Sample Storage

 Light may initiate oxidation so store in dark containers.

 For lipid analysis, antioxidants may be added if they wont

interfere with the analysis

 It is therefore desirable to store a number of identical analytical

samples

 Minimize the number of staff involved in taking portions from

them.
 Sample Storage
Effects of sample storage and preparation on nutrient content and
precautions required to minimize them
Effects Potential Nutrients Precaution
Changes Affected
Drying out Loss of water All nutrients Design of protocol, Keep
samples sealed, weigh food at
start and during preservation
Absorption Gain of water All nutrients Design of protocol, keep
samples in sealed container
Microbial Degradation/ Loss of CHO, Storage at low temperature,
activity autolysis/ proteins, gain in pasteurization or addition of
synthesis thiamin, Vit B6 inhibitors
Oxidation Destruction of Alterations in Store at -30C in sealed
unsaturated fatty profile of fats containers under nitrogen. Add
acids, loss of antioxidants, bacteriostatic
vitamins agents
Acid Hydrolysis Loss of sucrose Store at low temperatures
and higher Neutralize acids
oligosaccharides
 Sample Storage
Effects of sample storage and preparation on nutrient content and precautions
required to minimize them
Effects Potential Nutrients Precaution
Changes Affected
Alkaline Destruction Loss of thiamine Avoid alkaline conditions and
SO2
Light Photo Loss of Protect from light
degradation riboflavin
Contamination From cooking Increase Design protocol to minimize
during vessels, soil, inorganic contamination, gently rinse with
sampling dust nutrients distilled water
Contamination Increase in Increase in Select apparatus with care
from metallic inorganic major trace Clean all utensils
blades, nutrients elements Store in plastic bags
glassware
Separation Separation of Changes in Avoid over vigorous mixing and
fats compositional thaw/freeze cycles
Alteration in
fibre content
 • Always wash hands before and after the collection of
specimens.
• Wear gloves when necessary.
• Disposal of needles, syringes and sharps must be into
sharps containers.
Sample Collection
• Always identify the patient.
• Select the right equipment required to collect the
specimens (blood tubes, swabs etc.).
• Once the sample is collected, dispose of any sharps
objects immediately.
 Specimen identification and labeling:
 EVERY individual tube, container, specimen sent to the lab must have a
label applied to it (not loose in the bag.)
 All specimens or blood samples without a label will be rejected.
 All labels & requisitions must be examined to determine if all information
necessary is present & correct.
 Identification of the patient and labeling of specimens must occur at the
point of collection (at the bedside).
 For any specimen, there are necessary items that need to be present on the
label and they must all be correct or the specimen will be rejected. Adults
items include :last name, first name, date of birth, collection date, collection
time collector’s initials
 Storage
 To ensure the quality of results, specimens should be transported to the
laboratory as soon as possible.
 Microbiology Specimens
 Specimens that should be stored at refrigerator temperature
until transport to the laboratory are swabs, Urine , Feces ,Body
fluids / aspirates ,Sputum , FNA and Tissue samples
 some specimens should be stored at room temperature such as
Blood Cultures and Mycology skin scraping
 Seminal Fluids for infertility Keep at body temperature (to lab
within 1 hr.).
 Chemistry / Hematology / Immunology It is preferable and
ideal to have all blood specimens sent to the lab as soon as
possible.
 Histology Specimens fixed in Formalin at Room temperature.
 Cytology Smears Fixed slides are transported to Lab in slide
holders after fixing and air-drying.
Proper sample storage and prevention of cross contamination are the main
considerations after receipt of samples in the laboratory. Some suggested
guidelines are provided here.
•Sample labels should be legible and include sample details. Such details
should include sample name, batch number (if applicable), date of
preparation or collection and recommended storage conditions.
•Ensure that sample container or pouch is properly sealed and there is no
leakage of material
•Samples need not be stored in an alphabetical order. It may be easy to
locate samples stored alphabetically but there are other better plans for
sample storage such as storage on basis of priority in separate bins – most
urgent, urgent or normal priority. This plan may involve movement of
samples between different bins when priorities change.
•Make a manual/soft record on sample details such as sample name, code(if
applicable) date and time of receipt , sample source, analysis requirements,
promised result delivery date, actual date of delivery and finally sample
status ,ie, pass or fail
•Light and temperature sensitive samples should be stored under the
prescribed conditions
Sample Disposal
Technical details for sample disposal procedures are not part of this write-up
and only general guidelines are provided. It is a good to keep in mind that
samples after analysis should not be disposed off in washbasins or dustbins.

