Information Collection Request

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

ICR 201302-0925-004 · OMB 0925-0406 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 7 Attachment 25: Paper/pen, CAWI or CATI Instruments for Private Applicators for AHS Form and Instruction Modified Available
Form 14 Attachment 26: Paper/pen, CAWI, and CATI for Proxy for AHS Form and Instruction New Available
Form 5 Attachment 19: BEEA Home Visit CAPI, Blood, & Urine x 3 Form and Instruction Modified Available
Form 1 Attachment 10: BEEA Schedule Home Visit Scripts for AHS Form and Instruction Modified Available
Form 3 Attachment 19: BEEA Home Visit CAPI, Blood, & Urine x 1 for AHS Form and Instruction Modified Available
Form 2 Attachment 20 or 21: BEEA CATI Screener for AHS Form and Instruction Modified Available
Form 1 Attachment 9: Reminder, Missing or Damaged Scripts for AHS Form and Instruction Modified Available
Form 12 Attachment 25: Paper/pen, CAWI or CATI for Spouses for AHS Form and Instruction Modified Available
Supporting State B_1107012.docx Supporting Statement B Uploaded 2013-02-08 Available
Attachment 28_AHS_PrivacyImpactAssessments.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 27_PhaseIV_HFUP_FAQs_CAWI_CATI.docx Supplementary Document Uploaded 2013-02-05 Available
Attachment 24_Phase_IV_HFUP_Letters.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 23_Phase_IV_HFUP_IRB_Appr_Signature_Pages.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 22_BEEA_Objectives.doc Supplementary Document Uploaded 2013-02-05 Available
Attachment 18_BEEA_Consent_Forms.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 17_BEEA_Letters.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 16_Phase_IV_Buccal_Cell_Collection_Information.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 15_Phase_IV_Buccal_Consents.docx Supplementary Document Uploaded 2013-02-05 Repair queued
Attachment 14_Phase_IV_Buccal_Cell_Pre-Contact_Letters.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 13_BEEA_IRB_Approval_Signature_Pages.pdf Supplementary Document Uploaded 2013-02-05 Repair queued
Attachment 12_Phase_IV_Buccal_Cell_IRB_Approval_Signature_Pages.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 11_BEEA_FAQs.pdf Supplementary Document Uploaded 2013-02-05 Repair queued
Attachment 08_STARS_AHS_Confidentiality_Agreement.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 07_Contractor_Confidentialiy_Agreement.dot Supplementary Document Uploaded 2013-02-05 Repair queued
Attachment 06_ NIH_Privacy_Act_Memo.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 05_Certificate_Of_Confidentiality_NCI-02-028A.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 04_NAP_Members_Consultants.doc Supplementary Document Uploaded 2013-02-05 Available
Attachment 03_AGRICOH_Steering_Committee_Mbr_2011.pdf Supplementary Document Uploaded 2013-02-05 Available
Attachment 02_Bibliography.docx Supplementary Document Uploaded 2013-02-05 Available
Attachment 01_List_Of_Attachments_2012.docx Supplementary Document Uploaded 2013-02-05 Available
Cover Memo_Ag Health_12132012_FINAL.docx Supplementary Document Uploaded 2013-02-05 Available
Attachment 09-1_Phase_IV_Initial_Script_Consent_Buccal_Cell.docx Supplementary Document Uploaded 2013-02-06 Repair queued
Supporting State A_1102012.docx Supporting Statement A Uploaded 2013-02-08 Available
IC Document Collections
ICR Details
0925-0406 201302-0925-004
Historical Active 201005-0925-004
HHS/NIH 18763
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 without change 04/19/2013
Retrieve Notice of Action (NOA) 02/15/2013
  Inventory as of this Action Requested Previously Approved
04/30/2016 36 Months From Approved 05/31/2013
25,551 0 1,780
10,465 0 550
0 0 0

The Agricultural Health Study (AHS) program staff is requesting approval of this revision to begin information collection in February, 2013. AHS is a cohort study of 89,568 licensed pesticide applicators (both private and commercial applicators) and the spouses of the private applicators in Iowa and North Carolina that is to be followed for 20 years or more. The stimulus for this prospective investigation comes from the growing evidence that, despite a low mortality overall, farmers experience an excess of several cancers, including lymphatic and hematopoietic system, connective tissue, skin, brain, prostate, stomach and lips. This suggests a common set of exposures which may explain the high rates in farmers and rising rates in the general population. NCI is primarily interested in cancer outcomes and NIEHS is interested in other disease outcomes. For this phase of the data collection, NIEHS will be taking the lead role in collecting information for this phase of the study. This revision is to initiate and complete the phase IV follow-up interview (2013-2015) as well as to continue and complete the ongoing Study of Biomarkers of Exposures Effects in Agriculture (BEEA) and buccal cell collections. The primary objective of the AHS study remains to be determination of the health effects resulting from occupational and environmental exposures in agriculture. Similar questionnaires are being used as in previous AHS interviews to obtain information on non-cancer outcomes. New for phase IV, questionnaire data will be collected by using one of three methods of the cohort member's choosing: self-administered computer assisted web survey; self-administered paper-and-pen; or an interviewer administered computer assisted telephone interview. Additionally, because loss to follow up of diseased individuals is a critical issue, we have added proxy interviews for those deceased or too ill to complete themselves will be completed by using one of the three methods.

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

Not associated with rulemaking

  77 FR 72871 12/06/2012
78 FR 8151 02/05/2013
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 25,551 1,780 0 23,771 0 0
Annual Time Burden (Hours) 10,465 550 0 9,915 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 an increase in burden from the previous submission approved in 2010. The increase in burden for this revision is accounted for by the initiation of the phase IV follow up scheduled from February 2013 through December 2015. As well, this is a continuation to complete the information collection related to the Study of Biomarkers of Exposures Effects in Agriculture (BEEA) and buccal cells. Similar questionnaires are being used to ones that have been employed in previous AHS interviews to obtain information on non-cancer outcomes. New for phase IV, questionnaire data will be collected by using one of three methods of the cohort member's choosing: self-administered computer assisted web survey; self-administered paper-and-pen; or an interviewer administered computer assisted telephone interview. Additionally, because loss to follow up of diseased individuals is a critical issue, we have added proxy interviews for those deceased or too ill to complete themselves will be completed by using one of the three methods. The Agricultural Health Study has been conducted through contractors since its inception. An additional change is that the National Institutes of Environmental Health (NIEHS) will be taking the lead role in collecting updated health information for this phase of the study. For this reason, the OMB clearance number is being transferred from that National Cancer Institute to NIEHS.

$1,246,372
Yes Part B of Supporting Statement
No
No
No
No
Uncollected
Saleda Perryman

  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.
02/15/2013