APPENDIX A: Room/Lab Safety Sheet (RLSS) Information
1.List agent, materials, biohazard, or chemical to be used in animals:
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2.Provide short description of the agent, material, biohazard, or chemical:
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3.The agent, material, biohazard, or chemical is HAZARDOUS for:
☐- Animals
☐- Humans
☐- Both
If animals is checked, for which species?
4. The agent can be spread by:
☐- Blood
☐- Feces/Urine
☐- Saliva/Nasal droplets
☐- Does not leave the animal
☐- Other – please describe: Click here to enter text.
4.Describe any human health risk associated with this agent: (i.e.: effects of overexposure, eye contact, skin contact, inhalation, ingestion, target organs, etc.)
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6. Please check the precautions below that will apply to this protocol:
a. The following items must be assumed to be contaminated with hazardous material and must be handled only by the researcher or his/her technicians:
☐Cage/Pen/Stall/Tank
☐Animal carcasses
☐Bedding
☐Water bottle or other watering device
☐Other – please describe:Click here to enter text.
b. ☐Cages must be autoclaved before cleaning
c. ☐Label cages and remove label after decontamination
d. Animal carcasses must be labeled and disposed of as follows:
☐Standard animal facility disposal method (i.e. Biohazardous waste containers for Stericycle pick-up)
☐Needs to be bagged and autoclaved prior to removal from animal facility
☐EH&S will pick-up (2-1493)
☐Incineration
e. All contaminated waste (soiled bedding or other animal waste) must be properly labeled and disposed of as follows:
☐Standard animal facility disposal method(i.e. Biohazardous waste containers for Stericycle pick-up)
☐Needs to be bagged and autoclaved prior to removal from animal facility
☐EH&S will pick-up (2-1493)
☐Incineration
f. The researcher or his/her technicians are responsible for the feeding and care of these animals.
YES ☐ NO ☐
7. Please check the following Personal Protective Equipment required to be worn/used in animal room:
☐Lab Coat/Coveralls☐Shoe Covers/Booties
☐Disposable gloves☐Head cover
☐Face mask☐Disinfectant footbath
☐Eye Protection/Face shield☐Fitted respiration – Type: Choose an item.
☐Other – please describe: Click here to enter text.
a. ☐Personal protective equipment must be removed before leaving the room
b. ☐Personal protective equipment must be discarded or decontaminated at the end of the project
c. ☐Hands and arms must be thoroughly washed upon leaving the room
d. ☐Full shower, including washing of hair, must be taken upon leaving the room
e. ☐Decontaminate room (Inform vivarium area supervisor when cage and/or room can be returned to general use)
8. Provide any other information needed to safely work in this room:
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