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    Ibbc Form 2

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    This document is a biosafety declaration and risk assessment form for a laboratory at the University of the Philippines Manila National Institutes of Health. It requires information about the laboratory personnel, activities, potentially hazardous biological materials and agents handled, biosafety equipment used, waste disposal procedures, and transportation of materials. The completed form must be submitted to the Biosafety Officer for review to ensure proper biosafety practices are followed when working with biological hazards.

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    Ibbc Form 2

    Uploaded by

    For Study
    42 views4 pages
    This document is a biosafety declaration and risk assessment form for a laboratory at the University of the Philippines Manila National Institutes of Health. It requires information about the laboratory personnel, activities, potentially hazardous biological materials and agents handled, biosafety equipment used, waste disposal procedures, and transportation of materials. The completed form must be submitted to the Biosafety Officer for review to ensure proper biosafety practices are followed when working with biological hazards.

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    IBBC-FORM-2

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    This document is a biosafety declaration and risk assessment form for a laboratory at the University of the Philippines Manila National Institutes of Health. It requires information about the laboratory personnel, activities, potentially hazardous biological materials and agents handled, biosafety equipment used, waste disposal procedures, and transportation of materials. The completed form must be submitted to the Biosafety Officer for review to ensure proper biosafety practices are followed when working with biological hazards.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    42 views4 pages

    Ibbc Form 2

    Uploaded by

    For Study
    This document is a biosafety declaration and risk assessment form for a laboratory at the University of the Philippines Manila National Institutes of Health. It requires information about the laboratory personnel, activities, potentially hazardous biological materials and agents handled, biosafety equipment used, waste disposal procedures, and transportation of materials. The completed form must be submitted to the Biosafety Officer for review to ensure proper biosafety practices are followed when working with biological hazards.

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    University of the Philippines Manila

    NATIONAL INSTITUTES OF HEALTH


    UPM-IBBC
    INSTITUTIONAL BIOSAFETY AND Guidelines in Biosafety
    and Biosecurity
    BIOSECURITY COMMITTEE
    G/F NIH Bldg. 623 Pedro Gil St., Ermita, Manila 1000 Philippines
    Tel Nos: (632) 5264266; (632) 5264349 Telefax No: (632) 5250395 Web-
    site:http://nih.upm.edu.ph/nihrdms FORM 2

    OFFICE OF THE VICE-CHANCELLOR FOR RESEARCH

    INSTITUTIONAL BIOSAFETY COMMITTEE

    BIOHAZARD DECLARATION AND RISK ASSESSMENT FOR LABORATORY WORK

    INSTRUCTIONS: The laboratory manager/supervisor is responsible for completing this form and must be
    submitted to the Biosafety Officer for comments and review.

    A. NAME AND LOCATION OF LABORATORY (indicate room number, building, department and unit)

    B. LABORATORY PERSONNEL

    Name Highest Educa- Brief Description of years of ser- relevant training and experience immunization
    tional Attainment Tasks vice in lab work and biosafety prac- record
    tices

    C. BRIEF DESCRIPTION OF LABORATORY AND ACTIVITIES


    D. DECLARATION OF POTENTIALLY HAZARDOUS BIOLOGICAL MATERIALS

    D1. Enumerate the potentially hazard- D2. Source/s D3. Tests conducted D4. potential pathogen/s present
    ous biological materials manipulat-
    ed/stored human and non-human
    blood,tissue, body fluids/cells, rDNA,
    vectors, and others), add rows if nec-
    essary.

    E. DECLARATION OF POTENTIALLY HAZARDOUS BIOLOGICAL AGENTS

    E1. list the pathogens manipulated/stored E2. Source/s E3. Genus/species/strain


    in the lab (name of bacteria, fungus, para-
    site, virus, rickettsia, prion, toxin of biologi-
    cal origin) add row if necessary

    F. DECLARATION OF BIOBANKED AGENTS

    F1. Enumerate and F2. source/s F3. quantity stored F4. purpose of stor- F5. Are there any
    specify what materi- ing material records available for
    als/agents are stored reference of stored
    materials?
    University of the Philippines Manila
    NATIONAL INSTITUTES OF HEALTH
    UPM-IBBC
    INSTITUTIONAL BIOSAFETY AND Guidelines in Biosafety
    and Biosecurity
    BIOSECURITY COMMITTEE
    G/F NIH Bldg. 623 Pedro Gil St., Ermita, Manila 1000 Philippines
    Tel Nos: (632) 5264266; (632) 5264349 Telefax No: (632) 5250395 Web-
    site:http://nih.upm.edu.ph/nihrdms FORM 2

    G. DECLARATION OF LABORATORY AND PROCEDURAL HAZARDS

    G1. Identify primary G2. Indicate specific proce- G3. Describe the procedures/equipment that you use to
    laboratory hazard (inha- dures/activity corresponding to poten- minimize risk. (i.e standard and special microbiological
    lation, ingestion, pene- tial hazard (i.e. pipetting, flaming of practices, primary containment, personal protective
    tration thru skin, contact loop, vortex mixing, centrifugation, equipment, biosafety cabinet, etc.)
    with mucous mem- disposal of animal bedding, etc.)
    branes of eyes, nose
    and mouth, allergens,
    etc.)

    H. LIST OF EQUIPMENT IN THE LABORATORY

    H1. Enumerate and specify H2. describe purpose or use H3. Indicate if used with potentially infec-
    name of equipment tious material/s, specify what material
    I. DECLARATION OF WASTES GENERATED AND DESCRIPTION OF PROCEDURES FOR DECON-
    TAMINATION AND DISPOSAL PROCEDURES
    (Describe the method of disposal of all cultured materials and other potentially hazardous biological
    agents).

    I1. Specify and I2. indicate of I3. procedure for decontamina- I4. procedure for disposal
    enumerate wastes infectious or tion
    generated non-infectious

    J. TRANSPORT OF BIOLOGICAL MATERIALS

    J1. Enumerate and specify what J2. Location/s to where material are J3. Describe briefly procedure/s for
    potentially material/s are transported transported packing
    out of the laboratory

    Prepared by:

    ____________________________________ _________________ ____________________


    LABORATORY MANAGER/SUPERVISOR SIGNATURE DATE

    Noted by:

    ________________________________ __________________ ____________________


    BIOSAFETY OFFICER SIGNATURE DATE

    ___________________________________ __________________________ _______________________


    DEPARTMENT CHAIR SIGNATURE DATE

    ___________________________________ ________________________ _________________________


    DEAN SIGNATURE DATE

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