this form on the lab/animal room door two weeks prior to start of protocol. / Date last revised: Date Posted:
Department: / Protocol #:
Room: / Building:
Authorized Personnel
/ Campus Phone / Home Phone / Pager/MobilePrincipal Investigator:
Authorized Personnel:
Authorized Personnel:
Precautions for this protocol (for assistance, contact OEH&S and/or DLAR)
Animal Species:Type of Hazard
Biohazardous Agents:
Check category and list agent(s) / [ ] BSL 1:
[ ] BSL 2:
[ ] human cell lines or human tumors*:
Location of Biosafety Cabinet
Chemical Agents (including gas anesthetics)**:
Radioisotopes**:
How long should precautions be followed?
(Note: You must notify DLAR each time these precautions should be instituted) / [x] One week
[ ] Duration of project
[..] Other______
Protective Clothing: / [x] gloves [x] dust mask [ ] N95 respirator
[ ] foot covers [ ] head cover/ bonnet [x] safety glasses
[ ] goggles [x] sleeves (while working in biological safety cabinet)
[x] for lab/ research staff: gown or lab coat
[x] other: recommend lab coat or disposable gown for DLAR staff
Route of Animal Excretion: / [x] urine [x] feces [ ] saliva
[ ] respiratory [ ] none expected
[ ] other:______
Animal Carcass Disposal: / [x] routine incineration [x] *chemical waste, see comments below
[ ] biohazardous waste [ ] radioactive waste
[x] other: *chemical hazard carcasses are to be placed in tagged waste containers, frozen and stored for disposal by OEHS, see comments below
Biohazardous Caging/Bedding Disposal: / [ ] regular waste
[ ] autoclave then treat as regular waste
Chemical or Radioactive Caging/Bedding Disposal: / Bedding:
[ ] regular waste [x] *chemotherapeutic/chemical waste, see below
[ ] radioactive decay [ ] radioactive waste
Caging:
[x] regular waste
[ ] autoclave then treat as regular waste
Surface and Equipment Decontamination [ ] radioactive decay [ ] other: ______/ [ ] autoclave [ ] bleach [ ] Spor-Klenz
[ ] quat. ammonia compound [x] regular cage wash procedure
[ ] any of the above marked options
Note: avoid using bleach on stainless steel surfaces (biosafety cabinets)
Animal Handling Precautions: / [ ] room pressurization negative to corridor
[x] biological safety cabinet used for cage changes and animal handling (req. for BSL 2)
Additional Precautions: (e.g.: immunizations, restricted access, special decontamination, specific waste disposal, etc.) / Employees who are pregnant, nursing or actively trying to conceive should be informed of potential reproductive hazards associated with cytotoxic (chemotherapy) drugs/ hazardous drugs, and advised to avoid any contact with these agents. Consultation with the PI and an Occupational Physician is recommended. Employees are advised to wear lab coats and latex gloves or nitrile rubber gloves when handling animal wastes for the first one week after treatment or when handling chemotherapy drugs. For the first one week throw away any contaminated materials used to handle or clean animal waste products after chemotherapy drug treatment.
*N95 respirators are recommended during handling of contaminated waste and/or contaminated bedding (risk of creating airborne dust). After one week from the last injection of chemotherapeutic agent it is metabolized by the animal and is no longer hazardous.
All hazardous chemotherapy-contaminated bedding materials or fecal material is to be disposed of in color-coded chemotherapy waste bags. Bedding is to be dumped from solid bottom cages in front of a filtered negative flow bedding dumping station into color-coded chemotherapy waste bags.
*Soiled empty cages must be placed directly into the automatic cage washer. Do not manually wash cages that housed animals given cytotoxic drugs/ hazardous drugs.
Liquid waste (ex. urine from urine collection devices) can be disposed of down the sanitary sewer (wash basin, hopper, sink) with copious amounts of water to ensure that no residue remains in the basin. Make sure to wear personal protective equipment (gloves, lab coat).
Hazardous drug/ cytotoxic waste (contaminated bedding, personal protective equipment, etc.) is to be disposed of in color-coded (yellow) chemotherapy waste bags and placed in specially marked cardboard boxes provided by OEHS. Use the yellow chemotherapy waste bags for chemotherapy waste only. Ask your DLAR Team Leader for supplies
Dry chemo waste (gloves, gowns, pads that are not grossly contaminated) will be disposed of as regular waste. Any residual drug left over in vials will be disposed of as hazardous chemical waste. Empty chemotherapy drug vials can be disposed of as hazardous chemical waste waste. Unused portions of chemotherapeutic drugs will be handled as hazardous chemical waste. Place the vials in the yellow plastic sharps container.
After one week from the last administration of cytotoxic drug the animal waste is no longer considered a chemical hazard. In this case (post one week after last exposure) the carcass can be placed in a regular bag for routine incineration
* If the animal is euthanized or expires before one week from the last chemotherapy injection the carcass is to be placed in a chemotherapy waste bag, then placed in a plastic tub, tagged with the IACUC protocol number and placed in the freezer for off-site incineration.
**NOTE: Individual cages must be identified with the hazardous agent, date of administration and appropriate hazard label.
1. My staff and I will comply with all standards for animal care and investigation established in the Guide for the Care and Use of Laboratory Animals and the Federal Animal Welfare Act, and will follow all policies established by the University to assure that these standards are met.
2. I assume responsibility for the work described here.
3. All individuals working with the animals on this protocol are qualified by virtue of training or experience to perform proper handling, experimental, and restraint techniques required for the species to be used.
4. I recognize my responsibility to identify occupational health hazards related to this protocol including identifying hazards, providing the necessary training for those involved, and supplying the appropriate protective clothing and equipment to minimize the risks.
5. This research does not represent unnecessary duplication of previous experiments.
6. I realize that failure to adhere to policies related to animal care and use may result in suspension or revocation of permission to perform animal research in Wayne State University facilities.
7. For more information please read the safety standard operation procedures (SOPs). The PI and OEHS will maintain a copy of the SOPs.
Signature of Principal Investigator
(must be original; no copies, image files, etc.) / Date
Approval Date (to be filled in by OEH&S):