[ Office use only ] IBC Application Number: Application received: Application approval date: Notifiable Low Risk Dealing (NLRD) Application Form Use this form to apply to the Curtin University Institutional Biosafety Committee for permission to carry out an NLRD. If you need assistance filling in this form then please contact the Biosafety Advisor, Dr Bernadette Bradley on 9266 1383 or 0401 103 655 or bernadette.bradley@curtin.edu.au . Abbreviations GMO genetically modified organism IBC Institutional Biosafety Committee NLRD notifiable low risk dealing OGTR Office of the Gene Technology Regulator PI Principle Investigator Identifying Information The Notifying Organisation is Curtin University of Technology, Accreditation Number Accr-105. The assessing IBC is the Curtin University Institutional Biosafety Committee. The Chair of the IBC is Assoc/Prof David Groth. The Executive Officer of the IBC is Dr Bernadette Bradley. 1. Application type Is this application for a new Dealing or a renewal of an old one? (Give any relevant previous IBC Approval Numbers for renewals) 2. Confidential Commercial Information (CCI) If your Dealing needs to be covered by CCI then please indicate it below (yes/no). The CCI information needs to be included in the final section of this Form, and it will be expurgated from the IBC Records. 3. Applicant Information The Principle Investigator (PI) of the Dealing being applied for must be a Curtin staff member, and NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 1 cannot be a postgraduate student. The PI is ultimately responsible for how the Dealing is performed, who performs it, how they are trained, and stewardship of the GMOs. 3.1 PI title and full name Position, Department and Faculty Phone number(s) Email address Summary of previous experience performing GM Dealings and working in OGTR-certified facilities. Have you completed the Curtin GMO training? The PI must nominate a Deputy PI for the Dealing, who will assume stewardship of the GMOs and the NLRD in the absence of the PI. The Deputy can be a staff member or a postgraduate student. 3.2 DPI Title and full name Position, Department and Faculty Phone number(s) Email address Summary of previous experience performing GM Dealings and working in OGTR-certified facilities. Have you completed the Curtin GMO training? The applicant may choose to name other researchers who will perform this Dealing, by copying and pasting the table above. 4. The classes of people who will be performing this Dealing Classes of person Will they perform the NLRD (i.e. handle the GMOs)? (yes/no) You may choose to name the people who will initially be involved in performing the Dealing. Have they completed the Curtin GMO training? (yes/no) PI DPI Postdoctoral Research Fellows Research Assistants Higher Degree by Research students Undergraduate students Animal Care Technicians Lab Technicians 5. Dealing Information 5.1 Dealing title NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 2 5.2 Description of the Dealing Please provide enough information, about the experimental work that you want to do involving GMOs, that the IBC can envision the processes. 5.3 Please advise about the desired start date and the estimated end date of the work 6. Source of the GMO 6.1 Identify the source of the GMO – will it be purchased from a supplier, gifted from a colleague, constructed during the Dealing, or other. Give details of any supplier or donor. 6.2 Will the GMO be imported under an AQIS permit and/or QWA Approval – if so, attach a copy of the permit/approval. 7. Details about the GMO(s) If you have different types of GMOs, and want to describe them separately, then you can copy and paste the table below as many times as you need to. 7.1 What are the common and scientific names of the living organism that will be the GMO? This is also referred to as the “parent organism” and the “host”. 7.2 If this organism produces spores then provide the spore size and normal method of transmission (e.g. airborne, splash-mobilised, etc). 7.3 What vector(s) and methods are to be used to transfer the genetic material? Provide copies of references (or vector maps) for novel vectors or methods of transfer. Include the name of the company supplying any commercially obtained vectors. State if plasmids are conjugative or non-conjugative. Which species of cells can be transformed/transfected/transduced by the vector. Note any special or uncommon features. 7.4 Are the proposed host/vector systems listed as Exempt host/vector systems in the reference material at the end of this form? NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 3 7.5 Have either the host or the vector been implicated in, or have a history of causing, disease in otherwise-healthy human beings, animals, plants or fungi? If so, then describe. 