Information Collection Request

Examining In-Vehicle Exposures to Air Pollutants and Corresponding Health Outcomes of Commuters

ICR 201006-0920-001 · OMB 0920-0859 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
In-vehicle data collection during scripted commute Form New Available
Symptom diary Form New Available
Baseline questionnaire Form New Available
ACE_consent_112409_v4.doc Supplementary Document Uploaded 2010-08-05 Available
supporting statement B.docx Supporting Statement B Uploaded 2010-05-10 Available
Approval for ACE study 2010-2011.pdf Supplementary Document Uploaded 2010-05-10 Available
Attach6_IRBapproval letter_Emory.pdf Supplementary Document Uploaded 2010-05-10 Available
Attach2-E9-12746_60d-0920-09BQ_30Mar2010.pdf Supplementary Document Uploaded 2010-05-10 Available
Attach 1 Sept09.rtf Supplementary Document Uploaded 2010-05-10 Available
Commuter_0920-09BQ_suppstatement_July2010_II.doc Supporting Statement A Uploaded 2010-08-05 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
193098 In-vehicle data collection during scripted commute Form New
193097 Symptom diary Form New
193096 Baseline questionnaire Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
08/31/2011 12 Months From Approved
320 0 0
180 0 0
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Baseline questionnaire none Baseline Health and Exposure Questionnaire
Symptom diary none Symptom diary
In-vehicle data collection during scripted commute none In-vehicle data collection during scripted commute

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 320 0 0 320 0 0
Annual Time Burden (Hours) 180 0 0 180 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No