Appendix A :
Good Laboratory Practices Questionnaire
Name of Laboratory: ____________________________________ Date: ______________
Address: _________________________________________________________________
Country:_____________________ Tel: _________________________________________
E-mail address:______________________________Fax:___________________________
Head of the laboratory: _____________________________________________________
Position: _________________________________________________________________
1. BIOSAFETY
General Laboratory Safety
Personnel has received laboratory safety training....……………………………..…………………………. Yes No
A « Safety Handbook » is provided to each new arrival ……………………………………………………. Yes No
Biosafety regulations are documented, updated, and available for consultation ………………………… Yes No
Hazard warning labels are properly used: UV, lasers, radioactive substances, etc. .............................. Yes No
The laboratory is equipped with an eyewash station............................................................................... Yes No
The laboratory is equipped with an emergency shower ……………........................................................ Yes No
Laboratory equipment is clearly labeled for biological hazard, toxic risk, etc.……………………............. Yes No
Flammable substances are stored in a safety cabinet ............……………...........…............................... Yes No
Food and drinks are not permitted in the laboratory ……………………………………..…………………. Yes No
Biosafety practices include:
a. Washing of hands …………………………………………………………………………………..Yes No
b. Use of mechanical pipettes………………………………………………………….……………..Yes No
c. Wearing of gloves, lab coats, and protective eyewear ………………………………………… Yes No
e. Decontamination of all trash containers containing infected waste ….………………………. Yes No
f. Decontamination of laboratory bench tops……………………………………………………….. Yes No
The head of the laboratory maintains a safety logbook of incidents/accidents that have occurred on
site…………………………………………………………………………………………………………………. Yes No
The laboratory is equipped with a water and a powder fire extinguisher………………………………….. Yes No
Lab technicians have been trained in or are familiar with the use of fire extinguishers………….……… Yes No
Emergency exits in the laboratory are clearly marked ………………………………………………….…... Yes No
Laboratories are checked that lab coats are replaced, areas are tidy, supplies are kept up to date…… Yes No
Emergency instructions in case of exposure to chemical or biological hazards are posted in the laboratory……….
……………………………………………………………………………………………………………………... Yes No
Freezer gloves for temperatures to minus 80°C are located near the freezers…………………………… Yes No
Equipment
Scientific instruments are in working order and in good condition………………………………………… Yes No
Scientific instruments have identification and registration numbers……………………………………… Yes No
Scientific instruments are checked regularly in accordance with recommendations, and dates of maintenance are
recorded …………………………………………………………………………………………………………. Yes No
The temperatures of incubators, refrigerators, and freezers are recorded daily………………………….. Yes No
The measurement accuracy of balances is checked………………………………………………………… Yes No
The measurement accuracy of pipettes is checked…………………………………………………………. Yes No
Key lab equipment (refrigerators, freezers, PCR machines) is connected to a backup power system… Yes No
Backup cold storage is available in case of breakdown of refrigerators or freezers …………………….. Yes No
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Appendix A :
Good Laboratory Practices Questionnaire
Level 2 Laboratory Biosafety:
Access to the laboratory is restricted to authorized personnel……………………………………………... Yes No
Access is restricted to personnel aware of risk of exposure to all types of hazards………………..……. Yes No
Biological hazard warning signs are posted at the laboratory entrance.…………………........................ Yes No
Mandatory individual protective equipment (protective smocks, gloves, eyewear) is worn exclusively in the
laboratory………………………………………………………………………….……………………………… Yes No
Lab wear and street wear are kept in distinctly separate lockers. .......……............................................ Yes No
Air pressure in the different laboratory rooms is monitored. ………………..……………………………… Yes No
Procedures have been set up in case of changes in pressure differential………………………………... Yes No
Biological Safety Cabinets (BSC)
Biological safety cabinets are maintained according to specifications, including the replacement of air filters, and
dates of maintenance are recorded. ………………………………………………………………………….. Yes No
A complete inventory of pathogens and other potentially infectious specimens is maintained………… Yes No
The BSCs received prior year certification.......……………………………………..................................... Yes No
The BSC workbench is appropriately disinfected before and after each use………………………….…. Yes No
Biological safety cabinets are uncluttered. …………………………………………………………………… Yes No
Air grates and evacuation filters are clog-free ..……………………………………………………………… Yes No
Centrifuge buckets and rotors can only be opened inside a BSC .........………....................................... Yes No
Infectious samples for use outside a BSC are carried in approved containers that meet specified regulations for
transport of such samples ....................……………………………………………………………………….. Yes No
Pipettes are exclusively assigned to a microbiological security station and cannot be used at other
workbenches………………..……………………………………………………………………………………. Yes No
