Information Collection Request

Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture (NCI)

ICR 201005-0925-004 · OMB 0925-0406 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 1 Phase III CATI v. 2 Instrument for Agricultural Health Study Form and Instruction Modified Available
Form 12 BEEA Home Visit CAPI for Agricultural Health Study Form and Instruction New Repair queued
Form 10 BEEA Schedule Home Visit Script for Agricultural Health Study Form and Instruction New Repair queued
Form 9 BEEA Home Visit CAPI for Agricultural Health Study Form and Instruction New Repair queued
Form 7 BEEA CATI Eligibility Screener for Agricultural Health Study Form and Instruction New Repair queued
Form 5 Phase III Buccal Cell Reminder, Missing or Damaged Scripts for Agricultural Health Study Form and Instruction New Available
Form 2 Phase III Telephone Interview and Buccal Cell Scripts for Agricultural Health Study Form and Instruction Modified Available
Passback_Attachment_Biomarker Study Protocol 2010-02-25.doc Supplementary Document Uploaded 2010-05-21 Available
Supporting State B_4-2010_v 3_highlight.docx Supporting Statement B Uploaded 2010-04-28 Available
Attach 26_BEEA IRB Approvals.pdf Supplementary Document Uploaded 2010-05-20 Available
Attach 22_BEEA consent forms.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 14_Phase III Buccal Consent Forms.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 12 - Phase III IRB Approvals.pdf Supplementary Document Uploaded 2010-04-28 Available
Attach 11_STARS_AHS Confidentiality Agreement.pdf Supplementary Document Uploaded 2010-04-28 Available
Attach 9_Contractor Confidentialiy Agreement.dot Supplementary Document Uploaded 2010-04-28 Repair queued
Attach 8_ NIH Privacy Act Memo.pdf Supplementary Document Uploaded 2010-05-20 Available
Attach 7_Certificate of Confidentiality_NCI-02-028A.pdf Supplementary Document Uploaded 2010-04-28 Available
Attach 6_NAP Members_consultants (2).docx Supplementary Document Uploaded 2010-04-28 Repair queued
Attach 5_International Ag Consort Consultants.doc Supplementary Document Uploaded 2010-04-28 Available
Attach 1_Bibliography.doc Supplementary Document Uploaded 2010-04-28 Available
Pre-Submission Cover Memo_Ag Health.docx Supplementary Document Uploaded 2010-04-28 Repair queued
Attach 27_Letter for CBC lymphocyte assay results_NCI_generic.doc Supplementary Document Uploaded 2010-04-29 Available
Attach 25A&B_BEEA Advance Letters for First Post-Diazinon Application Visit.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 24_BEEA pre-visit reminder letters and script.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 23_BEEA consent mailing letters and pre-visit prep.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 21_BEEA introductory letters and information sheets.pdf Supplementary Document Uploaded 2010-04-29 Repair queued
Attach 17B_Buccal Remail Consent Form Cover Letter Iowa.rtf Supplementary Document Uploaded 2010-04-29 Available
Attach 18B_Buccal Remail Kit Cover Letter Iowa.doc Supplementary Document Uploaded 2010-04-29 Available
Attach 13_Phase III buccal contact scripts and letters.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 15_Phase III buccal kit cover letters and instructions.pdf Supplementary Document Uploaded 2010-04-29 Available
Attach 10_Phase III Introductory letters.pdf Supplementary Document Uploaded 2010-04-29 Available
Supporting State A_4-2010_v.3_highlight.docx Supporting Statement A Uploaded 2010-04-29 Available
ICR Details
0925-0406 201005-0925-004
Historical Active 200807-0925-003
HHS/NIH
Agricultural Health Study: A Prospective Cohort Study of Cancer and Other Diseases Among Men and Women in Agriculture (NCI)
Revision of a currently approved collection   No
Regular
Approved with change 05/21/2010
Retrieve Notice of Action (NOA) 05/12/2010
Approved consistent with revised documents uploaded on 5/20/2010. In the event of subsequent phases, NCI/NIH will sumbit a change package that describes the design and protocol for the next phase of the study before beginning the data collection for that phase.
  Inventory as of this Action Requested Previously Approved
05/31/2013 36 Months From Approved 10/31/2011
1,780 0 6,861
550 0 4,140
0 0 0

The Agricultural Health Study (AHS) is a cohort study of 89,568 licensed pesticide applicators and their spouses in Iowa and North Carolina to be followed for 20 years or more. The focus of the phase III follow-up period (2005-2013) is to update exposure information and health histories by means of a computer assisted telephone interview, and to follow the cohort to determine disease incidence and mortality. This request is to complete the follow-up for phase III including interviews and buccal cell collection, and to incorporate a new biomarker component of the AHS, the Study of Biomarkers of Exposures and Effects in Agriculture (BEEA). In BEEA, we will conduct computer-assisted telephone (CATI) and in-person (CAPI) interviews, and will collect blood and urine samples from a subset of AHS participants. The stimulus for the AHS comes from the growing evidence that, despite a low mortality overall, farmers experience an excess of several cancers. The new biomarker component of the AHS will allow us to evaluate risk of monoclonal gammopathy of undetermined significance (MGUS), a pre-clinical marker for multiple myeloma, and to assess the biological plausibility and mechanism-of-action of associations between pesticides and cancers observed in earlier AHS studies.

US Code: 42 USC 285a Name of Law: Public Health Service Act
  
None

Not associated with rulemaking

  75 FR 9902 03/04/2010
75 FR 9902 03/04/2010
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 1,780 6,861 0 -5,081 0 0
Annual Time Burden (Hours) 550 4,140 0 -3,590 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
Yes
Miscellaneous Actions
Yes
Miscellaneous Actions
This revision is a program change due to agency discretion and represents a decrease in burden from the previous submission approved in October, 2008. The substantial decrease in burden for this revision is accounted for by fewer Phase III participants being interviewed. The phase III collection was scheduled from November 2005 through November 2011 and has been impacted by restricted scheduling due to the planting season and budgetary issues, resulting in the need for additional time to complete the questionnaire administration. This request will allow the Agricultural Health Study to complete phase III of its research and to add an important additional component, the study of Biomarkers of Exposures and Effects in Agriculture (BEEA) which will help NCI investigators to identify occupational exposures in the agricultural environment that increase the risk of monoclonal gammopathy of undetermined significance (MGUS).

$537,041
Yes Part B of Supporting Statement
No
Uncollected
Uncollected
No
Uncollected
Mikia Currie 3014350941

  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.
05/12/2010