Form 0920-1013 Attachment G_Pediatric Interview Form CLEAN VERSION

 CASE  CONTROL Form Approved

OMB No.0920-1013

Exp. Date 04/30/2017

Patient ID:__________________________

State ID:­­­­­­­­­­­­­­­­­­­­__________________________

REFERENCE Date _____/_____/______

Attachment G: Community-associated Clostridium difficile Infection (CDI) Risk Factor Study Pediatric Case and Control Interview

Section 1: Identifiers***Cases AND Controls*******

1.  CASE  CONTROL

2. Study ID: __________________________________

3. If Control, Reference date: _____/_____/______

(mm/dd/yyyy)

2 weeks before _____/_____/______

4 weeks before _____/_____/______

12 weeks before _____/_____/______

4. Age: Years Months

5. Sex:  Male  Female

Section 2: Illness Questions- ****CASES ONLY ****CONTROLS SKIP TO SECTION 3, Q.11****

Now I will ask you questions about your child’s illness.

6. Do [you] remember when your child’s diarrhea began around (positive specimen date ___/_____/______)?

Yes 1 (If Yes –fill in date diarrhea began and use as reference date.)

No 2 (fill in date of specimen collection and use as reference date.)

Don’t know/Not sure 7 (fill in date of specimen collection and use as reference date.)

Refused 9 (fill in date of specimen collection and use as reference date.)

 REFERENCE DATE: _____/_____/______

(mm/dd/yyyy)

2 week before _____/_____/______

4 weeks before _____/_____/______

12 weeks before _____/_____/______

7. How many days did your child’s diarrhea last around the time of (reference date ____/_____/______)? 

Don’t know/Not sure 7

Refused 9

7A. On the worst day of your child’s diarrhea around the time of (reference date ____/_____/______), what was the approximate number of stools your child had in a 24-hour period?

≥3-<5 stools 1

5-10 stools 2

>10 stools 3

Don’t know/Not sure 7

Refused 9

8. Did your child have any of the following symptoms associated with [his/ her] C. difficile illness around the time of (reference date ____/_____/______)?

[READ LIST] Yes No DK/NS Refused

Bloody stools 1 2 7 9

Fever 1 2 7 9

Nausea 1 2 7 9

Vomiting 1 2 7 9

Abdominal pain 1 2 7 9

Other 1 2

Specify:_­­­­­______________________________________________________________

9. Was your child hospitalized overnight for [his/ her] C. difficile illness around the time of (reference date ____/_____/______)?

9A. If yes, where: _____________________________

(name of hospital will not be transmitted to CDC)

Yes 1

No 2

Don’t know/Not sure 7

Refused 9

10. At the time of your child’s C. difficile diagnosis around the time of (reference date ____/_____/______), was your child told by a doctor or healthcare provider that [she/ he] had any other stomach [enteric, gastrointestinal] infection?

Yes 1

No 2 (Go to Q.11)

Don’t know/Not sure 7 (Go to Q.11)

Refused 9 (Go to Q.11)

10A. If yes, what was the name of the infection?

[Read list if necessary] Yes No DK/NS Refused

Campylobacter 1 2 7 9

E. coli 1 2 7 9

Listeria 1 2 7 9

Salmonella 1 2 7 9

Shigella 1 2 7 9

Vibrio 1 2 7 9

Yersinia 1 2 7 9

Cryptosporidium 1 2 7 9

Giardia 1 2 7 9

Rotavirus 1 2 7 9

Norovirus 1 2 7 9

Other 1 2

Specify:_____________________________________________________________________

Section 3: Healthcare contacts- Cases and Controls

Now I will ask you questions about your child’s healthcare contacts between 12 weeks before [Reference Date_____/_____/______] to [Reference Date_____/_____/______].

11. Did your child receive care in any doctor’s office, dental office, hospital, or any other medical facility in the 12 weeks before [REFERENCE DATE ____/_____/_____]?

Yes 1

No 2 (Go to Q.12)

Don’t know/Not sure 7 (Go to Q. 12)

Refused 9 (Go to Q.12)

11A. I will now ask you about the types of places your child visited for [his / her] healthcare in that time period and when [he / she] made the visit. Did your child visit any of the following places?

[READ LIST]	YES=1	NO=2	DN/NS=7	Refuse=9	How many weeks prior to [Reference Date_____/_____/______] did your child visit this place?
					2 weeks	4 weeks	12 weeks
Outpatient Procedure Center
Ambulatory /Outpatient surgery center
Dental office
Doctor’s office
Emergency department/room
Hemodialysis
Hospital
Outpatient lab
Physical therapy center
Urgent care
Other (Specify)

IF NO TO ALL OPTIONS IN Q.11A then SKIP to Q.12

11B. during those visits in the 12 weeks before [Reference Date_____/_____/______] did your child have any of the following procedures performed?