7.6 List all the types of modified DNA, genes and gene segments that have been introduced into the host and will remain in the GMO after the modification. Include the associated reporter genes and selectable markers, promoters, fluorescent tags etc. Name the organism that each piece of DNA originally came from. Describe the original function of each sequence and anything the gene encoded, if known. Note if the gene will be expressed in the GMO, and what the gene product is expected to do to the GMO. 7.7 If the GMO will then be placed inside or onto another organism, such as a mouse or plant, then name it. 8. When the GMO is a whole plant or is to be used in conjunction with a whole plant 8.1 If the parent organism or GMO is a weed, or closely related to plants that are weeds, then please identify this. 8.2 To what stage of development are the plants to be grown? Will the plant produce pollen or seeds? 8.3 Indicate the type of growth medium (soil or soil substitute) to be used, and how it will be subsequently sterilised or disposed of. 9. Risk assessment and management 9.1 Does the GMO, or the vector used to make the GMO, pose a threat to the health and safety of the people handling the GMO? What are the possible hazards from the proposed genetic modifications, and the likelihood and consequence of the hazards occurring? Note: GMOs and vectors that are made from organisms that are pathogenic to humans may be hazardous. 9.2 If unintentionally released from containment, does the GMO, or the vector used to make the GMO, pose a threat to the health and safety of people in the general population? What are the possible hazards from the proposed genetic modifications, and the likelihood and consequence of the hazards occurring? Note: GMOs and vectors that are made from organisms that are pathogenic to humans may be hazardous. NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 4 9.3 If unintentionally released into the environment, does the GMO, or the vector used to make the GMO, pose a threat to the health of organisms in the environment, or their position in the ecosystem? What are the possible hazards from the proposed genetic modifications, and the likelihood and consequence of the hazards occurring? Note: GMOS and vectors that are made from organisms that are pathogenic to animals, plants or fungi may be hazardous. GMOs might outcompete non-GMOs in the environment. 9.4 Over and above the precautions that are outlined in the OGTR PC2 Procedures or Guidelines, are there any other actions and precautions you will take to minimise risks posed by the proposed dealing(s)? 9.5 In addition to those actions listed below, which are required, what (if any) are the steps will you take in the event of an unintentional release of the GMO(s)? In the event of an unintentional release of GMOs from containment, I will notify the Manager of the certified facility that housed the GMO, plus the Biosafety Advisor, Dr Bernadette Bradley as soon as possible, by phone on 0401 103 655 and by email bernadette.bradley@curtin.edu.au . 10. Kind of NLRD Refer to the kinds of NLRDs listed in the reference material at the end of this form, and list the category(s) of NLRD you will do. 11. Facility Information Identify which OGTR-Certified facility or facilities you will perform the Dealing in. Note that use of a facility is at the discretion of the Facility Manager. Facility name Facility type B308 Rm 140-144 B305 L2 East Wing B305 L2 West Wing B300 animal facility B300 Rm111-123 B300 Rm155 B300 Rm147-148 B300 PC3 lab B126G Glasshouse B126K Convirons PC2 lab PC2 lab PC2 lab PC2 animal facility PC2 lab PC2 lab PC2 plant facility PC3 lab PC2 plant facility PC2 lab (plant) Certification number 2405 3489 3490 2406 2407 3085 3086 2541 3370 future Facility Manager The NLRD will be done here (yes/no) TBA Dr Rob Steuart Dr Rob Steuart Dr Beng Chua Dr Beng Chua Dr Beng Chua Dr Beng Chua Dr Beng Chua Mr John Jackson Mr John Jackson NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 5 12. Storage outside the Certified facility 12.1 Identify the site(s) of any storage outside the Certified facility. 