Download Risk Assessment Form For Transgenic Animal (rev4)

Local Genetic Modification Safety Committee
THE GENETICALLY MODIFIED ORGANISMS (CONTAINED USE) REGULATIONS 2000
FURTHER DETAILS
http://www.hse.gov.uk/biosafety/gmo/acgm/acgmcomp/
RISK ASSESSMENT FORM FOR TRANSGENIC ANIMAL (REV4)
This form should be used for preliminary assessment of all transgenic animals.
Provide sufficient information for each table entry to justify your proposal.
Name of principle investigator:
Status (eg staff/PG)
Project licence holder
(This person is responsible for project)
Address of research laboratory
Telephone:
Fax:
E-mail:
Project licence number:
Species and name of strain:
List all workers (staff and students) involved in the
transgenic animal work and include date of GMM
medical if known
1.
… …………………………...….
2.
………………………………….
3.
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4.
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5.
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Room and building where animals are housed:
Description of transgene or knockout including:
Nature of DNA introduced, including details of
heterologous promoters and genes*
Identity of targeted locus (in the case of a
knockout)*
Method of DNA introduction (e.g. oocyte
injection, homologous recombination in
embryonic stem cells, etc.)
Source (External supplier, or internally
generated)
Reference (if published)
*
indicate normal function of disrupted or misexpressed gene
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Perceived risk
To users and handlers
Is this construct designed or likely to
generate or activate pathogens or toxins
to which a user/handler may be exposed?
Could the genetic modification cause the
animals or their progeny to become the
host for human pathogen(s)?
Other
To environment
Is this construct likely to confer a
growth/survival advantage to the animal?
Is this construct designed to generate
pathogens that may have a
survival/growth advantage?
Is the modification likely to render the
animals and their progeny resistant to
control measures?
Other
Of escape
(This should essentially be zero unless animals
are regularly removed from the transgenic
facility alive for experiments. Even in this case,
transgenic animals should be being removed
only to HO-approved labs which should have
been assessed as being escape-proof)
Summary of Risk Assessment:
Date of assessment:
Signed by the assessor:
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