29 CFR 1910.1450- “The circumstances under which a particular laboratory operation, procedure or activity shall require prior approval
from the employer or the employer’s designee(s) before implementation”
NEW JERSEY INSTITUTE OF TECHNOLOGY
LABORATORY HAZARD ASSESSMENT
FOR NEW OR MODIFIED PROCESSES OR
PROCEDURES*
Date of Request: __________________________
Requestor:
Telephone: _______________________________ E-mail:
Name of Project: _____________________________________________________________________
Department Chair: ________________________ Department:
Building / Room
Chair Telephone___________________________ E-mail _________________________ _
PERSONNEL PROPOSED FOR THIS PROJECT
All personnel authorized to handle hazardous materials, biological agents or radiological material must
complete NJIT safety training. List the personnel participating in the proposed activity and the required
training:
Personnel
Training Completion Date
Other Applicable Training
LABORATORY OPERATIONS, PROCEDURES OR ACTIVITY
Briefly describe the operation, procedures or activity. You can also attach activity description or other
NJIT Laboratory Application.
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POTENTIAL HAZARDS
Review the Hazard Description of each Exposure Condition and check the ones that are present (column
1). For every condition present, review the Examples of Engineering Controls and Personal Protective
Equipment and complete the Specific Engineering Controls and PPE that you intend to use to reduce or
eliminate the hazard.
Check if
Present
Exposure
Condition
Hazard Description
Examples of
Engineering Controls
and Personal
Protective Equipment
(PPE)
Specific Engineering Controls and
Personal Protective Equipment
(PPE)
Biological Hazards (All components may require IBC approval.)
Animals
(vertebrate)
Splash, bites, exposure to
animal body fluids; injuries
due to animal size, caging,
allergies, and disease
transmission
Requires approval by
IACUC.
Animals
(invertebrate)
Splash, bites, exposure to
animal body fluids; injuries
due to animal size, caging,
allergies, development of
allergies, and disease
transmission
Lab-specific controls and
equipment
Carcinogens
Cancer causing agent
Posted work areas,
glove box, fume hood,
special handling, and
gloves
Human Blood
or other
potentially
infectious
materials
Disease transmission
Blood-borne Pathogen
training and Universal
Precautions. May require
IRB approval.
Infectious
Pathogens
Disease transmission
Good microbiological
methods, engineering
controls, gloves
Nano-particles
Unknown health hazards
due to small size
Containment, respirators
Check if
Present
Exposure
Condition
Hazard Description
Examples of
Engineering Controls
and Personal
Protective Equipment
(PPE)
Specific Engineering Controls and
Personal Protective Equipment
(PPE)
Recombinant
DNA
Depends on nature of DNA
segments, host vector
systems. Introduction of
foreign genetic materials
into personnel or
environment
Good microbiological
methods, engineering
controls, gloves
Select agents
and toxins
Infectious agents and
toxins with potential to
pose a severe threat to
human health.
Contact EHS. See
www.selectagents.gov
Chemical Hazards
Chemicals,
low hazard with
low splash
probability
Skin and eye irritation
Safety glasses, chemical
resistant gloves, lab coat,
closed shoe of good
structure, long pants; Be
aware of the nearest
eyewash and shower
Compressed
gases
Asphyxiation, accidental tip
over, content release, and
pinch points
Gas cylinders must be
secured to stationary
objects in a safe location
away from danger or
impact; Safety glasses
and gloves
Controlled
Substances
Drugs and certain other
chemicals (narcotic and
non-narcotic)
Proper training, handling
& dispensing procedures,
recordkeeping, safety
glasses; Under the
jurisdiction of federal and
state laws
Corrosive
liquids
w/reasonable
probability of
splash
Skin and eye damage
Chemical splash goggles
or face shield, neoprene
gloves, lab coat, closed
shoes, chemical resistant
apron
Cryogenic
liquids, ultra-
cold freezers,
dry ice
Asphyxiation, skin, eye and
tissue damage, frostbite
Ventilation, safety
glasses, goggles or face
shields for splash
hazards, insulated
gloves, closed shoes
Check if
Present
Exposure
Condition
Hazard Description
Examples of
Engineering Controls
and Personal
Protective Equipment
(PPE)
Specific Engineering Controls and
Personal Protective Equipment
(PPE)
Organic
solvents
Skin/eye damage,
absorption through skin,
organ damage
Chemical splash goggles
or face shield, heavy
resistant gloves, lab coat,
closed shoes, chemical
resistant apron, eyewash
and shower
Volatile
hazardous or
highly
hazardous
chemicals
Inhalation of toxic vapors,
skin contact
Fume hood, glove box,
safety glasses, and
gloves
Regulated
Wastes
Exposure, environmental
release
Safety glasses, gloves,
proper storage and
disposal procedures;
Training and safe
handling procedures
Special
cleaning
agents
Exposure, allergies
Material Safety Data
Sheets, hazard
communication training,
proper procedures,
gloves, safety glasses
Toxic
Substances
Poisons, neurotoxins,
teratogens, mutagens,
carcinogens, and
subsequent environmental
impact.
