May 2011

LifeLabs couriers play an essential role in ensuring patient specimens are transported from Physician offices to a LifeLabs Laboratory safely and in accordance with Transportation of Dangerous Goods (TDG) Regulations.  The majority of specimens transported by LifeLabs are classified as “Exempt Human Specimens” (formally “Diagnostic Specimens”).  Exempt Human Specimens/ Diagnostic Specimens are patient specimens with minimal likelihood of pathogen presence.  Examples include but are not limited to:

·       blood or urine specimens to monitor cholesterol levels;

·       blood glucose levels, hormone levels, prostate-specific antigens (PSA) or organ function;

·       specimens to determine the presence of drugs or alcohol for insurance or employment purposes;

·       biopsies to detect cancer.

However, a small minority of specimens acquired at Physician offices and transported by Lifelabs are infectious in nature. LifeLabs requires Physicians or their delegates to identify Infectious Substances to our Couriers in order to ensure Infectious Substances are labeled accurately, packaged securely and transported in accordance with Transportation of Dangerous Goods. 

Typically test requests requiring “confirmation or identification” where the specimen is suspected of being infectious must be packaged more stringently.  Transport Canada breaks down Infectious Substances into two categories:  Category A and Category B. 

Category A Specimens are considered “outbreak” specimens and are required to be transported in the most stringent leak proof and pressure tested packaging. These are infectious substances in a form that, when exposure to it occurs, is capable of causing permanent disability, life-threatening or fatal disease in otherwise healthy humans. Category A substances include but are not limited to Rabies virus, HIV, Smallpox virus, Hepatitis B virus, Hendra virus, Ebola Virus and highly pathogenic avian influenza virus.  

Category B Specimens are specimens being tested for investigational purposes that are known to originate from a patient with an infectious disease.  Category B substances include but are not limited to; Hepatitis C PCR or RNA, Acid Fast Bacillus “for identification”, Astrovirus (all serotypes), Human herpes virus 1 and 2.  

Please note, TDG allows many Category A specimens to be packaged in Category B packaging however there are 19 which are highly transmissible and infectious that must be packaged as Category A some examples include but are not limited to; Hendra virus, Ebola Virus and Hantaviruses causing hemorrhagic fever with renal syndrome or pulmonary syndrome and highly pathogenic avian influenza virus.  A list of these 19 substances can be found in Section 5.16 Means on Containment for Class 6.2, Infectious Substances at the following link http://www.tc.gc.ca/eng/tdg/clear-part5-300.htm#sec516

A complete list of Category A and Category B Specimens can be found on the Transport Canada Website, Appendix 3 SOR/2008-34 http://www.tc.gc.ca/eng/tdg/clear-part2-339.htm

LifeLabs physicians must identify Infectious Substances to LifeLabs couriers to ensure regulatory compliance with packaging.  Proper packaging can prevent the spread of infectious disease if a leak or spill were to occur with the sample. LifeLabs couriers carry both Category A and Category B packaging in their vehicles incase required by the Physician office.