In this section
Specimens for histology or cytology are not allowed to be transported via the pneumatic tube system.
The transport of the specimens to the department is undertaken by the respective hospital transport portering teams from both the Wythenshawe and the Tameside site. Dedicated barrels are provided, by the histology department, as the secondary packaging for use to transport the samples. The primary packaging being the container the specimen is in. Urgent samples, e.g. transplant biopsies, frozen sections, may be delivered to the department ad hoc; these should be transported in an appropriate container, with a tightly fitting lid. The transport containers should be labelled as Diagnostic Specimens – UN3373 and have the department name and telephone number to ensure the containers comply with transport regulations.
Specimens should not be transferred to the department without appropriate packaging. All specimens should be received with a documented tracking sheet detailing the patient identifiers, specimen type and where the specimen has been taken. These tracking sheets are checked on arrival in the histology department and returned to the department or area the specimen was taken from for staff to record that the specimen has been received safely in Histology.
Transport of samples on the Wythenshawe site occurs twice daily with specimens delivered at 9am and 3.30pm, Monday – Friday.
Transport of the Tameside samples occurs twice daily. The transport collects specimens from theatres, endoscopy and then pathology before leaving pathology at 9.30 am and 3.30 pm. This transport also delivers samples from GP surgeries within the Tameside borough. This transport also delivers supplies from Wythenshawe Site back to Tameside for the relevant theatres and clinics.
For specimens received from hospitals where there is not a routine transport service arranged, a courier service is used. This includes specimens transported from Stepping Hill Hospital and independent providers. Transport between Wythenshawe Histopathology, Withington Community Hospital, and Oxford Road Campus is in place at regular intervals throughout the day to ensure timely transport of specimens to be processed at each site.
Samples from all sites should be delivered to Histopathology specimen reception in the clinical sciences building so Histopathology staff can accept these and ensure all specimens are accounted for. Delivery of specimens should be Monday – Friday between 8.00am and 5.30 pm unless by prior arrangement as there are no staff on site over the weekend to accept specimens into the department.
Any fresh specimens (not delivered in formalin or preservative for non-gynae cytology specimens) should be delivered directly to a member of histopathology staff to ensure processing is undertaken quickly with no degradation to specimen.
If you have any queries or should extra transport be required for any reason please contact the Trust transport department via switchboard.
Samples received from both Trusts are recorded using a paper-based system and in some cases electronically. Please ensure such records are completed before dispatch of samples.
For paper-based requesting, only specimen request forms provided by histopathology should be used to request specimen testing. These forms should not be photocopied, for a supply of forms, please contact the laboratory.
Samples from the GP surgeries within the South Manchester District are delivered to the main pathology reception area and then collected by histology staff on an ad hoc basis. Some of these samples are requested electronically others are accompanied by handwritten request forms. For paper-based requesting, only specimen request forms provided by histopathology should be used to request specimen testing. These forms should not be photocopied, for a supply of forms, please contact the laboratory.
If samples from Wythenshawe Site cannot be accepted due to failing the specimen acceptance criteria, the requesting Clinician will be contacted via the messaging facility in HIVE and asked to attend the laboratory as soon as possible to make the necessary amendments and complete a Specimen Labelling Amendment form. This will form part of the record of this sample.
If samples are from GPs within the Wythenshawe borough, these are returned to the GP practice for amendments and completion of a Specimen Labelling Amendment Form. The specimen can then be returned to the Wythenshawe Histology department for processing. Records are maintained at Wythenshawe hospital of all specimens returned to GP surgeries.
If samples from Tameside Hospital cannot be accepted due to failing the specimen acceptance criteria, the requesting Clinician will be contacted and informed the sample will be returned to Tameside Pathology Specimen Reception. The Clinician should then attend the department to make any necessary amendments and complete a Specimen Labelling Amendment form. This will form part of the record of this sample. The sample is then returned to Histology at Wythenshawe Site for processing. Records are maintained at Wythenshawe hospital of all specimens returned to Tameside.
If samples are from GPs within the Tameside borough, these are returned to Tameside Specimen Reception to then be sent to the GP practice for necessary amendments to be made and Specimen Amendment Form. This is then returned to Wythenshawe Histology via Specimen Reception at Tameside. Records are maintained at Wythenshawe hospital of all specimens returned to Tameside.
Please be aware that a final report will not be made available until the necessary amendments have been made (although specimens may be processed should there be a clinical urgency or risk in specimen degradation should processing be delayed). Failure to amend the specimen request form of specimen pot in a timely fashion will lead to a delay in the final report and if the specimen is not amended in 7 days, a Ulysses record will be raised.
All specimens should be transported in the relevant fixative or transport medium as indicated below in section 5. All specimen pots should be tightly sealed and transported using specimen bags, where appropriate. The request card should be placed in the pocket of the specimen bag, and the pot inside the sealed bag to ensure the safety of all staff.
All specimens sent via Royal Mail should adhere to the packaging guidance available on the Royal Mail website. It is the responsibility of the sender to ensure that specimens are appropriately labelled and packaged.
Specimen tracking
Many of our service users have systems in place to track specimens. If specimen acceptance criteria are applied at the time of tracked receipt, the specimen can be returned to the sender quickly should any discrepancy be identified.
Appropriate action in the event of a specimen acceptance failure involving fresh tissue (e.g. frozen section, gel sample) or an Urgent / HSC 205 sample is decided at the discretion of the reporting pathologist. The decision to accept and process pending confirmation may be taken.
If a specimen has been requested using HIVE, the sender can use HIVE to check whether the specimen has been received.
