Application for the use of Hazardous Chemicals in Animal Protocols


This form is used to review hazardous chemicals used in animal protocols.


For any chemical administered to an animal within your protocol, follow these instructions:

  • Check the Chemicals Requiring Review criteria below. Note that most chemicals routinely used in animal protocols (e.g. non-inhalant anesthetics and euthanasia solutions) do NOT meet the criteria for registration.
  • If the chemicals to be used in the protocol do not meet any of the criteria described in the list, you do not need to complete this form. Contact EHS at 801-581-6590 if you are unsure if a chemical in your protocol meets the criteria, or if no data are available for the chemical.
  • If you are using, or plan to use, a chemical that meets the criteria for Chemicals Requiring Review as shown below, complete this form providing the necessary information for each chemical.
  • Submit the completed application, in Word™ format via email to:
  • Once the completed application is received it will be assigned for reviewed by an EHS research safety specialist. They will contact you with any questions and/or recommendations for changes. Once the specialist review is complete the application will be reviewed by the research safety manager and the approval issued.

Please note: Every laboratory that uses chemicals must also have a Chemical Hygiene Plan. A copy of the final approved application form must be included in the standard operating procedures section of your laboratory’s Chemical Hygiene Plan.

Chemicals Requiring Review

Chemicals meeting any of the following criteria require review:

Agent is a teratogen or has possesses significant reproductive hazards

Agent is a select carcinogen

Select carcinogens are any substance that meets one of the following criteria:

  • It is regulated by OSHA as a carcinogen
  • It is listed under the category “known to be carcinogens” in the Annual Report on Carcinogens published by the National Toxicology Program (NTP) (latest editions)
  • It is listed under Group 1 “carcinogenic to humans” by the International Agency for Research on Cancer Monographs (IARC) (latest editions)
  • It is listed in either Group 2A or 2B by IARC or under the category “reasonably anticipated to be carcinogens” by NTP, and causes statistically significant tumor incidence in experimental animals.

Restricted Pesticides

  • “Pesticides classified for restricted use” by the EPA under the Federal Insecticide, Fungicide Rodenticide Act (FIRFA) – 40 CFR 152.175

Highly Toxic

Agent is classified as “Highly Toxic”, meaning it falls within one of the following categories:

  • A chemical that has a median lethal dose (LD(50)) of 50 milligrams or less per kilogram of body weight when administered orally to albino rats weighing between 200 and 300 grams each.
  • A chemical that has a median lethal dose (LD(50)) of 200 milligrams or less per kilogram of body weight when administered by continuous contact for 24 hours (or less if death occurs within 24 hours) with the bare skin of albino rabbits weighing between two and three kilograms each.
  • A chemical that has a median lethal concentration (LC(50)) in air of 200 parts per million by volume or less of gas or vapor, or 2 milligrams per liter or less of mist, fume, or dust, when administered by continuous inhalation for one hour (or less if death occurs within one hour) to albino rats weighing between 200 and 300 grams each.

Agent is an antineoplastic or other hazardous drug.

The National Institute for Occupational Safety and Health (NIOSH) publishes a list of antineoplastic and other hazardous drugs.

The list can be found at 

Additionally, the following is a link to OSHA’s website, which includes a list of references that may assist in recognizing and controlling hazards associated with hazardous drugs in the workplace:


Please download and send the completed form to OEHS

Application for the Use of Hazardous Chemicals in IACUC Protocols