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Postal Explorer > Publication 52 - Hazardous, Restricted, and Perishable Mail > Appendix C USPS Packaging Instructions for Mailable Hazardous Materials > USPS Packaging Instruction 6H
(Regulated medical waste, sharps waste, and used health care products
classified in Risk Group 1 must be packaged and mailed under the applicable
requirements in Packaging Instructions 6E or 6F.)
A diagnostic (clinical) specimen in Risk Group 4 or a biological product in
Risk Group 2, 3, or 4 must be packaged under DMM 601.10.17.5. A
diagnostic specimen in Risk Group 2 or 3 must be packaged under DMM
601.10.17.6. The packaging of a diagnostic specimen in Risk Group 1 (e.g.,
a urine specimen or blood specimen used in drug testing programs or for
insurance purposes) or a biological product (e.g., polio vaccine) in Risk
Group 1 is subject to the following standards:
• Not applicable (not regulated under 49 CFR as a hazardous material in
domestic commerce).
• International Mail: Mailable only via registered airmail letterpost with
prior written approval from the Manager, Mailing Standards as
permitted in 622.2 and IMM135.
• Domestic Mail: Mailable only as First-Class Mail, Priority Mail, Express
Mail, or Parcel Post.

• A diagnostic specimen or biological product consisting of 50 ml or less
per mailpiece must be packaged in a securely sealed primary
receptacle.
• Two or more primary receptacles whose combined volume does not
exceed 50 ml may be enclosed within a single mailpiece.
• Sufficient absorbent material and cushioning material to withstand
shock and pressure changes must surround the primary receptacle(s),
or be otherwise configured to take up the entire liquid contents in case
of leakage.
Secondary Container
• The primary receptacle(s) and the absorbent cushioning must be
enclosed in a secondary container having a leakproof barrier that can
prevent failure of the secondary container.
• The secondary container must be securely sealed, and it may serve as
the outer shipping container, provided it has sufficient strength to
withstand ordinary Postal Service processing.
• The secondary container must be marked with the international
biohazard symbol except when the secondary container also serves as
the outer shipping container (See Exhibit 346.32e). In that case, the
biohazard symbol must appear either on the inner packaging or on the
primary container.
Marking/Documentation
• The biohazard symbol should not appear on the outer shipping
container.
• A shipping paper and content markings on the outer shipping container
are not required.
• Each mailpiece must bear a comoplete delivery and return address.

• A clinical specimen or biological product that exceeds 50 ml must be
packaged in a securely sealed primary receptacle.
• A single primary receptacle must not contain more than 500 ml of
specimen.
• Two or more primary receptacles whose combined volume does not
exceed 500 ml may be enclosed in a single secondary container.
• Sufficient absorbent material and cushioning material to withstand
shock and pressure changes must surround the primary receptacle(s),
or be otherwise configured to take up the entire liquid contents in case
of leakage.
Secondary Container
• The primary receptacle(s) and the absorbent cushioning must be
enclosed in a secondary container having a leakproof barrier that can
prevent failure of the secondary container if the primary receptacle(s)
should leak during transport.
• The secondary container cannot serve as the outer shipping container.
• The secondary container must be marked with the international
biohazard symbol (See Exhibit 346.32e).
Outer Shipping Container
• The secondary container must be securely and snugly enclosed in a
fiberboard box or container of equivalent strength that serves as the
outer shipping container.
• The maximum amount of a specimen that may be enclosed in a single
mailpiece must not exceed 4,000 ml.

Marking/Documentation
• The biohazard symbol should not appear on the outer shipping
container.
• A shipping paper and content markings on the outer shipping container
are not required.
• Each mailpiece must bear a complete delivery and return address.
Primary Receptacle
• A solid or dry specimen, such as a saliva swab, blood spot, or fecal
smear in Risk Group 1 must be completely dried prior to placing it in or
on a secure primary receptacle.
• Cushioning material to withstand shock and pressure changes is
required only if the dry specimen is held in a breakable primary
receptacle.
• When required, the cushioning material must surround the primary
receptacle to prevent breakage or damage to the primary receptacle.
Secondary Container
• The primary receptacle (and cushioning material, if required) must be
enclosed in a secondary container having a leakproof barrier that can
prevent failure of the secondary container if the primary receptacle
breaks during shipment.
• The secondary container must be securely sealed and it may serve as
the outer shipping container provided it has sufficient strength to
withstand ordinary Postal Service processing.
• The secondary container must be marked with the international
biohazard symbol (See Exhibit 346.42C) except when the secondary
container also serves as the outer shipping container. In that case, the
biohazard symbol must appear either on the inner packaging or on the
primary container.

Marking/Documentation
• The biohazard symbol should not appear on the outer shipping
container.
• A shipping paper and a content marking on the outer shipping container
are not required.
• Each mailpiece must bear a complete delivery and return address.
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