Morbidity Study of Former Marines, Dependents, and Employees Potentially Exposed to Contaminated Drinking Water at USMC Base Camp Lejeune

Forms and Documents

Document	Type	Status	Availability
Health Survey	Form	Modified	Repair queued
Attachment N health survey protocol 4_11.docx	Supplementary Document	Uploaded 2011-04-25	Available
support state B 4_11 clean.doc	Supporting Statement B	Uploaded 2011-04-11	Repair queued
Changes to OMB package 0923 0042 April 2011.docx	Justification for No Material/Nonsubstantive Change	Uploaded 2011-04-11	Available
Attachment M Consent for registrants April 2011 redline.doc	Supplementary Document	Uploaded 2011-04-14	Repair queued
Attachment L Consent for Health Study participnats April 2011.doc	Supplementary Document	Uploaded 2011-04-14	Available
Attachment K telephone reminder 2_11 clean.doc	Supplementary Document	Uploaded 2011-04-14	Repair queued
Attachment J email reminder 2_11 clean.doc	Supplementary Document	Uploaded 2011-04-14	Repair queued
Attachment I reminder letter 2_11 clean.doc	Supplementary Document	Uploaded 2011-04-14	Available
Attachment H email reminder 2_11 clean.doc	Supplementary Document	Uploaded 2011-04-14	Repair queued
Attachment G postcard 2_11 clean.doc	Supplementary Document	Uploaded 2011-04-14	Repair queued
Attachment F email invite 2_11 clean.doc	Supplementary Document	Uploaded 2011-04-14	Repair queued
Attachment D prenotice and invite ltr USMC 2_11 clean.docx	Supplementary Document	Uploaded 2011-04-14	Repair queued
support state A 4_11 clean.doc	Supporting Statement A	Uploaded 2011-04-11	Available

IC Document Collections

IC ID	Collection	Type	Status	Form
195214	Health Survey	Form	Modified

ICR Details

OMB Control No: 0923-0042	ICR Reference No: 201104-0923-001
Status: Historical Active	Previous ICR Reference No: 201011-0923-001
Agency/Subagency: HHS/TSDR	Agency Tracking No:
Title: Morbidity Study of Former Marines, Dependents, and Employees Potentially Exposed to Contaminated Drinking Water at USMC Base Camp Lejeune
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/28/2011
	Date Received in OIRA: 04/14/2011
Terms of Clearance: Previous Terms of Clearance apply.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	11/30/2013	11/30/2013	11/30/2013
Responses	47,601	0	47,601
Time Burden (Hours)	35,701	0	35,701
Cost Burden (Dollars)	0	0	0

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Abstract: On Jan. 28, 2008, President Bush signed H.R. 4986: National Defense Authorization Act for FY 2008 which requires ATSDR to develop a health survey of individuals possibly exposed to contaminated drinking water at Camp Lejeune that would collect: "...personal health information that may lead to scientifically useful health information associated with exposure to trichloroethylene (TCE), [tetrachloroethylene or perchloroethylene] (PCE), vinyl chloride, and the other contaminants identified in the ATSDR studies that may provide a basis for further reliable scientific studies of potentially adverse health impacts of exposure to contaminated water at Camp Lejeune." The health survey will be mailed to everyone identified as having lived or worked at Camp Lejeune during the period of drinking water contamination. This includes anyone who registers with the US Marine Corps or ATSDR and those identified by computerized databases from the Defense Manpower Data Center or ATSDR. To have an unbiased sampling frame, the morbidity study population will consist of those identified by computerized databases who lived or worked at Camp Lejeune during the period of drinking water contamination. A comparison group is randomly sampled from Marines and civilian employees who were stationed at Camp Pendleton and not at Camp Lejeune during the period of water contamination.

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Authorizing Statute(s): PL: Pub.L. 110 - 181 315 Name of Law: National Defense Authorization 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

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Health Survey	none	Health Survey

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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	47,601	47,601	0	0	0	0
Annual Time Burden (Hours)	35,701	35,701	0	0	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

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

Burden Increase Due to:

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

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $4,900,000

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? Yes

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

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: 04/14/2011

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