Building Related Asthma Research in Public Schools

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
SS_Part B_Asthma_(FINAL).doc	Supporting Statement B	Uploaded 2008-05-29	Available
Appendix_B.doc	Supplementary Document	Uploaded 2008-05-29	Available
Appendix_F.doc	Supplementary Document	Uploaded 2008-05-29	Available
Appendix_D.doc	Supplementary Document	Uploaded 2008-05-29	Available
Appendix_A.doc	Supplementary Document	Uploaded 2008-05-29	Available
Appendix_I.doc	Supplementary Document	Uploaded 2008-05-29	Available
Appendix_E.doc	Supplementary Document	Uploaded 2008-05-29	Available
Appendix_F.doc	Supplementary Document	Uploaded 2008-05-29	Available
SS_Part A_Asthma_(FINAL).doc	Supporting Statement A	Uploaded 2008-05-29	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
185272	Semi-Quantitative Assessment Sheet	Other-WORD	New
185271	Serial Spirometry	Other-WORD	New
185270	NIOSH-Health Questionnaire	Other-WORD	New
185269	NIOSH-Former Worker Questionnaire	Other-WORD	New
185268	NIOSH-Administered Questionnaire	Other-WORD	New

ICR Details

OMB Control No: 0920-0793	ICR Reference No: 200806-0920-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Building Related Asthma Research in Public Schools
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: 10/21/2008
	Date Received in OIRA: 06/09/2008
Terms of Clearance: Clearance is provided for this study consistent with the understanding that this is a case study, not a robust evaluation of the intervention. Thus, NIOSH will not be using the results to drive public policy.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/2011	36 Months From Approved
Responses	653	0	0
Time Burden (Hours)	1,060	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: NIOSH will conduct a longitudinal study among teachers and staff in public schools. The goal of the study is: 1) to document the time course of changes in respiratory health, sick leave, and quality of life in relation to building remediation for water incursion and dampness problems; 2) to validate the reporting of building-related lower respiratory symptoms in school staff with bronchial hyper-responsive by the use of serial spirometry to look for building-related patterns of airflow variability; and 3) to demonstrate that a toolkit comprised of a semi-quantitative index for assessing water damage and signs of moisture in schools, along with a short health questionnaire, can be used by school personnel to pinpoint specific problem areas and aid remediation efforts.

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Authorizing Statute(s): PL: Pub.L. 91 - 596 20(a)(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 35489	06/28/2007
30-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 31488	06/02/2008
Did the Agency receive public comments on this ICR? No

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

table that charts list of burden

IC Title	Form No.	Form Name
NIOSH-Administered Questionnaire
NIOSH-Former Worker Questionnaire
NIOSH-Health Questionnaire
Serial Spirometry
Semi-Quantitative Assessment Sheet

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ICR Summary of Burden

table that charts list 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	653	0	0	653	0	0
Annual Time Burden (Hours)	1,060	0	0	1,060	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 information collection.

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Annual Cost to Federal Government: $297,000

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: 06/09/2008

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