OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Epidemiologic Study of Health Effects Associated with Low Pressure Events in Drinking Water Distribution Systems

ICR 201510-0920-007 · OMB 0920-0960 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
CDC Water and Health Study (paper questionnaire) Form Modified Available
S.Customer Contact.docx Supplementary Document Uploaded 2016-02-17 Repair queued
H.Cover Letter E-mail.msg Supplementary Document Uploaded 2016-02-17 Available
E7. Utility Water Sample Fact Sheet.docx Supplementary Document Uploaded 2016-02-17 Available
E6. Utility Customer Fact Sheet.docx Supplementary Document Uploaded 2016-02-17 Repair queued
E5. Utility Promotional Postcard.pdf Supplementary Document Uploaded 2016-02-17 Available
E4. Utility Social Media Posts.docx Supplementary Document Uploaded 2016-02-17 Repair queued
E3. Utility Newsletter Paragraph.docx Supplementary Document Uploaded 2016-02-17 Available
E2. Utility Radio PSA.docx Supplementary Document Uploaded 2016-02-17 Available
E1. Utility Press Release.docx Supplementary Document Uploaded 2016-02-17 Available
D.Pilot Summary and Evaluation Report.pdf Supplementary Document Uploaded 2016-02-17 Available
P.Final Appeal Letter.docx Supplementary Document Uploaded 2016-02-17 Available
O.Phone script.docx Supplementary Document Uploaded 2016-02-17 Available
K.Survey2 Cover Letter Paper.docx Supplementary Document Uploaded 2015-11-06 Available
J.Thank youReminder Letter.docx Supplementary Document Uploaded 2015-11-06 Available
I.Consent Brochure.pdf Supplementary Document Uploaded 2016-02-17 Available
G.Cover Letter Paper.docx Supplementary Document Uploaded 2016-02-17 Available
F.Advance Letter.docx Supplementary Document Uploaded 2016-02-17 Available
CDC Water and Health Study needs your help .msg Supplementary Document Uploaded 2015-11-06 Available
Q.IRB Approval Continuation.docx Supplementary Document Uploaded 2016-02-17 Available
Attach B 60 day published.pdf Supplementary Document Uploaded 2015-11-06 Available
0920-0960 Epi Study of Health Effects associated with LPE_SSB_OMB_16FEB2016.docx Supporting Statement B Uploaded 2016-02-17 Repair queued
0920-0960 Epi Study of Health Effects LPE in Drinking Water_SSA_OMB_16FEB2016.docx Supporting Statement A Uploaded 2016-02-17 Available
C.Pilot Evaluation Log Frame.pdf Supplementary Document Uploaded 2014-09-26 Available
OMB Appendix A Authorizing Legislation 42 CFR 241.pdf Supplementary Document Uploaded 2013-03-22 Available
IC Document Collections
IC IDCollectionTypeStatusForm
204806 Utility Customer Information - Line Listings Other-WORD Modified
204805 Low Pressure Event Form - Ultrafilter and Grab Samples Other-WORD Modified
204803 Low Pressure Event Form - Grab Samples Other-WORD Modified
204802 CDC Water and Health Study (paper questionnaire) Form Modified
204801 CDC Water and Health Study (Web-Based Questionnaire) Other-Screen shots Modified
ICR Details
0920-0960 201510-0920-007
Historical Active 201409-0920-014
HHS/CDC 0920-0960
Epidemiologic Study of Health Effects Associated with Low Pressure Events in Drinking Water Distribution Systems
Extension without change of a currently approved collection   No
Regular
Approved with change 02/22/2016
Retrieve Notice of Action (NOA) 11/19/2015
Approved consistent with the understanding that this prospective cohort study is designed to provide insights into whether individuals exposed to low-pressure events in selected water distribution systems are at an increased risk for acute gastrointestinal or respiratory illnesses. The five utilities studied are not intended to be representative of population exposures or illness rates across the United States more broadly. Furthermore, given low response rates in the pilot, CDC commits to highlighting the implications of any nonresponse bias identified for the generalizability of the study results.
  Inventory as of this Action Requested Previously Approved
08/31/2018 30 Months From Approved 03/31/2016
2,095 0 2,095
571 0 571
0 0 0
Approximately 200 million cases of acute gastrointestinal illness (AGI) occur in the U.S. each year. The Centers for Disease Control and Prevention requests approval for data collection to assess whether individuals exposed to low pressure events in water distribution system are at increased risk for acute gastrointestinal or respiratory illnesses.. The ICR requests a 30 month extension. No changes are being made to the information collection instruments or respondents. Increase time is required to complete the data collection.
US Code: 42 USC 301 Name of Law: Public Health Service Act
  
None
Not associated with rulemaking
  80 FR 52287 08/28/2015
80 FR 67760 11/03/2015
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 2,095 2,095 0 0 0 0
Annual Time Burden (Hours) 571 571 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
$319,796
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Jeffrey Zirger 404 639-7118 [email protected]
  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.
11/19/2015