Protocol Involving the Use of Hazardous Chemicals in Animals
Principal Investigator(s):
Protocol Title:
Contact Person Name:
IACUC Number:
Phone Number:
Chemical Name and CAS Number
(Include synonyms)
Highest
Conc.
Type of Hazard
(e.g. carcinogen)
MSDS
Posted/Present
Yes
No
Health Hazard/ Route of Entry
Acute Effect
Chronic Effects
Description
Skin Absorption / Contact
Inhalation
Eye exposure
Ingestion
Injection
Exposure Controls
Personal Protective Equipment Use
Gloves *Check integrity of gloves before each use.
Safety glasses/goggles
Lab Coat
Apron
Respirator/ Mask
Other: (i.e. double glove, barrier cream)
Animal Care
ARC will provide daily observation,
feeding/watering and cage cleaning
ARC will provide daily observation; Lab
responsible for feeding/watering and cage
cleaning
Lab is responsible for both daily observation
and cage cleaning
Biological Safety cabinet required for cage
cleaning
Chemical Fume hood required for cage
cleaning
Specify type:
Specify type:
Specify:
Disposal
Bedding disposed routinely (landfill)
Bedding disposed of in red bags as
biomedical waste
Bedding disposed of in red bags as
biomedical waste after autoclaving. Location
of autoclave:
Bedding disposed of in yellow bags as
hazardous waste
Animals disposed of in red bags as
biomedical waste
Animals disposed of in red bags as
biomedical waste after autoclaving. Location
of autoclave:
Animals disposed of as hazardous waste
Spill procedures:
Signing of this document indicates that I understand these hazards and agree to follow these procedures .
Name
Date
I hereby acknowledge that research staff are authorized to shut down this project if there is an imminent danger.
Name
Date
A COMPLETED COPY OF THIS FORM MUST BE POSTED IN HOUSING AND PROCEDURE ROOMS WHEN HAZARDOUS
CHEMICALS ARE USED IN ANIMAL STUDIES.