OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Long-Term Efficacy of a Program to Prevent Beryllium Disease

ICR 200710-0920-009 · OMB 0920-0771 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Response to OMB 0920-07AY_2008Feb21.doc Supporting Statement B Uploaded 2008-03-20 Repair queued
Appendix F 308 Approval .pdf Supplementary Document Uploaded 2007-10-12 Available
NIOSH Prevent Be Appendix D.pdf Supplementary Document Uploaded 2007-10-12 Available
NIOSH Prevent Be Appendix C 60 day FRN.pdf Supplementary Document Uploaded 2007-10-12 Available
NIOSH DRDS Appendix A Prevent Be Disease 29 usc 669.doc Supplementary Document Uploaded 2007-10-12 Available
NIOSH DRDS Prevent Be Disease Part A of SS Sept. 20 revision.doc Supporting Statement A Uploaded 2007-10-15 Available
IC Document Collections
IC IDCollectionTypeStatusForm
182449 Consent to Participate and Authorization for Release of Information Other-Consent Document New
182448 Medical and Work History Questionnaire Other-Computer Assisted Survey New
ICR Details
0920-0771 200710-0920-009
Historical Active
HHS/CDC
Long-Term Efficacy of a Program to Prevent Beryllium Disease
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 03/24/2008
Retrieve Notice of Action (NOA) 10/24/2007
Approved consistent with CDC responses to OMB questions and comments.
  Inventory as of this Action Requested Previously Approved
03/31/2011 36 Months From Approved
386 0 0
193 0 0
0 0 0
Beryllium is a lightweight metal with many applications. Exposed workers may be found in the primary production, nuclear power and weapons, aerospace, scrap metal reclamation, speciality ceramics, and electronics industries, among others. Exposure to Beryllium can lead to sensitization and cause immunologic granulomatous lung disease. This proposed study is designed to evaluate the effectiveness of a comprehensive preventive program at three beryllium plants.
US Code: 42 USC 306 Name of Law: Public Health Service Act
   US Code: 42 USC 308(d) Name of Law: Public Health Service Act
   US Code: 29 USC 669 Name of Law: Occupational Safety and Health
   US Code: 42 USC 241 Name of Law: Public Health Service Act
   US Code: 30 USC 501 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  72 FR 21022 04/27/2007
72 FR 57581 10/10/2007
No
2
IC Title Form No. Form Name
Consent to Participate and Authorization for Release of Information
Medical and Work History Questionnaire
  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 386 0 0 386 0 0
Annual Time Burden (Hours) 193 0 0 193 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a new data collection.
$350,206
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
Uncollected
Uncollected
Carol Walker 4046394773
  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.
10/23/2007