*****If Subject answered YES to dental visits only in 11A then only ask about last two items (oral surgery and dental cleaning)*****

[READ LIST]	YES=1	NO=2	DN/NS=7	Refuse=9	How many weeks prior to [Reference Date_____/_____/______] did this procedure happen?
					2 weeks	4 weeks	12 weeks
Upper Endoscopy (Did the doctors pass a tube through your mouth or nose into your stomach?)
Colonoscopy or Sigmoidoscopy (Did the doctors pass a tube into your rectum to look into your colon/bowel?)
X-ray that required GI Prep (Did you have an X-ray performed where you had to swallow something first?)
Chemotherapy
Surgery in an operating room If yes, Specify type:
Other Medical Procedure:
Oral Surgery
Dental Cleaning

12. Did your child visit a person in or go with anyone to a doctor’s office, dental office, hospital, nursing home, or any other medical facility in the 12 weeks before [Reference Date_____/_____/______]?

Yes 1

No 2 (Go to Q.13)

Don’t know/Not sure 7 (Go to Q.13)

Refused 9 (Go to Q.13)

12A. What type of facility did your child visit or go withsomeone to in the 12 weeks before [Reference Date ____/_____/_____]?

[READ LIST]	YES=1	NO=2	DN/NS=7	Refuse=9	How many weeks prior to [Reference Date_____/_____/______] did your child visit this place?
					2 weeks	4 weeks	12 weeks
Outpatient procedure center
Ambulatory / Outpatient surgery center
Dental office
Doctor’s office
Emergency department/room
Hemodialysis
Hospital
Long term care/ skilled nursing facility
Outpatient lab
Physical therapy center
Urgent care
Other (Specify):

Section 4: Household contacts

The next few questions are about your child and persons who lived with your child during the 12 weeks before [Reference Date_____/_____/______].

13. Excluding your child, how many people lived in your child’s household during that time? 

13A. What were the ages of the people living in your child’s household, not including your child?

[List number of people in each group]

Ages <1 1 to 3 4 to 10 11 to 17 18 to 34 35 to 59  60+

14. Did any household member excluding your child wear diapers around the time of (reference date ____/_____/______)? (Including adults in diapers)

Yes 1

No 2

Don’t know/Not sure 7

Refused 9

15. Did any household members excluding your child attend a group childcare setting, daycare, or adult daycare around the time of (reference date ____/_____/______)? We consider daycare to be any place inside or outside your home where a household member spends at least 4 hours per week under an adult’s care with at least two other people who do not live with your child.

Yes 1

No 2 (Go to Q.16)

Don’t know/Not sure 7 (Go to Q.16)

Refused 9 (Go to Q.16)

15A

. If yes, what type(s) of daycare setting was it?[Read description of setting types if necessary

Home……………………………………1

Center…………………………………..2

Members attend both types of daycare………….3

Don’t know / Not Sure………………..7

Refused……………………………….9

]

Home – care is provided in someone’s home typically by one person

Center- care is provided typically in a commercial building with many providers and rooms

16. In the 12 weeks before [Reference Date_____/_____/______], did any household member stay overnight in a hospital?

Yes 1

No 2

Don’t know/Not sure 7

Refused 9

17. In the 12 weeks before [Reference Date_____/_____/______], did any household member stay overnight in a nursing home?

Yes 1

No 2

Don’t know/Not sure 7

Refused 9

18. In the 12 weeks before [Reference Date_____/_____/______], did anyone else in your child’s household have diarrhea?

Yes 1

No 2 (Go to Q.19)

Don’t know/Not sure 7 (Go to Q.19)

Refused 9 (Go to Q.19)

18A. Was this person diagnosed with C. difficile?

Yes 1

No 2

Don’t know/Not sure 7

Refused 9

19. Did any of your child’s household members work at or volunteer, in any capacity, at a hospital, other medical facility, or in any facility where patient care is provided in the 12 weeks before [Reference Date____/_____/_____]? Volunteering can mean doing anything that requires you to enter a healthcare facility. Examples include: playing a musical instrument in the lobby, helping to direct patients to the correct area.

Yes 1

No 2 (Go to Q.20)

Don’t know/Not sure 7 (Go to Q.20)

Refused 9 (Go to Q.20)

19A. If yes, what type of healthcare setting?