•Maintain record of disposal of samples similar to the ones maintained for

samples before analysis

•Retain sufficient quantity of sample under recommended storage conditions

for the purpose of retesting for verification of results in case of disputes or
confirmation of results

•Engage special agencies in case of hazardous sample disposal

•Disposal of samples should not pose any hazard to other laboratory workers
or visitors to the laboratory so it is absolutely essential to adopt
recommended practices for storage and disposal of samples.
 My lab collects and
cares for specimens
properly

Proper specimen
Desired collection, labeling,
packaging, storage,
Outcome tracking, and disposal

Module 7: Specimen Collection & Processing

(2014) 1
6
 Track the specimen from
order placement through
the release of results and
storage of records &
documents

1
7
Steps What Who’s Procedures Pitfalls
happens responsible needed
Order placed

Patient
presents to lab

Requisition
completed &
reviewed
Type of
specimen
determined
Collect
Specimen
Specimen Log

Specimen
Rejection
Test Request

1
8
After hours, a clinician obtained a venipucture specimen
from a small child. The clinician left the specimen in the
laboratory without notifying the laboratory staff on call. The
following morning you receive a call from the clinician who
asks for the laboratory result. You find no documentation of
a result or the receipt of this specimen. After searching, you
find the specimen in the refrigerator grossly hemolyzed.

How will you handle this situation?

What steps will you take to prevent a reoccurrence of this
situation?
On Thursday, a patient submits 3 specimens collected
during the previous week for AFB testing. None of the
specimens are acceptable. You overhear the patient angrily
yelling in the reception room that he did what he was told
to do. After you
clarify the procedure to the patient for recollection, you
discover that during the patient’s first visit, he was only
given the cups with no further explanation.

How will you handle this situation?

 Determine appropriate tests based on test request
and assign test responsibility
 Enforce good specimen handling and processing
practices
 Review specimen log for completeness
 Ensure adherence to specimen referral
requirements
 Track specimen referral status and review referral
reports to ensure timely return of test results
• Avoid contact of the skin and or mucous membranes with reagents or
specimens. If accidental contact, wash abundantly with water.
• Use personal protective equipment (PPE) is must while handling
specimens.
• Use Personal Protective Equipment (PPE) while handling
Formaldehyde/Xylene.
• Formaldehyde and Xylene vapor concentration must be monitored in all
areas where these reagents are used: (example: Gross room, Histology
laboratory, coverslipping areas etc.).
• Any fresh unfixed specimens are considered infectious.
• Any tissues that may contain radioactive material (e.g. sentinel lymph
nodes, breast biopsies, prostate "seeds," etc.) should be safely handled
according to the specific policies and procedure .
• The dangers inherent in the handling of fresh and unfixed tissues are
enormous. Therefore, extra care and attention is paid to frozen sectioning
technique.
• All waste containers should line with disposable color coded liners.
• Red for anatomical contaminated infectious materials, used by
Histopathology Lab.
• Yellow for infectious samples and items such as contaminated gloves
and masks.
• Blue or Black for non-contaminated, ordinary or community waste
materials.
• All pathological infectious waste must be placed in a color coded
biohazard container with a double bag which will be disposed of in the
hospital incinerator by the housekeeping supervisor.
• Hazardous physical waste like Sharp objects e.g. blades, microtome
knives, broken glass, used slides and cover glasses shall be segregated
from other waste and disposed in sharp containers and kept in color
coded (yellow) biohazard plastic buckets for disposal by infection
control Procedures.
• Under no circumstances should the above items be disposed of in the
normal trash collection.
DISPOSAL OF USED GLASS SLIDES AND PARAFFIN BLOCKS.
•Slides must be kept in sharp containers and closed tightly.

• Paraffin blocks treated as infectious materials, stored in pathological waste bags.

•Liquid wastes such as washing from instruments are treated with disinfectant after use and drained in the respective tubing connected to the sewerage if the vendor recommends such disposing.

•Fetuses and other tissues demanded by parents or patients must obtain permission from the Hospital authorities before they are released.

•Official disposal of all tissue remnants i.e. unused tissues are collected by the Local Government Mortuary Service of the laboratory for burial every month.

