Download Biological Materials Shipping Form

UCDenver
Dept. of Environmental Health & Safety
Instructions for Shipping Biological Materials
1. UCDenver personnel shipping biological materials, to include infectious substances and
diagnostic human or animal patient specimens, must be in compliance with the applicable
regulations for shipping these materials by any ground or air carrier.
2. Infectious substances are NOT CATEGORIZED BY RISK GROUP. Federal agencies and
air carriers have adopted a simplified system of classification, with the nomenclature:
 Category A, Infectious Substances (See Table below)
 Category B, Biological Substances (See Table below)
 Exempt Patient Specimens (may be human or animal in origin)
3. You must notify the Biosafety Office whenever you are shipping any “Category A,
Infectious Substances,” or “Category B, Biological Substances” from the University.
Use the form below. Please print or type all information legibly. Email or fax submission is
sufficient. FAX: 303-724-0388.
4. You may need a Materials Transfer Agreement (MTA) to exchange biological materials with
colleagues and other outside entities. Please consult the CU Technology Transfer Office,
(303) 735-4525, for additional information.
5. You must be trained to properly prepare packages and shipping documents, including
shipments of research, clinical or diagnostic specimens. On-line training for Shipping of
Biological Materials is offered by the University for all UCDenver employees.
6. Questions on appropriate classification, documentation and packaging may be addressed to
the Biosafety Office, Dept. of Environmental Health and Safety, UCDenver, 303-724-0235.
7. Effective January 2006, shipping papers must be retained by shippers (your office) for two
(2) years. You may be required to produce these documents in the event of an inspection by
federal agencies.
8. Emergency Response Information
a. Chemtrec is our contracted, 24-hour response for emergencies or spills involving
shipments of dangerous goods. The telephone number to be used on Declaration of
Dangerous Goods is (800) 424-9300.
b. You must contact the Biosafety Office with the appropriate information about the
biological materials and Emergency Response/Spill Response information for any
“Category A, Infectious Agents” and “Category B, Biological Substances” being
shipped from this institution. The Biosafety Office will add this information to the
University profile maintained at Chemtrec.
Notification to BSO-Shipping of Biological Materials
Rev March 2014
c. Information for Category A Infectious Substances and “Category B, Biological
Substances” must include:
 Basic description and technical (scientific) name of the materials in the shipment.
You can use the MSDS (if available) for this. If you need an MSDS for an infectious
agent, check the Health Canada website. Alternatively you can use information from
the CDC BMBL or contact the Biosafety Office for assistance, prior to shipping.
 A description of any immediate hazards posed to life and health by the hazardous
materials if spilled or released.
 Any immediate precautions to be taken in the event of an incident.
 The initial methods for handling a spill or leak.
 Preliminary first aid methods.
Table 1
Category A Infectious
Substances
UN No. and proper shipping
name
UN 2814—Infectious
substances affecting
humans and animals
Micro-organism
Includes but is not limited to:
All Risk Group 4 infectious (viral) agents or specimens from patients suspected
or known to be infected with RG 4 agents.
Bacillus anthracis (cultures only).
Brucella abortus (cultures only).
Brucella melitensis (cultures only).
Brucella suis (cultures only).
Burkholderia mallei—aka Pseudomonas mallei—Glanders (cultures only).
Burkholderia pseudomallei—aka Pseudomonas pseudomallei (cultures only).
Chlamydia psittaci—avian strains (cultures only).
Clostridium botulinum (cultures only).
Coccidioides immitis (cultures only).
Coxiella burnetti (cultures only).
Dengue virus (cultures only).
Eastern equine encephalitis virus (cultures only).
Escherichia coli, verotoxigenic (cultures only).
Flexal virus.
Francisella tularensis (cultures only).
Hantaan virus.
Hantaviruses causing hemorrhagic fever with renal syndrome.
Hendra virus.
Human immunodeficiency virus (cultures only).
Highly pathogenic avian influenza virus (cultures only).
Japanese Encephalitis virus (cultures only).
Monkeypox virus.
Mycobacterium tuberculosis (cultures only).
Nipah virus
Poliovirus (cultures only).
Rabies and other lyssaviruses (cultures only).
Rickettsia prowazekii (cultures only).
Rickettsia rickettsia (cultures only).
Rift Valley fever virus (cultures only).
Notification to BSO-Shipping of Biological Materials
rev March 2014
Shigella dysenteriae type I (cultures only).
Variola virus.
Venezuelan equine encephalitis virus (cultures only).
Vesicular stomatitis virus (cultures only).
West Nile virus (cultures only).
Yellow fever virus (cultures only).
Yersinia pestis (cultures only)
Category A infectious
substances (continued)
UN No. and proper shipping
name
UN 2900—Infectious
substances affecting animals
only
Category B, Biological
Substances
Micro-organism
Includes but is not limited to:
African swine fever virus (cultures only).
Avian paramyxovirus Type 1—Velogenic Newcastle disease virus (cultures
only).
Classical swine fever virus (cultures only).
Foot and mouth disease virus (cultures only).
Lumpy skin disease virus (cultures only).
Mycoplasma mycoides—Contagious bovine pleuropneumonia (cultures
only).
Peste des petits ruminants virus (cultures only).
Rinderpest virus (cultures only).
Sheep-pox virus (cultures only).
Goatpox virus (cultures only).
Swine vesicular disease virus (cultures only).
Laboratory cultures and/or clinical specimens of any infectious substance which
does not meet the criteria for inclusion in Category A. Typically Risk Group 2
human pathogens.
Consult Biosafety Office (303-724-0235) if you need assistance.
Notification to BSO-Shipping of Biological Materials
rev March 2014
COMPLETE AND RETURN TO BIOSAFETY OFFICE PRIOR TO YOUR SHIPMENT
BY FAX TO 303-724-0388
OR
EMAIL TO [email protected]
Date:
Principal Investigator
Phone #:
Email:
Individual Preparing Shipment (Packaging and Documents)
Phone #:
Email:
I acknowledge that I have completed the appropriate training for shipment of
biological materials from the UCDenver campuses within the past 24 months.
Signature (Your email will substitute as an electronic signature for this form.)
Dept/Division & Mailstop:
Bldg:
Room:
Describe materials being shipped§ (i.e. scientific names, include volumes in metric
measurements, DOT classifications, packing group and other pertinent label information
(e.g. on dry ice, in 4% formalin, etc)
Ship to Address: (Name of individuals, exact shipping address and telephone contact)
Shipping Contractor: (e.g. Fedex, DHL, etc)
Tracking Number:
Date of Shipment:
Estimated Date of Delivery
Category A Materials: Infectious Substance affecting humans, UN2814 or Infectious
Substance affecting Animals, UN2900 OR Biological Substance, Category B, UN 3373,
for diagnostic, clinical or research specimens, not otherwise exempt.
§
EHS-BSF-004
Notification to BSO-Shipping of Biological Materials
Rev March 2014