(READ LIST) Yes No DK/NS Refused

Hospital 1 2 7 9

Emergency department/room 1 2 7 9

Doctor’s office 1 2 7 9

Dentist 1 2 7 9

Long term care/skilled nursing facility 1 2 7 9

Hemodialysis facility 1 2 7 9

Other facility 1 2

Specify:_____________________________________________________________________

19B. Did their job involve direct physical contact with patients? For example touching the patient to help her get out of a chair.

Yes 1

No 2 (Go to Q.20)

Don’t know/Not sure 7 (Go to Q.20)

Refused 9 (Go to Q.20)

19B1. If yes, what was their main job? _____________________________________________________

19C2. Job Code- (Fill in job code after interview is finished)

20. Did your child attend a group childcare or daycare in the 12 weeks before [Reference Date____/_____/_____]? We consider daycare to be any place inside or outside your home where your child spends at least 4 hours per week under an adult’s care with at least two children who do not live with you.

Yes 1

No 2 (Go to Q.21)

Don’t know/Not sure 7 (Go to Q.21)

Refused 9 (Go to Q.21)

20A. If yes, what type of childcare setting? [Read list if necessary]

Home–care is provided in someone’s home typically by one person 1

Center-care is provided typically in a commercial building with many providers and rooms 2

Other 4

Specify: __________________________________________________

Don’t know/Not sure 7

Refused 9

Section 5: Diet Exposures

I’d like to change direction now and ask you about the foods your child generally eats in a given week and the kind of water your child drinks.

21. In a current typical week, not in the pat timeframe we have talked about, how frequently does your child consume the following foods?

[READ LIST]	Often	Sometimes	Rarely	Never	DK/NS	Refused
	>5/week	2-5 /week	<2/ week	Never
Eggs	1	2	3	4	7	9
Dairy (milk, yogurt)	1	2	3	4	7	9
Fresh-cut raw vegetables	1	2	3	4	7	9
Plant-based protein (tofu, tempeh, seitan)	1	2	3	4	7	9
Red Meat (beef, lamb, other game meat)	1	2	3	4	7	9
Poultry (chicken, turkey)	1	2	3	4	7	9
Seafood (fish, shellfish)	1	2	3	4	7	9

22. Did your child receive food / formula through a feeding tube called a G-tube or J-tube in the 12 weeks before [Reference Date_____/_____/______]?

Yes 1

No 2

Don’t know/Not sure 7

Refused 9

23. Which one of the following is the source of tap water in the home your child was living in around the time of (reference date ____/_____/______) (select only one):

 water utility  private well  spring  unknown  other

Name of the water utility, if known ______________________________________

If other, specify type and location ______________________________________

23A. At that home, what type of unboiled water did your child most often use for drinking (chose only one)?

______Tap water not treated in the home

______Tap water treated in the home (for example, filtered, UV light, distilled, or whole house point-of-entry device)

______Commercially bottled water

______Other (specify): ________________________

24. During the first 6-months of your child’s life, would you say: [READ CHOICES]

Almost 100% of feedings were breast milk with no or very little formula…………1

Most feedings (about 75%) were breast milk and the rest were formula………...2

About half (or 50%) of feedings were breast milk and half were formula………...3

Most feedings (about 75%) were formula and the rest were breast milk…………4

Almost 100% of feedings were formula with no or very little breast milk…………5

Don’t know/Not sure…………………………………………………………………….7

Refused …………………………………………….9

Section 6: Medical History

The next set of questions is about medications your child may have been taking in the 12 weeks before [Reference Date_____/_____/______]. Medicine bottles or records may help you remember about specific medications. Would you like to gather this information before we go on?

25. Did your child take any antibiotics by mouth or in an I.V. (in his/ her vein) in the 12 weeks before [Reference Date_____/_____/______]?

Yes 1

No 2 (Go to Q.27)

Don’t know/Not sure 7 (Go to Q. 27)

Refused 9 (Go to Q.27)

26. Why did your child take these antibiotics?

Note: Subjects may indicate more than one reason (For example, if more than one course of antibiotics was taken for different illnesses or if one antibiotic was taken for and ear infection and a pneumonia)

[DO NOT READ LIST]	Yes	No
Bronchitis/ pneumonia	1	2
Dental cleaning	1	2
Ear, sinus, upper respiratory infection	1	2
Eye infection	1	2
Oral surgery	1	2
Skin or soft tissue infection (abscess or cellulitis)	1	2
Surgery	1	2
Urinary tract infection	1	2
Urinary tract infection prophylaxis	1	2
DK/NS	7	7
Refused	9	9
Other	1	2
Specify:

26A. Which antibiotic(s) did your child take in the 12 weeks before [Reference Date_____/_____/______]? [DO NOT READ LIST]