• All gross specimens are retained for 2 weeks (refer to Retention policy) after the final reports are verified by the pathologist on duty.
Biological waste can be categorized into the following types. 1.
Infectious waste 2. Pathological waste 3. Sharps wastes
Infectious waste contaminated with infected blood and
other body fluids are categorized under this group.
• Culture media and stocks used to grow infectious
organisms.
• Petri dishes.
• Pipettes and pipette tips.
• Microtiter plates.
• Disposable waste materials from infected patients. e.g.,
swabs, bandages and disposable medical devices
. Pathological waste: The following types of waste products are
categorized as pathological waste.
• Human blood, serum, plasma, body fluids (e.g., cerebrospinal
fluid, synovial fluid, peritoneal fluid, pericardial fluid) and
blood products.
• Non-glass containers filled with body fluids that need to be
discarded.
• Any substance contaminated with visible blood, semen,
vaginal secretions or body fluids, human tissues, organs, body
parts, surgical biopsies and autopsy
Sharps waste These are highly hazardous, health care waste. Even
without contamination with infectious material, these have the
potential to penetrate and damage the skin and body parts. Sharps
waste include,
● Needles
● Scalpel blades
● Razor blades
● Syringes with attached needles
● Pasteur pipettes
● Disposable pipettes
● Vials
● Test tubes
● Pipette tips
● Microscope slides
● Cover slips
● Plastic or glass culture dishes
● Other sharp waste like broken and unbroken glassware
Segregation and handling:
● An appropriate container should be used to collect
biological waste.
● Containers should be clearly labelled as
‘Biohazard waste’.
● The label should indicate whether the waste is
treated or non-treated.

Infectious waste a) Liquid waste - These should be collected in leak-proof, unsealed, autoclavable containers.
b) Solid waste - These should be collected in a specially designed, clearly labelled container. e.g., plastic pails
 Infectious waste

