Transporting medical specimens: classification, packaging, responsibilities and what a courier checks

The ADR is the European agreement on the carriage of dangerous goods by road. In the Netherlands it does not only apply to international rides: the Act on the Transport of Dangerous Goods applies to carrying, offering, accepting, loading, unloading and packing without regard to borders, and the regulation on the transport of dangerous goods by land makes the Dutch translation of the ADR applicable to road transport within the Netherlands. The European directive on the inland transport of dangerous goods prescribes the same. The ILT supervises and puts it simply: anyone transporting something must first determine whether it has to be classified as a dangerous good.

Infectious substances form Class 6.2 of the ADR. The ADR is revised every two years; the 2025 edition is in force now.

Not every specimen is the same. Category A (UN 2814 and UN 2900) can cause permanent disability or life-threatening disease on exposure; Category B (UN 3373, 'Biological Substance, Category B') is any infectious substance that does not meet those criteria; and the exempt specimen has a minimal likelihood of pathogens and is not a dangerous good, provided it is packed leakproof, in three layers and marked 'Exempt human specimen'. According to the WHO most shipments can be transported as Category B. Classification requires professional judgement, and in case of doubt Category A applies.

The full explanation, with the examples from the ADR and the common misconceptions, is in what UN3373 means.

The ADR places classification, packaging, marking and information with the sender, who may outsource these tasks but remains responsible. The carrier checks that the shipment is authorised for carriage and that the information has been provided, ascertains by visual inspection that there are no defects, leakage or cracks, may rely on the sender's information, and may not continue after an infringement. The WHO puts it practically: the carrier may advise, the sender decides and has to be able to justify the decision.

What a courier sees at pickup is the outside: mark, proper shipping name, integrity, dryness. What it does not see, the inner packaging, the absorbent material and the pressure resistance, remains the sender's responsibility. How that division of roles works in the daily chain from collection to analysis is explained in laboratory transport.

Packing instruction P650 applies to UN 3373: at least three layers (primary receptacle, secondary packaging, outer packaging, one of which rigid), absorbent material for the entire contents in the case of liquids, a primary or secondary packaging that withstands 95 kPa, a drop test of 1.2 metres, and on the outside the diamond-shaped UN3373 mark of at least 50 by 50 millimetres with the proper shipping name in letters at least 6 millimetres high. For road transport P650 sets no quantity limit per package; the limits of 1 and 4 litres come from the air transport rules.

If a shipment is packed and marked in this way, special provision 319 says it is not subject to any other provision of the ADR: no dangerous goods transport document, no ADR certificate for the driver, no orange plates. Dry ice as a coolant (UN 1845) brings the provisions of chapter 5.5.3 with it: a packaging that lets the gas escape, ventilation or a warning, and the marking 'dry ice as coolant'. The packaging in detail is in packing instruction P650; how the ADR applies in the Netherlands and the exemptions in ADR and medical specimens.

In specimen transport there are two handovers: from sender to courier and from courier to laboratory. For both, the time, the name of the person handing over and receiving, and where agreed the measured temperature should be recorded. That is how the laboratory can answer a question about a result afterwards, and how the file shows who was responsible for what. A signature or a photo of the handover is personal data and is therefore handled with care.

How UrgentX transports specimens as UN3373 and what we check at pickup is described under transport of laboratory samples. For the temperature on the way, see temperature-controlled transport.

ISO 20658:2023 is the standard for the collection and transport of samples for medical laboratory examinations and, according to its public scope, is also aimed at service providers involved in the transport independently of the laboratory; it is voluntary, and its contents are only available for a fee and are not reproduced here. ISO 15189:2022 sets requirements for medical laboratories themselves, not for carriers; the laboratory wants from the carrier the data (times, temperatures) with which it can demonstrate its own process. A carrier cannot call itself 'certified' to either standard without external assessment.