Download Bio-safety Precautions in Animal Rooms Form

BIOSAFETY PRECAUTIONS IN ANIMAL ROOMS
must be posted on door prior to housing animals
Agent:
Animal Bio-Safety Level
IACUC Protocol #
Building/Room#:
IBRDSC Protocol #
Investigator:
1.
2.
3.
4.
5.
Dept:
This agent is: 9 Bacteria
9 Parasite
This agent is infectious for:
9 Virus 9 Fungus
9 SE agent (prion)
BIOHAZARD
9 Humans only
9 Animals only
9 Humans and Animals
The agent can be spread in: 9 Blood
9 Feces/Urine
9 Saliva/nasal droplet
9 Placental fluid
9 Does not leave animal
You can become infected in the following way(s):
9 Ingestion..contaminated hands, clothing
9 Inhalation
9 Mucus membranes..contact with eyes/nose/mouth
9 Contact with breaks in skin
9 Biological vector....tick or insect bite
Sticker Here
If you are exposed to this agent, you may develop the following clinical signs:
6.
The following applies to the management/husbandry of these animals:
9 Researcher or his/her staff is responsible for the feeding and care.
9 All cages must be autoclaved before cleaning.
Animal carcasses must be labeled and disposed of as follows:
9 No special handling needed
9 Incineration
9 Bag and autoclave
9 Bio-hazardous waste container
Soiled bedding or other waste must be disposed of as follows:
9 No special handling needed
9 Incineration
9 Bag and autoclave
9 Bio-hazardous waste container
The following personal protective equipment must be used in the room:
9 Lab coat/overalls
9 Shoe covers/boots
9 Disposable gloves
9 Disinfectant footbath
9 NIOSH certified N95
9 Fitted respirator w/HEPA filters
Other information or procedures:
Investigator:
Biological Safety Manager:
Date:
IACUC Chair:
Date:
Date: