SURVEY OF MEDICAL SURVEILLANCE

OMB Control No: 1218-0168	ICR Reference No: 199006-1218-002
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: DOL/OSHA	Agency Tracking No:
Title: SURVEY OF MEDICAL SURVEILLANCE
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 08/02/1990
Retrieve Notice of Action (NOA)	Date Received in OIRA: 06/07/1990
Terms of Clearance: We have approved this survey as revised through March of 1991. We note that because of the detailed and specialized nature of the data requested, combined with the use of the telephone to collect the data, the quality of the results generated will depend on contacting a knowledgeable person in each firm. OSHA has assured us that it will make every effort to contact the correct person. In addition, OSHA shall ensure that the response rate from small businesses are adequate, so that the medical surveillance, exposure monitoring, and PSM programs of small businesses are properly represented in survey results. When citing any results of this survey, OSHA shall state the item-by-item response rate as well as the overall survey response rate. Also, OSHA shall explain how the survey results either support or do not support each of the hypotheses listed in OSHA's August 2, 1990 letter.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	03/31/1991	03/31/1991
Responses	10,192	0	0
Time Burden (Hours)	6,553	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: OSHA NEEDS DATA ON THE NATURE AND EXTENT OF MEDICAL SURVEILLANCE AND OTHER HEALTH AND SAFETY PROGRAMS IN GENERAL INDUSTRY IN ORDER TO ANALY THE POTENTIAL EFFECTS OF REGULATORY ACTION IN THIS AREA. A SAMPLE OF ESTABLISHMENTS FROM ALL GENERAL INDUSTRY WILL BE SURVEYED.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 1

IC Title Form No. Form Name SURVEY OF MEDICAL SURVEILLANCE

---

ICR Summary of Burden

	Total Approved	Previously Approved	Change Due to New Statute	Change Due to Agency Discretion	Change Due to Adjustment in Estimate	Change Due to Potential Violation of the PRA
Annual Number of Responses	10,192	0	0	10,192	0	0
Annual Time Burden (Hours)	6,553	0	0	6,553	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

---

Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).
The following is a summary of the topics, regarding the proposed collection of information, that the certification covers:
		(a) It is necessary for the proper performance of agency functions;
		(b) It avoids unnecessary duplication;
		(c) It reduces burden on small entities;
		(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;
		(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;
		(f) It indicates the retention periods for recordkeeping requirements;
		(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:
			(i) Why the information is being collected;
			(ii) Use of information;
			(iii) Burden estimate;
			(iv) Nature of response (voluntary, required for a benefit, or mandatory);
			(v) Nature and extent of confidentiality; and
			(vi) Need to display currently valid OMB control number;
		(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.
		(i) It uses effective and efficient statistical survey methodology (if applicable); and
		(j) It makes appropriate use of information technology.
If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.
Certification Date: 06/07/1990

---