Requesting formalin pots
We supply prefilled containers of all sizes to departments at Wythenshawe Hospital and empty buckets and prefilled biopsy pots to Tameside Hospital. We also supply specimen pots and buckets to external hospitals on a like for like basis following receipt of specimens for processing e.g. to the Spire hospital.
The exceptions to this rule are specimens requiring an urgent frozen section report, lung wedges and resection specimens and specimens being transferred to the department by the Biobank team for which they will have explicit patient consent for sampling. These specimens should not be sent in formalin.
Prefilled specimen pots are only to be transported by the Trust transport department using the dedicated barrels.
Any formalin that is identified as out of date and therefore shouldn’t be used should be returned to the Histology department at Wythenshawe site so that the fluid can be safely disposed of.
Most specimens for histology need to be placed in an appropriately sized container with adequate amount of formalin (ideally 10x the volume of the sample) as soon as removed from the patient. Specimen containers of all sizes, pre-filled with formalin, are available from histology, to request, please contact the laboratory on 0161 291 4800. For specimens to be sent to the department not in formalin, empty specimen containers of all sizes are also available.
Please be aware that porters and transport have limited capacity to deliver formalin pots. Frequent smaller orders are advised rather than occasional large orders.
Handling formalin
The department uses 10% neutral buffered Formalin (4% formaldehyde) and this should be handled with care at all times. Genta is our supplier of Formalin and has issued the following safety information:
10% Formalin
Acute Toxicity Category 4 – Harmful if inhaled
Skin Sensitizer Category 1 – May cause an allergic reaction
Carcinogen Category – 1B May cause cancer
Mutagen Category 2 – Suspected of causing genetic defects
All solutions containing formalin are suspected carcinogens, mutagens and sensitisers. The solutions should be handled with care, minimising skin contact. Safety equipment including gloves should be worn and any spill on the skin should be washed as soon as possible. Contaminated clothing should be removed immediately and washed before re-use as the chemical can soak through clothing to stay in contact with the skin for a long period of time. In general, formalin solution, like any other chemical should be treated with respect. Handle with care and avoid any situations which could potentially result in formalin spillage.
Formaldehyde vapours in the air are also harmful. The safety limit for formaldehyde in air is two part per million (2ppm). This means workers should not be exposed to formaldehyde vapour above this level (averaged over the period) for more than 15 minutes at a time. Testing machines are available to monitor the level of formaldehyde vapour in air but as a rough guide, 2ppm of formaldehyde will have a strong, unpleasant smell and will start to sting the nose and eyes on first entering the room. This check is only valid on first entering the room as the senses quickly acclimatise and will be less sensitive. In most hospitals with proper bench extraction it is unlikely that the limit will be reached in normal use but may be in the event of a spill.
Information from: Formalin Usage Guide for Hospitals – Genta, Version 2.1 (Jan 2016)
Formalin can be disposed of down a sink suitable for clinical waste with copious amounts of running water in a well-ventilated room.
Formalin spillages
Formalin should be handled with care and sent in appropriately sized containers with secure lids to minimise the risk of a spillage. Specimen pots should be secured in a sealable plastic specimen bag.
Each sender who handles Formalin should have their own policy or procedure and equipment for handling Formalin and dealing with a spill. Spillages should be dealt with as soon as it safe to do so. Salvage of any specimen should be of the highest importance as it is likely to not be repeatable. Specimens must not be discarded.
The sender must inform the laboratory of any spillage where the specimen may have been lost, partially lost or its integrity compromised. This should be reported as an incident and the sending clinician should be informed as soon as possible.
Couriers and porters should not attempt to handle a Formalin spillage in transit without having received proper training. In the event of a spillage please follow local spillage protocols. The Histology laboratory can be contacted for advice Mon-Fri 09:00-17:30 on 0161 291 4800.
Our Formalin supplier, Genta, has issued the following guidance on spillages.
Spillage volumes:
- Minor spillages (up to 200ml) – usually can be dealt with by 1 or 2 staff using simple procedures
- Large spillages (200ml – 5 litres) – require the use of a Formaldehyde spillage kit
- Major Spillages (over 5 litres) – should be dealt with by Fire Service
Dealing with minor spills
In a hospital environment formalin is mostly handled in very small containers with less than 100ml of 10% formalin solution. A spill of this size is unlikely to contaminate the air to dangerous levels if dealt with promptly. The spill can be wiped up with absorbent material by staff members wearing suitable impervious gloves such as nitrile gloves. The contaminated material should be sealed in plastic bags for disposal and removed from the room as soon as possible. It is important not to simply dispose of the contaminated material in an open bin as the formaldehyde will continue to contaminate the air.
Dealing with large spills
Some hospitals use formalin solutions in larger quantities, for example large specimen containers/buckets for whole organ fixing. A spill in this case can be up to ten litres and can cause more serious air contamination. Such a spill should only be tackled by trained personnel with appropriate personal protective equipment. This should include protective gloves, over-suit, boots and respiratory protective equipment (R.P.E.) with forced air feed or formaldehyde selective filters. The spill should be contained by absorbent booms and prevented from entering drains. The spill should then be absorbed into an appropriate absorbent medium, sealed in an airtight container and kept as special waste for professional disposal.
- Evacuate all staff from immediate area and nearby areas of spillage
- Wearing the appropriate personal protective equipment and full face mask, use a Formaldehyde spill kit to contain the spillage
- Ensure all materials used to tackle the spillage are appropriately contained and disposed of
- If no protective equipment phone emergency number for your department (e.g. 2222)
- Inform of nature and site of spillage
Dealing with major spills
- Evacuate the area
- Break nearest fire alarm point
- Phone emergency number for your department (e.g. 2222)
- Inform of nature and site of spillage
(Last reviewed January 2024)