12.2 If you will be storing your GMO using methods that differ from those described in the Guidelines for Transport, Storage and Disposal of GMOs, then describe the conditions by replacing the text below. Leaving the text below indicates that you will comply with the Guidelines. I will be storing my GMOs following the methods described in the OGTR Guidelines for Transport, Storage and Disposal of GMOs. 13. Transport outside of a Certified facility If you will be transporting your GMO using methods that differ from those described in the Guidelines for Transport, Storage and Disposal of GMOs, then describe the transport methods by replacing the text below. Leaving the text below indicates that you will comply with the Guidelines. I will be transporting my GMOs following the methods described in the OGTR Guidelines for Transport, Storage and Disposal of GMOs. 14. Disposal of the GMO 14.1 If you will be disposing of your GMO using methods that differ from those described in the Guidelines for Transport, Storage and Disposal of GMOs, then describe the disposal methods by replacing the text below. Leaving the text below indicates that you will comply with the Guidelines. I will be disposing of my GMOs following the methods described in the OGTR Guidelines for Transport, Storage and Disposal of GMOs. 14.2 Which chemical disinfectant(s) will be used to disinfect surfaces that the GMO has been handled over? 14.3 Below, write the procedure to decontaminate a spill of your GMO. 15. Confidential Commercial Information Include any CCI information below, or as an attachment to this form. It will be expurgated from the IBC Minutes. Please also explain why the information is sensitive. NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 6 The reference material below comes from the Gene Technology Regulations 2001. It includes the table of Host/vector systems for exempt dealings, and the kinds of NLRDs. Host/vector systems for exempt dealings Item 1 Class Host Vector Bacteria Escherichia coli K12, E. coli B, E. coli C or E. coli Nissle 1917 — any derivative that does not contain: (a) generalised transducing phages; or (b) genes able to complement the conjugation defect in a non-conjugative plasmid 1. Non-conjugative plasmids Bacillus — specified species — asporogenic strains with a reversion frequency of less than 10–7: (a) B. amyloliquefaciens (b) B. licheniformis (c) B. pumilus (d) B. subtilis (e) B. thuringiensis Pseudomonas putida — strain KT 2440 2. Bacteriophage (a)lambda (b) lambdoid (c)Fd or F1 (eg M13) 3. None (non-vector systems) 1. Non-conjugative plasmids 2. Plasmids and phages whose host range does not include B. cereus, B. anthracis or any other pathogenic strain of Bacillus 3. None (non-vector systems) 1. Non-conjugative plasmids including certified plasmids: pKT 262, pKT 263, pKT 264 2. None (non-vector systems) Streptomyces — specified species: (a) S. aureofaciens (b) S. coelicolor (c) S. cyaneus (d) S. griseus (e) S. lividans (f) S. parvulus (g) S. rimosus (h) S. venezuelae 1. Non-conjugative plasmids Agrobacterium radiobacter Agrobacterium rhizogenes — disarmed strains Agrobacterium tumefaciens — disarmed strains 1. Non-tumorigenic disarmed Ti plasmid vectors, or Ri plasmid vectors 2. Certified plasmids: SCP2, SLP1, SLP2, PIJ101 and derivatives 3. Actinophage phi C31 and derivatives 4. None (non-vector systems) 2. None (non-vector systems) NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 7 Item 2 3 Class Fungi Slime moulds Host Vector Lactobacillus Lactococcus lactis Oenococcus oeni syn. Leuconostoc oeni Pediococcus Photobacterium angustum Pseudoalteromonas tunicata Rhizobium (including the genus Allorhizobium) Sphingopyxis alaskensis syn. Sphingomonas alaskensis Streptococcus thermophilus Synechococcus — specified strains: (a) PCC 7002 (b) PCC 7942 (c) WH 8102 Synechocystis species — strain PCC 6803 Vibrio cholerae CVD103-HgR 1. Non-conjugative plasmids Kluyveromyces lactis Neurospora crassa — laboratory strains Pichia pastoris Saccharomyces cerevisiae Schizosaccharomyces pombe Trichoderma reesei Yarrowia lipolytica 1. All vectors Dictyostelium species 1. Dictyostelium shuttle vectors, including those based on the endogenous plasmids Ddp1 and Ddp2 2. None (non-vector systems) 2. None (non-vector systems) 2. None (non-vector systems) 4 Tissue culture Any of the following if they cannot spontaneously generate a whole animal: (a) animal or human cell cultures (including packaging cell lines); (b) isolated cells, isolated tissues or isolated organs, whether animal or human; (c) early non-human mammalian embryos cultured in vitro 1. Non-conjugative plasmids 2. Non-viral vectors, or replication defective viral vectors unable to transduce human cells 3. Baculovirus (Autographa californica nuclear polyhedrosis virus), polyhedrin minus 4. None (non-vector systems) NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 8 Item Class Host Vector Either of the following if they are not intended, and are not likely without human intervention, to vegetatively propagate, flower or regenerate into a whole plant: (a) plant cell cultures; (b) isolated plant tissues or organs 1. Non-tumorigenic disarmed Ti plasmid vectors, or Ri plasmid vectors, in Agrobacterium tumefaciens, Agrobacterium radiobacter or Agrobacterium rhizogenes 2. Non-pathogenic viral vectors 3. None (non-vector systems) NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 9 Notifiable low risk dealings in relation to a GMO (regulations 12 and 13) Part 1 Notifiable low risk dealings suitable for at least physical containment level 1 Note Because of subregulation 12 (1), a dealing mentioned in this Part is not a notifiable low risk dealing if it is also a dealing of a kind mentioned in Part 3. 