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Formalin-free surgical specimen management: transforming the workflow

An innovative vacuum packing solution has been adopted in order to reduce formalin use and exposure throughout the Cwm Taf Morgannwg University Health Board in Wales, as the following overview of progress illustrates.

Cwm Taf Morgannwg UHB, South Wales, provides healthcare services for the population of Merthyr Tydfil County Borough, Rhondda Cynon Taf and Bridgend County Borough. The United Kingdom Accreditation Service (UKAS)-accredited cellular pathology department is split over two sites, one large laboratory at the Royal Glamorgan Hospital (RGH), and a smaller ‘satellite’ laboratory for specimen receipt at Prince Charles Hospital (PCH). Both sites have theatres that send surgical specimens for histological analysis. Concerns about the health effects of formalin (formaldehyde) exposure, reclassified as a Class 1 carcinogen to humans (IARC) prompted the Health Board to assess ways to reduce staff exposure. Critical exposure points for hospital personnel were identified as the theatre area and during transfer of specimens to the pathology laboratory.

Situation before adoption of vacuum packing solutions

Prior to adoption of vacuum packing, 10% neutral buffered formalin (NBF) was made up in 50-L batches from concentrate, as and when required in the cellular pathology specimen reception areas of RGH and PCH. Theatre staff would replenish NBF by bringing empty carboys to the laboratory area and refilling. The filled carboys would be carried back to the theatre area and kept in sluice rooms near to the operating theatres where formalin was manually decanted into specimen buckets.

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