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BIOHAZARD RISK ASSESSMENT Information on Biological Material Type: ________________________________________________________________ Denomination: _______________________________________________________________ Code no.(if available)__________________________________________________________ Hazard level: ________________________________________________________________ Pathogenicity for human yes no unknown Pathogenicity for animals yes no unknown Laboratory information Medium and other reagents: ____________________________________________________ Number/concentration viable agent/cell _____________________________________________ Other information: ____________________________________________________ Pathogen contamination Bacteria, fungi, yeasts yes no unknown Mycoplasma yes no unknown Virus yes no unknown Indicate contamination by the following human viruses HBV: yes no unknown HCV. yes no unknown HIV: yes no unknown Others: ___________________________________________________________________ Reference : Directive 93/88/EEC, 1993 www.who.org/emc/biosafe/index.htm Anon 1996a. Categorization of pathogens according to hazard and categories of containment. Fourth edition. Advisory Committee on Dangerous Pathogens (ACSP). London: HMSO Date (dd/mm/yyyy) ____/____/______ Depositor Signature ______________________ BIOBANKING OF VETERINARY RESOURCES ISTITUTO ZOOPROFILATTICO SPERIMENTALE DELLA LOMBARDIA E DELL’EMILIA ROMAGNA -WEB www.ibvr.org VIA BIANCHI 9 - 25124 BRESCIA (ITALY) - TEL +39 030 2290536 - FAX +39 030 2290386 -E-MAIL [email protected] VAT NUMBER IT: 00284840170
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