Experimental and Theoretical Study of Early Detection and Isolation of Influenza

Forms and Documents

Document Name	Status
Form No number Aim 2: Emergency Department Patients Consent Form Form	New
Form No Number Aim 2: Consent Form Form	New
Form No Number Aim 2: Health Questionnaire Form	New
Form No Number Aim 1: Consent Form Form	New
Form No Number Aim 1: Health Questionnaire Form	New
Lindsley SS Part B.doc Supporting Statement B	2007-12-14
Lindsley influenza OMB Attach 2 FRN.pdf Supplementary Document	2007-12-14
Lindsley influenza OMB Attach 1 Authorizing legislation.doc Supplementary Document	2007-12-14
Lindsley influenza OMB Attach 10 IRB approval.pdf Supplementary Document	2007-12-14
Lindsley SS Part A.doc Supporting Statement A	2007-12-14

IC Document Collections

IC ID	Document Title	Status
183378	Aim 2: Emergency Department Patients Consent Form Form	New
183377	Aim 2: Consent Form Form	New
183376	Aim 2: Health Questionnaire Form	New
183375	Aim 1: Consent Form Form	New
183374	Aim 1: Health Questionnaire Form	New

ICR Details

OMB Control No: 0920-0777	ICR Reference No: 200801-0920-007
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Experimental and Theoretical Study of Early Detection and Isolation of Influenza
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: 05/23/2008
	Date Received in OIRA: 01/11/2008
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	05/31/2009	12 Months From Approved
Responses	159	0	0
Time Burden (Hours)	35	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The purpose of this study is to gain a better understanding of the production and dissemination of aerosols containing the influenza virus. The results of this research will give scientist and health professionals greater insight into the airborne transmission of influenza and allow them to better assess the potential effectiveness of preventive measures.

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Authorizing Statute(s): PL: Pub.L. 91 - 256 20a 1 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 21021	04/27/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	72 FR 73021	12/26/2007
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 5

IC Title	Form No.	Form Name
Aim 2: Emergency Department Patients Consent Form	No number	Attachment 9 - Aim 2 Emergency Department Consent Form
Aim 1: Health Questionnaire	No Number	Attachment 4 - Aim 1 Health Questionnaire
Aim 1: Consent Form	No Number	Attachment 5 - Aim 1 Consent Form
Aim 2: Health Questionnaire	No Number	Attachment 7- Aim 2 Health Questionnaire
Aim 2: Consent Form	No Number	Attachment 8 - Aim 2 Consent Form

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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	159	0	0	159	0	0
Annual Time Burden (Hours)	35	0	0	35	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: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $29,900

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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

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Common Form ICR:  No

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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: 01/11/2008

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