HANDLING OF BIO - HAZARDOUS CLINICAL SPECIMENS IN LABORATORIES

1. HANDLING OF BIO - HAZARDOUS CLINICAL SPECIMENS IN LABORATORIES
Dr.T.V.Rao MD
We live in a world with many hazards, However the laboratories we face the challenges with the
specimens arising in the bio hazardous patients , Recent ongoing epidemic with EBOLA OR SWINE
FLU in many regions in the world, how safe we are to handle the patients specimens before these
specimens are screened or the disease is established, Today it emphasizes that the specimens arising
from patients are potentially a threat to many laboratory workers who work with few resources and
many times are not aware of the implications of the disease if they get Infected, However we should
educate our technicians, in the event of spread of hazardous diseases or even in the times of scare
of infection even arising from patients arriving in our country, I think it is time we should reinforce
the fundamentals of Universal precautions once again, In the beginning of AIDS pandemic all of us
are scared of contacting from the Bio hazardous specimens and today we are many times casual to
handling the clinical specimens, rarely take Biohazard precaution, It is the responsibility of personal
who run or manage the matters, they should train the laboratory work force, All transport personnel
must be trained in the proper safety and packaging procedures for specimens transported. They
must be knowledgeable of the regulations for the transport of bio hazardous specimens. All
specimens must be handled in a manner in which the safety of the handler and the environment are
protected while preserving the integrity of the specimens laboratories have basic responsibility to
deal the problems in times of crisis to handle,
Specimen Handling for Routine Laboratory Testing should follow the following instruction
irrespective of infectious status as we do many tests in our central laboratories
Routine laboratory testing includes traditional chemistry, haematology, and other laboratory testing
used to support and treat patients. Precautions as described above offer appropriate protection for
healthcare personnel performing laboratory testing on specimens from patients with suspected
infection even with Ebola virus. These precautions include both manufacturer installed safety
features for instruments and the environment as well as PPE specified it is expected that all
laboratories and other healthcare personnel collecting or handling specimens follow established
standards compliant with the OSHA blood borne pathogens standard, which encompasses blood and
other potentially infectious materials. This includes wearing appropriate personal protective
equipment (PPE) and adhering to engineered safeguards, for all specimens regardless of whether
they are identified as being infectious.
When used according to the manufacturer’s instructions, Environmental Protection Agency (EPA)-
registered disinfectants routinely used to decontaminate the laboratory environment (bench tops
and surfaces) and the laboratory instrumentation are sufficient to inactivate enveloped viruses, such
as influenza, hepatitis C, and Ebola viruses. 1 All specimens must be placed into a primary container
labelled with at least two patient identifiers one is hospital registration number and other may be
ward or the minimal details of doctors so they can contacted personally in the event of hazardous
specimens. Primary containers include blood tubes, urine cups, formalin containers, blood culture
bottles or any other suitable sealed container which safely contains the specimen for testing.
2. The specimen is then placed into a secondary leak proof container, even a small sized zip pouches
if not available, we can just pin with stapler labelled transparent pouch or little cellophane bags in
the market the purpose of the secondary container is to contain the specimen if the primary
container breaks or leaks in transit to the laboratory. Secondary containers include small biohazard
specimen bags, large red hospital designated biohazard bags or any other suitable leak proof

2. container which has a biohazard label on it. When specimens are transported in clear secondary
containers, there is no requirement for biohazard labeling. Once the specimen has been sealed in a
secondary container it may be handled without gloves.
3 The overnight samples if they could not be transported to the laboratory immediately can be kept
in refrigerator If specimens are held in a refrigerator or freezer prior to transport, that appliance
must be labelled as containing a biohazard and be located in an area with restricted access.
4 If the specimens to be sent to reference laboratories and All specimens being transported to the
laboratory from outside the hospital must be properly prepared for transportation and also must
have a biohazard label so all workers will be alerted to follow Universal Precautions. In order to
protect specimen integrity, special attention must be taken to protect the specimen
6 Do not forget it is the responsibility of the Laboratories receiving the specimens to ascertain the
condition of the specimen arrived in the laboratory all specimens should be examined for visual
contamination or breakage before removal from the secondary container. Gloves are to be worn to
remove specimens from the secondary container and for all manipulations of the primary container
7 Train your staff to deal with the specimen leakage Accidents or Spills In case of an accident or spill,
the laboratory should be notified immediately. Laboratory personnel will then take any necessary
action to contain the spill or notify the appropriate officials.
8 Never underestimate the power of Hand washing with Soap, Water and judicious use of Antiseptic
or disinfectant as the situation warrants in the clinical situation
References and further reading consult Centre for disease Control (CDC) Atlanta USA)
Dr.T.V.Rao MD Professor of Microbiology Freelance writer