OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

An Investigation of Lung Health at an Indium-Tin Oxide Production Facility

ICR 201403-0920-006 · OMB 0920-1024 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Attachment G.docx Supplementary Document Uploaded 2014-06-23 Available
Attachment H.docx Supplementary Document Uploaded 2014-06-23 Repair queued
SupSta B_0920-14CL.docx Supporting Statement B Uploaded 2014-03-11 Available
Att M_IRB Approval.docx Supplementary Document Uploaded 2014-03-11 Repair queued
Att B_60d FRN.pdf Supplementary Document Uploaded 2014-03-11 Available
Att A_Authorizing Leg.docx Supplementary Document Uploaded 2014-03-11 Available
Att H Results letter for Blood tests.docx Supplementary Document Uploaded 2014-03-11 Available
Att G_Results letter for Lung tests.docx Supplementary Document Uploaded 2014-03-11 Available
Att L_Results letter for personal air sampling.docx Supplementary Document Uploaded 2014-03-11 Available
Att K_Personal Air Sampling Log.docx Supplementary Document Uploaded 2014-03-11 Available
Supporting statement A.docx Supporting Statement A Uploaded 2014-06-23 Available
IC Document Collections
IC IDCollectionTypeStatusForm
210762 Exposure Monitoring (mock form) Other-WOrd New
210761 Medical Testing Other-WORD New
210760 Personal Air Sampling _ Contact Information Form Other-WORD New
210759 Script for Industrial Hygiene Samples Other-WORD New
210758 Authorization to Disclose Other-WORD New
210757 Consent Other-WORD New
210756 Recruitment Letter Other-WORD New
210755 Indium Facility Questionnaire Other-WORD New
ICR Details
0920-1024 201403-0920-006
Historical Active
HHS/CDC 21559
An Investigation of Lung Health at an Indium-Tin Oxide Production Facility
New collection (Request for a new OMB Control Number)   No
Regular
Approved with change 06/23/2014
Retrieve Notice of Action (NOA) 03/18/2014
The primary goal of understanding the relationship between exposure and lung health outcomes in this facility, and using them to reduce exposures and prevent lung disease at this particular facility. To the extent that the industrial processes and exposures at this facility are relevant to some facilities in the United States and many more in Asia, the lessons learned may be useful to other workplaces here and abroad. We strongly encourage CDC, in consultation with their IRB, to develop a standardized template for returning the test results to participants that differentiates between comparisons to population studies vs. comparisons to clinical reference guidelines.
  Inventory as of this Action Requested Previously Approved
06/30/2015 12 Months From Approved
765 0 0
254 0 0
0 0 0
Indium-tin oxide (ITO) is a sintered material used in the manufacture of devices such as liquid crystal displays, touch panels, solar cells, and architectural glass. Indium lung disease is a novel, potentially fatal industrial disease that has occurred in workers making, using, or recycling ITO. This project aims to understand and prevent this occupational lung disease by investigating the relationship between exposure and lung health among current ITO manufacturing workers. CDC requests OMB approval to collect standardized information from current employees of the ITO production facility through an informed consent document, an interviewer-administered questionnaire, and a contact information form. As part of the same project, employees will be offered the opportunity to participate in medical testing and personal air sampling.
PL: Pub.L. 91 - 596 20(a)[1] Name of Law: Occupational Safety and Health Act
  
None
Not associated with rulemaking
  78 FR 69417 11/19/2013
79 FR 13053 03/07/2014
No
  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 765 0 0 765 0 0
Annual Time Burden (Hours) 254 0 0 254 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
No
This is a NEW collection request for a new OMB Control Number.
$305,161
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Thelma Sims 4046394771
  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.
03/18/2014