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Federal forms, ICRs, and supporting documents

Information Collection Request

Prospective Evaluation of Health Care Workers Exposed to Blood from Patients Infected with HIV

ICR 199706-0920-002 · OMB 0920-0131 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
No forms / supporting documents in this ICR. Check IC Document Collections.
IC Document Collections
IC IDCollectionTypeStatusForm
6643 Prospective Evaluation of Health Care Workers Exposed to Blood from Patients Infected with HIV Form Migrated
ICR Details
0920-0131 199706-0920-002
Historical Active 199306-0920-001
HHS/CDC
Prospective Evaluation of Health Care Workers Exposed to Blood from Patients Infected with HIV
Reinstatement with change of a previously approved collection   No
Regular
Approved without change 08/20/1997
Retrieve Notice of Action (NOA) 06/24/1997
This collection is approved on the condition that CDC add the OMB number, expiration date, and burden statement to the Health- Care Worker Follow-Up Form. In addition, OMB notes that this collection expired on 8/31/96 and thus is a violation under the Paperwork Reduction Act of 1995. CDC should take additional steps to ensure that such lapses do not occur in the future.
  Inventory as of this Action Requested Previously Approved
08/31/2000 08/31/2000
1,125 0 0
198 0 0
0 0 0
The objectives of this surveillance: Estimate the risk of HIV infection in health care workers (HCWs) exposed to HIV infected blood according to type of exposure; describe the type of devices and circumstances of exposures; describe the clinical natural history and development of laboratory markers of HIV infection in HCWs who seroconvert to HIV; and describe the use of post-exposure chemoprophylaxis by HCWs exposed to HIV infected blood.
None
None
No
1
IC Title Form No. Form Name
Prospective Evaluation of Health Care Workers Exposed to Blood from Patients Infected with HIV 57.34C, 57.34B, 57.34E, 57.42A
  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 1,125 0 0 1,125 0 0
Annual Time Burden (Hours) 198 0 0 198 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
No
$0
No
No
Uncollected
Uncollected
Uncollected
Uncollected
  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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
06/24/1997