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. …………………………………. 4. …………………………………. 5. …………………………………. 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 1 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: 2