If an autoclave is not
If an autoclave is
available
available
Put the waste in an Collect waste in a closed,
autoclave bag appropriate container
Paste autoclave Label as "Untreated biological
indicator tape waste"
Place in an autoclave Store preferably in the
safe tray
Liquids can be drained generating laboratory
Must not be left unattended
off
Remains keep for Label with a ‘Biohazard’
disposal symbol
Need to monitor Must be inactivated as soon as
effective function of the possible preferably within 24
autoclave regularly hours
C. Storage and transportation
●Store in a designated area until collected for disposal by an authorized body.
●Non-treated infectious biological waste should be kept away from general traffic and
preferably stored in a secure area.
●Do not leave unattended.
●Protect from weather.
●Do not allow it to accumulate. Dispose daily or on a regular basis.
●Maintain a schedule for regular disposal.
●Pathological waste such as human body parts, organs or tissues and surgical biopsies
should be stored in a refrigerator. The date of generation should be clearly mentioned on the
label. If putrefaction has occurred, disposal should be done as soon as possible.
●Display a poster with separate color codes to guide the storage and disposal of different types
of waste in the laboratory and storage areas.
●Always use closed, leak-proof containers to transport outside the laboratory and from storage
areas.
●Regular training should be given to all employees who handle biological waste on
- Proper use of personal protective equipment (PPE).
- Method of waste segregation.
- Handling, packaging, labelling and storage procedures
Disposal
a)Disposal of pathological waste
● Incineration is the preferred method.
● Precautions are mandatory during transport of waste for
incineration as they are usually located some distance away
from the waste generation areas.
● Human body parts, organs or tissues and surgical biopsies
must be disposed of by cremation or burial.
● Proper waste disposal locations and regular pickup
procedures must be arranged by the individual institutions.
b)Disposal of Liquid biological waste
● Sanitary sewer systems and sanitary pits should be
designed by each institution for disposal
of liquid biological waste. This will lower the chance of leaks
or spills during transport and lowers the disposal costs.
● Once liquid biological waste is decontaminated or
neutralized, it can be disposed through the sanitary sewer
by using running water. The efficacy of disinfectants
should be tested regularly.
● Human blood and body fluids can be disposed through
the sanitary sewer system with thorough rinse and
disinfection after disposal procedure.
c) Disposal of sharps waste
● Sharps should be disposed into proper sharps containers
placed in readily accessible
areas.
● Sharp destruction devices if available should be used and
kept located near sharp generating areas. e.g. - Needle
burners and needle cutters preferably with disinfectants
● Syringes can be shredded and re-melted after disinfection
either by autoclaving or chemical methods.
● Shredding of disinfected sharps can be used to reduce the
bulk of sharp waste.
● A special sharp pit or a secured area can be used to bury
sharps, or they can be placed in drums, sealed in cement
and then buried in landfills.
Non-hazardous general waste can be described as waste
material that has not been contaminated with hazardous or
harmful agents or material; namely infectious agents, toxic
chemicals, radioactive substances and sharps which can be
injurious to the body.
General waste contributes to a significant proportion of the
waste bulk generated in a histopathology laboratory.
Types of non-hazardous general waste generated from a
histopathology laboratory:
●Plastic - specimen containers, tissue cassettes, syringes,
goggles, face shields
●Glass - slides, specimen containers, glass pipettes,
chemical stored bottles
●Latex /rubber - gloves, aprons
●Polythene - aprons, surgical gowns
●Synthetic materials - masks, caps
●Paper wastes - record books, reports, data entry books
Food waste
Disposal of some of the paper waste in laboratory,
including patients reports, records and other important
documents need to be arranged in a responsible way, as
these contain confidential information.
Prior to disposal, permission from the head of the
laboratory is essential and the important paper material
should have exceeded the minimal retention times before
disposal. These records or reports should be shredded and
adequately mixed up before handing over for recycling.
 STORAGE PERIOD OF EXAMINED SPECIMEN
The examined specimens shall be stored for re-examination and/or additional tests for a
minimum period as specified below.
[Link] Biochemistry
Blood samples in vacutainers : 3 days (72 hours) at 2-8 0C.
Blood samples for ABG & Troponin-T: Discarded after reporting on the same day.
[Link]: Complete Blood Counts/Coagulation screening test: 3 days (72 hours)
at 2-8 0C
[Link] Pathology: Urine, Stool, & Semen samples: Discarded after reporting on the
same day.
[Link]
Urine, Stool, & Swabs are discarded after plating the same day.
Pus, aspirates, & fluids are stored for 3 days (72 hours) at 2-8 0C.
Bac-T bottles are discarded after unloading from the machine.
[Link] :3days (72 hours) at 2-8 0C.
[Link]
Specimens (Biopsy & Bone marrow): Discarded as per hospital
guidelines. (Grossed samples non-malignant - 3 months, grossed
sample malignant- 1 year, blocks and slides for 10 years / handed
over to the patient along with the report for safe keeping)
Bone Marrow Aspirates: 1 Year
[Link]
Fluids : 3 days (72 hours) at 2-8 0C
Slides : Dispatched to the patient*
[Link] sent to referral laboratories for testing: Excess sample, if
available, is stored for 3 days (72 hours) at 2-8 0C.
* The original slides/blocks of
Histopathology/Cytology/PAP smears are dispatched to the patients
that will aid them in obtaining second opinion or for treatment
elsewhere. The Laboratory maintains a record for receipt and issue
of slides/ blocks.
 SAMPLE DISCARD PROCEDURE
 Blood samples in vacutainers/syringes (without needle)/Stool samples,
catheter tips, grafts, etc., in containers: Discarded in red bag.
 Body Fluids/Urine/Semen/Other liquid biomedical wastes: Equal
amount of 1% Sodium Hypochlorite is added into the container, left
for 20 minutes to act & then drained. The containers are disposed into
red bag.
 Troponin T Syringes: Discarded into the white puncture-proof
containers.
 Histopathology Samples: All histopathology samples will be retained
for a prescribed period. After this period, the formalin will be drained
to the Sewage Treatment Plant and the samples will be disposed as per
guidelines for disposal of Bio-hazardous wastes.
 Disposal of Testing Materials
The testing cards like novocard, ABG cards, Minividas testing strips, & SPRs used in
Clinical Biochemistry Department are discarded into appropriate color-coded bins
after testing.
The dry chemistry strips/slides collected in the automated analyzer are disposed of
every morning into appropriate color-coded bins.
The microtips, droppers, plastic Pasteur pipettes, etc., are discarded into containers
with 1% Sodium Hypochlorite, & then disposed into red bag.
The serological testing rapid cards are collected in a box, then disposed every
morning into red bag.
Plastic tubes used for testing are treated with 1% Sodium Hypochlorite for an hour,
and then disposed into the red bag.
Microbiology culture plates, Blood Bags& urine containers are carried in
autoclavable bags to the Autoclave Station, autoclaved for 20 minutes at 121 0C and 15
psi pressure and then discarded into red bags (actual cycle will be about 60 minutes.
Please refer to protocol displayed near the Autoclave Station for autoclaving
procedure).
The used Sodium Hypochlorite solution in all the above cases are drained into sinks
connected to the Sewage Treatment Plant.
Thank you