ISU Protocol for Use of Infectious Agents in Research - Form B/IBC
IBC Protocol No. ________
I. Use of Infectious Agents/Toxins/Select Agents not involving rDNA:
I a. Name of the Agent(s) and Strain(s):
I b. Source of the Agent:
I c. 1. Maximum concentration and volume of the Agent(s) that will be used:
I c. 2. Maximum concentration and volume of the Agent(s) that will be stored:
I d. LD
50
or infectious dose in humans (if known):
I e. Risk Group classification (See Appendix B of NIH Guidelines)
http://www4.od.nih.gov/oba/rac/guidelines_02/APPENDIX_B.htm:
1 2 3 4 Animal Pathogen Plant Pathogen
I f. For each organism listed above describe the pathogenicity or attenuation of the organism: or N/A
I g. Indicate the location of ALL lab(s)/rooms in which the work will take place:
Room No.
, Building Name ; Room No. , Building Name ; Room No. , Building Name
I h. Indicate in which animal facility animal work will take place and type of housing in which animals will be
maintained:
Facility Name. BSL1 Standard Housing BSL2 Biohazard Housing BSL3 Biohazard Housing
I i. Indicate the location of ALL lab(s)/rooms in which the agents will be stored:
Room No.
, Building Name ; Room No. , Building Name ; Room No. , Building Name
I j. Indicate if any of the agent(s) are a select agent: Yes No
If yes, contact ISU Environmental Health and Safety Office at 996-7429 regarding use of select agents
I k. Indicate the highest biosafety level (BSL) required for this project: 1 2 3
Note: All work involving human or nonhuman primate cells/tissues requires yearly bloodborne
pathogen training and is considered BSL2. Biosafety level refers to the combination of laboratory
practices and techniques, safety equipment and laboratory facilities under which the project can be
conducted safely. For guidance on appropriate biosafety levels for specific agents refer to
Biosafety in Microbiological and Biomedical Laboratories, 5
th
Edition from the CDC and NIH
available at
http://www.cdc.gov/OD/ohs/biosfty/bmbl5/bmbl5toc.htm
A LABORATORY-SPECIFIC BIOSAFETY MANUAL MUST BE COMPLETED AND
SUBMITTED WITH THIS PROTOCOL. For work conducted at BSL1 or BSL2, complete the
appropriate biosafety manual template provided on IBC website. For BSL3, contact IBC
office to discuss biosafety manual requirements. FAILURE TO SUBMIT A MANUAL WITH
THE PROTOCOL WILL RESULT IN PROTOCOL BEING RETURNED TO PI WITHOUT
REVIEW.
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