Proper training,
procedures, storage, and
disposal
Washing
glassware
Skin lacerations from
broken glass
Safety glasses, rubber
gloves, lab coat.
Radiological Hazards
Ionizing
Radiation
Cancer, teratogenic
Time, distance, shielding;
Permit and controls
approved by Radiation
Safety Committee
Check if
Present
Exposure
Condition
Hazard Description
Examples of
Engineering Controls
and Personal
Protective Equipment
(PPE)
Specific Engineering Controls and
Personal Protective Equipment
(PPE)
Non-Ionizing
Radiation
Eye or skin damage, burns,
heat, cancer.
Training, curtains
(welding), signage,
interlocks, beam blocks,
safety eyewear
Physical Hazards
Compression
(pressure)
Injury from sudden release
of energy from valves,
compression chambers
Energy control, safety
classes, shields, body
position
Confined
Spaces
Exposure, falls, dangerous
atmospheres, asphyxiation,
noise, vibration
Buddy system, lanyards,
ventilation, monitoring
Elevated
heights
Fall injury Tethers, anchors
Energized
Equipment
Pinch, crush, caught,
pulled in, electrocution
Energy control, signage,
guards, no jewelry, tie
back long hair
Extreme
Environmental
Conditions
Hypothermia (cold),
frostbite (cold), heat
exhaustion (heat) or heat
stroke.
Training, physiological
monitoring. Rest cycles
and fluid replacement
Impact Injury to head or body
Hard hat, impact
resistant toed shoes,
body position
Check if
Present
Exposure
Condition
Hazard Description
Examples of
Engineering Controls
and Personal
Protective Equipment
(PPE)
Specific Engineering Controls and
Personal Protective Equipment
(PPE)
Manipulation of
large objects
Injury, death
Training, proper lifting
equipment, procedures,
inspections, buddy
system
Material
Handling
Physical injury, strains,
sprains
Training, buddy system,
gloves, standard
operating procedures
Noise
Deafness, hearing
damage, inability to
communicate
Noise monitoring,
hearing protection,
training, and engineering
controls (e.g.,
enclosures, baffles,
mufflers)
Penetration Injection, wounds
Training, padding of
surfaces, signage, and
body position
Respirable
Dust
Lung damage
Local exhaust ventilation.
monitoring, respirator
Vibrating
Equipment
Cumulative trauma
disorders.
Gloves, protective shoes,
hearing protection
Additional notes and information:
___________________________________________________________________________________
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CHEMICAL/BIOLOGICAL/RADIOLOGICAL MATERIALS TO BE USED
Name
CAS #
Synonym
Storage Location
Frequency of
Use
Maximum
Quantity
Stored
Hazard
Attach Safety Data Sheet for each listed material.
CONTROL PROCEDURES - Describe controls that will be employed to protect the individuals
participating in this research or attach IBC application.
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DECONTAMINATION PROCEDURES (surfaces, materials, instruments, personnel, equipment,
etc.) or reference IBC application:
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
DISPOSAL PROCEDURES (wastes and unused stock):
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
____________________________________________________________________________________________
The information above is accurate and complete. I agree to abide to all applicable NJIT, federal,
state and local regulatory requirements.
Requestor: _______________________________
Signature: __________________________________________________________________________________
Reviewed by Department Head (Required)
Name: __________________________ Date: _____________________
Reviewed by EHS (Required)
Name: __________________________ Date: _____________________
Reviewed by Vice Provost for Research (If applicable)
Name: __________________________ Date: _____________________
Reviewed by Facilities (If applicable)
Name: __________________________ Date: _____________________
Reviewed by IBC (If applicable)
Name: __________________________ Date: _____________________
Reviewed by IRB (If applicable)
Name: __________________________ Date: _____________________
Reviewed by IACUC (If applicable)
Name: __________________________ Date: _____________________
Reviewed by Risk Management (If applicable)
Name: __________________________ Date: _____________________
click to sign
signature
click to edit
Approval Conditions
(To be verified by EHS Department)
1) ________________________________________________________________________________
2) ________________________________________________________________________________
3) ________________________________________________________________________________
4) ________________________________________________________________________________
5) ________________________________________________________________________________
See Attachment for additional conditions.
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