All BSC wastes (bacteriological loops, spreaders, cones, suspensions) are discarded into a workbench container,
sealed, and transferred to DASRI for disposal ……….…………………………………………..…………. Yes No
Specimen handling is carried out exclusively in a BSC …………………………………………………….. Yes No
2. WASTE
Waste Management
Warning signs are posted against improper waste disposal………………………………………………... Yes No
Wastes are segregated and collected in suitable containers......……………........................................... Yes No
Chemical waste containers are identifiable, labeled, dated, and sealed................................................. Yes No
Chemical waste containers are properly handled and stored ........…………........................................... Yes No
Containers for sharp and cutting waste are properly handled and disposed of .........………………....... Yes No
Acid waste, basic waste, and solvents are stored in separate containers ………………………………... Yes No
Uncontaminated paper, cardboard, and plastic waste is discarded into office trash cans ……………… Yes No
Floors are litter-free ..........................…………………………………………………………………............. Yes No
Waste disposal instructions are posted ............……............................................................................... Yes No
Handling of contaminated waste
Containers for contaminated waste are used ………………………………………………………………... Yes No
Specific biological waste containers are assigned to each biological laboratory ……...……..………….. Yes No
Waste containers are not filled to the brim.....………………………………………………………………... Yes No
Waste containers are properly labeled and sealed………………………………………………………….. Yes No
Cultures and other materials subject to waste regulations are properly decontaminated before disposal …………..
……………………………………………………………………………………………………………………... Yes No
Decontaminated substances carried outside of the laboratory are placed in hard, sealed, leakproof containers in
accordance with local regulations …………………….......................................................……………..... Yes No
Waste decontamination
Decontamination processes are microorganism-specific ..............................………………………......... Yes No
The head of the laboratory is informed when infectious material has been released or is implicated in an accident
……………………………………………………………………………………………………………………... Yes No
A suitable decontaminating agent is used to remove infectious material that has been released……… Yes No
Workbenches are cleaned daily before and after each use and when infectious material has been spilled ..............
…………………………………………………………………………………………………………………….. Yes No
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Appendix A :
Good Laboratory Practices Questionnaire
Substances that are cancerogenic, mutagenic, or toxic for reproduction (CMR) (beta mercapto ethanol
etc…)
Lab rooms and stations where CMRs are handled or stored are properly marked…………..………….. Yes No
Cleaning personnel is prohibited from entering a CMR lab room……………………………….…………. Yes No
Double gloving is required for handling CMRs ………………………………………………………………. Yes No
STORAGE
Refrigerators and freezers are grouped according to contamination levels………….…….……………... Yes No
Inoculated Petri dishes are kept in specific refrigerators or on specific shelves…………………………. Yes No
PCR primers and probes are kept separately from PCR products ………………………………………… Yes No
Human samples are kept in specifically designated hoods or on specific shelves ………….…………… Yes No
TRACABILITY
Reactive agents and samples are labeled with the following information: name, date, storage temperature, expiry
date………………………………………………………………………………………………………………... Yes No
Each technician maintains a logbook of laboratory procedures and tests………………………………… Yes No
3. PCR ROOMS
Samples are prepared exclusively in a designated PCR room (extraction of nucleic acids) …………… Yes No
The extraction room is designated as BSL-2…………………………………………………………………. Yes No
Samples are handled at a microbiological security station………………………………………………….. Yes No
In the extraction room, the wearing of individual protective equipment (smocks, gloves) is mandatory. Yes No
Protective equipment is specifically designated to the extraction room…………………………………… Yes No
The handling of human samples requires double gloving ……… …………………………………………. Yes No
The second pair of gloves must be removed before leaving the room……………………………..……… Yes No
A room is specifically designated for the preparation of the mix ………..…………………………………. Yes No
Reactive agents are stored in the mix preparation room…………………………………………..………... Yes No
The mix is prepared in a sealed room………………………………………………… ……………………... Yes No
In the mix preparation room, the wearing of individual protective equipment (smocks, gloves) is mandatory……….
……………………………………………………………………………………………………………………... Yes No
Protective equipment is specifically designated to the mix preparation room…………………………….. Yes No
Amplification is carried out in a specifically designated room………………………………………………. Yes No
In the amplification room, the wearing of individual protective equipment (smocks, gloves) is mandatory…………..
……………………………………………………………………………………………………………………... Yes No
PCR product analysis is carried out in a specifically designated room ……………………………….…... Yes No
The policy of assigned materials and equipment to specific rooms is respected………….……………... Yes No
I certify that all information is true and complete
Date :
Name and Signature :
GABRIEL / GLP questionnaire/ FP / February 2011 / V1
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