1.1 Kinds of dealings suitable for at least physical containment level 1 The following kinds of notifiable low risk dealings must be undertaken, unless paragraph 13 (2) (c) or 13 (3) (b) applies, in facilities certified to at least physical containment level 1 and that are appropriate for the dealings: (a) a dealing involving a genetically modified laboratory guinea pig, a genetically modified laboratory mouse, a genetically modified laboratory rabbit or a genetically modified laboratory rat, unless: (i) an advantage is conferred on the animal by the genetic modification; or (ii) the animal is capable of secreting or producing an infectious agent as a result of the genetic modification; (c) a dealing involving a replication defective vector derived from Human adenovirus or Adeno associated virus in a host mentioned in item 4 of Part 2 of Schedule 2, if the donor nucleic acid: (i) cannot restore replication competence to the vector; and (ii) does not: (A) confer an oncogenic modification in humans; or (B) encode a protein with immunomodulatory activity in humans. Part 2 Notifiable low risk dealings suitable for at least physical containment level 2 or 3 Note Because of subregulation 12 (1), a dealing mentioned in this Part is not a notifiable low risk dealing if it is also a dealing of a kind mentioned in Part 3. 2.1 Kinds of dealings suitable for at least physical containment level 2 The following kinds of notifiable low risk dealings must be undertaken, unless paragraph 13 (2) (c) or 13 (3) (b) applies, in facilities certified to at least physical containment level 2 and that are appropriate for the dealings: (a) a dealing involving whole animals (including non-vertebrates) that: (i) involves genetic modification of the genome of the oocyte or zygote or early embryo by any means to produce a novel whole organism; and (ii) does not involve any of the following: (A) a genetically modified laboratory guinea pig; (B) a genetically modified laboratory mouse; (C) a genetically modified laboratory rabbit; NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 10 (aa) (b) (c) (d) (D) a genetically modified laboratory rat; (E) a genetically modified Caenorhabditis elegans; a dealing involving a genetically modified laboratory guinea pig, a genetically modified laboratory mouse, a genetically modified laboratory rabbit, a genetically modified laboratory rat or a genetically modified Caenorhabditis elegans, if: (i) the genetic modification confers an advantage on the animal; and (ii) the animal is not capable of secreting or producing an infectious agent as a result of the genetic modification; a dealing involving a genetically modified plant; a dealing involving a host/vector system not mentioned in paragraph 1.1 (c) or Part 2 of Schedule 2, if neither host nor vector has been implicated in, or has a history of causing, disease in otherwise healthy: (i) human beings; or (ii) animals; or (iii) plants; or (iv) fungi; a dealing involving a host and vector not mentioned as a host/vector system in Part 2 of Schedule 2, if: (i) the host or vector has been implicated in, or has a history of causing, disease in otherwise healthy: (A) human beings; or (B) animals; or (C) plants; or (D) fungi; and (ii) the donor nucleic acid is characterised; and (iii) the characterisation of the donor nucleic acid shows that it is unlikely to increase the capacity of the host or vector to cause harm; Example Donor nucleic acid would not comply with subparagraph (iii) if, in relation to the capacity of the host or vector to cause harm, it: (a) provides an advantage; or (b) adds a potential host species or mode of transmission; or (c) increases its virulence, pathogenicity or transmissibility. (e) a dealing involving a host/vector system mentioned in Part 2 of Schedule 2, if the donor nucleic acid: (i) encodes a pathogenic determinant; or (ii) is uncharacterised nucleic acid from an organism that has been implicated in, or has a history of causing, disease in otherwise healthy: (A) human beings; or (B) animals; or (C) plants; or (D) fungi; (f) a dealing involving a host/vector system mentioned in Part 2 of Schedule 2 and producing more than 25 litres of GMO culture in each vessel containing the resultant culture, if: (i) the dealing is undertaken in a facility that is certified by the Regulator as a large scale facility; and NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 11 (ii) the donor nucleic acid satisfies the conditions set out in subitem 4 (2) of Part 1 of Schedule 2; (g) a dealing involving complementation of knocked-out genes, if the complementation is unlikely to increase the capacity of the GMO to cause harm compared to the capacity of the parent organism before the genes were knocked out; Example A dealing would not comply with paragraph (g) if it involved complementation that, in relation to the parent organism: (a) provides an advantage; or (b) adds a potential host species or mode of transmission; or (c) increases its virulence, pathogenicity or transmissibility. (h) a dealing involving shot-gun cloning, or the preparation of a cDNA library, in a host/vector system mentioned in item 1 of Part 2 of Schedule 2, if the donor nucleic acid is derived from either: (i) a pathogen; or (ii) a toxin-producing organism; (i) a dealing involving the introduction of a replication defective viral vector unable to transduce human cells into a host not mentioned in Part 2 of Schedule 2, if the donor nucleic acid cannot restore replication competence to the vector; (j) a dealing involving the introduction of a replication defective non-retroviral vector able to transduce human cells, other than a dealing mentioned in paragraph 1.1 (c), into a host mentioned in Part 2 of Schedule 2, if the donor nucleic acid cannot restore replication competence to the vector; (k) a dealing involving the introduction of a replication defective non-retroviral vector able to transduce human cells into a host not mentioned in Part 2 of Schedule 2, if: (i) the donor nucleic acid cannot restore replication competence to the vector; and (ii) the donor nucleic acid does not: (A) confer an oncogenic modification in humans; or (B) encode a protein with immunomodulatory activity in humans; (l) a dealing involving the introduction of a replication defective retroviral vector able to transduce human cells into a host mentioned in Part 2 of Schedule 2, if: (i) all viral genes have been removed from the retroviral vector so that it cannot replicate or assemble into a virion without these functions being supplied in trans; and (ii) viral genes needed for virion production in the packaging cell line are expressed from independent, unlinked loci with minimal sequence overlap with the vector to limit or prevent recombination; and (iii) either: (A) the retroviral vector includes a deletion in the Long Terminal Repeat sequence of DNA that prevents transcription of genomic RNA following integration into the host cell DNA; or (B) the packaging cell line and packaging plasmids express only viral genes gagpol, rev and an envelope protein gene, or a subset of these; (m) a dealing involving the introduction of a replication defective retroviral vector able to transduce human cells into a host not mentioned in Part 2 of Schedule 2, if: (i) the donor nucleic acid does not: (A) confer an oncogenic modification in humans; or (B) encode a protein with immunomodulatory activity in humans; and NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 12 (ii) all viral genes have been removed from the retroviral vector so that it cannot replicate or assemble into a virion without these functions being supplied in trans; and (iii) viral genes needed for virion production in the packaging cell line are expressed from independent, unlinked loci with minimal sequence overlap with the vector to limit or prevent recombination; and (iv) either: (A) the retroviral vector includes a deletion in the Long Terminal Repeat sequence of DNA that prevents transcription of genomic RNA following integration into the host cell DNA; or (B) the packaging cell line and packaging plasmids express only viral genes gagpol, rev and an envelope protein gene, or a subset of these. 2.2 Kinds of dealings suitable for at least physical containment level 3 Any kind of dealing mentioned in this Part involving a micro-organism that satisfies the criteria in AS/NZS 2243.3:2010 for classification as Risk Group 3 must be undertaken, unless paragraph 13 (2) (c) or (3) (b) applies, in facilities that are: (a) certified to at least physical containment level 3; and (b) appropriate for the dealing. NLRD Application Form – Version 3 - Rev February 2015 by the Biosafety Advisor Page 13