
Appendix E Figure 4. Handling label for cryogenic liquids; for transport by air, where
cryogenic liquids (deeply refrigerated liquefied gases) are used, this label shall be
affixed to insulated vessels or flasks used as outer packaging in addition to other
labels, as appropriate.
Appendix E Figure 5. Orientation label to indicate position of closures on the primary

receptacles; for the air transport of quantities of liquid infectious substances in
Category A that exceed 50 ml per primary receptacle, this label shall be affixed to two
opposite sides of the package with the arrows pointing in the right direction, in addition
to other labels.
43
Appendix E Figure 6. Cargo Aircraft Only (CAO) label; to be used on packages that
may only be transported on a cargo aircraft. For example: for the air transport of
quantities of liquid or solid infectious substances in Category A (UN2814 or UN2900)
that exceed 50 ml or 50 grams respectively, per package, (excluding overpacks).
Appendix E Figure 7. The mark shown below is used for shipments of Category B
infectious substances.
44
References
Civil Aviation Authority of the Philippines. (2011). Advisory Circular AC 18-002.

Guidance for Development of Dangerous Goods Manuals.
Civil Aviation Authority of the Philippines. (2014). Memorandum Circular MC 02-14.
All AOC Holders, Shippers, Cargo Agencies, Freight Forwarders, Ground
Handling Service Providers, AMOs and ATOs.
International Air Transport Association. (2012). IATA Dangerous Goods Regulations
(53rd ed.).
International Air Transport Association. (2017). Packing Instruction 650. Retrieved
April 25, 2019, from International Air Transport Association:
https://www.iata.org/whatwedo/cargo/dgr/Documents/packing-instruction-
650-DGR56-en.pdf
International Civil Aviation Organization. (2005). Technical Instructions for the Safe
Transport of Dangerous Goods by Air, 2005-2006. Retrieved April 25, 2019,
from International Civil Aviation Organization:
https://www.icao.int/publications/Documents/guidance_doc_infectious_substa
nces.pdf
Research Institute for Tropical Medicine & Department of Health. (2014). Guidelines
for Specimen Collection, Transport and Referral during Infectious Disease
Outbreak: Manual for Clinical Specimens. Manila, Philippines.
United Nations. (2011). Recommendations on the Transport od Dangerous Goods,
Model Regulations, 17th Edition. Retrieved April 25, 2019, from United Nations
Economic Commission for Europe:

https://www.unece.org/fileadmin/DAM/trans/danger/publi/unrec/rev17/Englis
h/Rev17_Volume1.pdf
World Health Organization. (2004). Laboratory Biosafety Manual, Third Edition.
Retrieved April 25, 2019, from World Health Organization:
https://www.who.int/csr/resources/publications/biosafety/Biosafety7.pdf
World Health Organization. (2010, June). A Guide for Shipping Infectious
Substances.
World Health Organization. (2011). Guidance on Regulations for the Transport of
Infectious Substances 2011-2012. Retrieved April 24, 2019, from World Health
Organization: http
://www.who.int/ihr/publications/who_hse_ihr_20100801_en.pdf
World Health Organization. (2012). Guidance on regulations for the Transport of
Infectious Substances 2011-2012. Retrieved from
https://www.who.int/ihr/publications/who_hse_ihr_20100801_en.pdf
45
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MANUAL ONPACKAGINGANDTRANSPORTOFLABORATORY SPECIMENS FORREFERRAL

©2018 by the Department of Health. All rights reserved. Subject to

National Library Cataloging-in-Publication Data

Development of this Manual was initiated and completed, and

With the President’s approval of Republic Act No. 11223, or the

Nevertheless, now is not the time to be complacent in our efforts as stewards of a

FRANCISCO T. DUQUE III, MD, MSc

Health workers and Health Facility/Hospital Administrators have been

1. Manual of Standards on Quality Management System in the Clinical

The above-mentioned Manuals will serve as standard reference materials for

The Department of Health’s enactment of Administrative Order No. 2012-0021

To make the more complex laboratory examinations accessible to the lower

This Manual is designed to give proper packaging and transport of the

laboratory specimens in consideration of regional health laboratory network system

The formulation of the Manual on Packaging and Transport of Laboratory

Health Facility Development

Chairman, National TWG for the

Biological Risk Association of the

Dr. Razel L. Kawano Professor Angeles University Foundation

Mr. Richard Albert J. Medical Health Facility Development

Mr. Henry Ryan Dominic G. Administrative Health Facility Development

PHC – Philippine Heart Center

Courier – is a person or company that delivers messages, packages and mails.

Designated Referral Laboratory – is a DOH-licensed laboratory and a member of

Overpack – is an enclosure by a single shipper to contain one or more packages and

Preservative – is a chemical substance that is used to preserve the specimen’s

Primary receptacle – is a labelled primary leak-proof receptacle containing the

Referring Laboratory /Sender– is a laboratory that sends specimen to a referral

Regional Health Laboratory Network – is a group of laboratories that belongs to

Secondary container – is a second durable, leak-proof receptacle to enclose and

Triple packaging - a recommended packing of laboratory specimen using two (2)

A. Regulated and Unregulated Biological Materials Subject to IATA

Infectious substances are materials regulated for shipping. These

bacteria, plasmids, or other genetic elements), proteinaceous infectious

 Category A infectious substances are materials capable of causing

 Category B infectious substances are materials that do not meet

Patient specimens or diagnostic specimens are any human or animal

2. Unregulated Biological Materials

The following materials are not subject to IATA infectious substance

 Substances that do not contain infectious substances or that are

 Noninfectious biological materials from humans, animals, or plants.

B. MEANS OF SPECIMEN TRANSPORT

I. Identified Laboratories in the Regional Health Laboratory Referral

The means of transport can be generally classified into personal transportation

The means of transport include:

1. Personal Transportation by Land

1.1 Hand-carry transport between laboratories

1.2 Personal Transportation in a Motor Vehicle

Transportation of biological material using a private or government

1.3 Transport by Boat

The laboratory specimens should be transported triple packed by

The courier companies that are transporting laboratory specimens are

2.1 Transport by Land

The couriers/cargo companies that are transporting laboratory

2.2 Transport by Air

Delivery by courier or carrier with airline: It is required that

2.3 Transport by Ship

2.3.1 Transport by ship/ ship cargo

The ship/ ship cargo companies that are transporting