[DO NOT READ LIST]		If yes, how many weeks prior to [Reference Date_____/_____/______] did your child take this antibiotic?
	YES	2 weeks	4 weeks	12 weeks
Amoxicillin	1
Amoxicillin/Clavulanate or Augmentin	1
Ampicillin	1
Azithromycin	1
Cefaclor	1
Cefadroxil	1
Cefdinir	1
Cefixime	1
Cefuroxime	1
Cefprozil	1
Cephalexin or keflex	1
Cephradine	1
Ciprofloxacin or Cipro	1
Clarithromycin	1
Clindamycin	1
Dapsone	1
Doxycycline	1
Erythromycin	1
Erythromycin/sulfa	1
Fosfomycin	1
Levofloxacin or levaquin	1
Metronidazole or flagyl	1
Norfloxacin or Norflox	1
Ofloxacin or Oflox	1
Penicillin or Pen VK	1
Tetracycline	1
Trimethoprim/Sulfa or Bactrim, Septra	1
Vancomycin	1
Other antibiotic 1	1
Specify other antibiotic 1	1
Other antibiotic 2	1
Specify other antibiotic 2	1
Don’t know/Not sure	7
Refused	9

27. Did your child use any antibiotic eye drops or ointment in the 12 weeks before [Reference Date_____/_____/______]?

Yes 1

No 2 (Go to Q.28)

Don’t know/Not sure 7 (Go to Q.28)

Refused 9 (Go to Q.28)

27A. If yes, what was the name of the drop (read list if necessary)?

Polytrim (Polymyxin sulfate / TMP)…….1

Ciloxan (Ciprofloxacin)…………………..2

Ocuflox (Ofloxacin)……………………….3

Vigamox, Moxeza (Moxifloxacin) ……..4

Other……………………………………….9

Specify: ________________________

28. In the 12 weeks before [Reference Date_____/_____/______], did your child regularly take any acid-reducing medications to treat excessive stomach acid, heartburn, or gastroesophageal reflux disease (GERD)? We define regular use as use of the product at least 3 days per week. Such medications might include Prevacid, Tums, Maalox, Mylanta, Tagamet, Zantac, Prilosec, or Nexium.

Yes 1

No 2 (Go to Q.29)

Don’t know/Not sure 7 (Go to Q.29)

Refused 9 (Go to Q.29)

28A. If Yes, please specify which medicine your child regularly took in those 12 weeks.

[DO NOT READ LIST]	YES=1	NO=2	How many weeks prior to [Reference Date_____/_____/______ ] did your child take this medication?
			2 weeks	4 weeks	12 weeks
Aciphex/rabeprazole	1	2
Alka-Seltzer	1	2
Maalox	1	2
Mylanta	1	2
Nexium/esomeprazole	1	2
Pepcid/famotidine	1	2
Prevacid/lansoprazole	1	2
Prilosec/omeprazole	1	2
Protonix/pantoprazole	1	2
Rolaids	1	2
Tums	1	2
Tagamet/cimetidine	1	2
Zantac/ranitidine	1	2
Other (Specify):	1	2
Don’t know/Not sure	7	7
Refuse	9	9

If yes, in the

2 weeks before

I am now going to ask about medications that are given for many reasons. These reasons includethings like chronic pain, depression, anxiety, and to help sleep. Examples of these medications include: Prozac, Celexa, Remeron, Paxil, and Trazadone.

29. In the 12 weeks before [Reference Date_____/_____/______], did your child regularly take any such medications? We define regular use as use of the product at least 3 days per week.

Yes 1

No 2 (Go to Q.30)

Don’t know/Not sure 7 (Go to Q.30)

Refused 9 (Go to Q.30)

29A. If Yes, please specify which medicine your child regularly took in the 12 weeks before [Reference Date_____/_____/______]

[DO NOT READ LIST]			How many weeks prior to [Reference Date_____/_____/______] did your child take this medication?
	YES	NO	2 weeks	4 weeks	12 weeks
Amitriptyline	1	2
Anafranil (Clomipramine)	1	2
Asendin (Amoxapine)	1	2
Celexa, Cipramil (Citalopram)	1	2
Cymbalta (Duloxetine)	1	2
Effexor (Venlafaxine)	1	2
Eldepryl, Emsam, Zelapar (Selegiline)	1	2
Escitalopram	1	2
Limbitrol (Chlordiazepoxide/Amitriptyline)	1	2
Ludiomil,(Maprotiline)	1	2
Luvox (Fluvoxamine)	1	2
Marplan (Isocarboxazid)	1	2
Nardil, Nardelzine (Phenelzine sulfate)	1	2
Norpramin (Desipramine)	1	2
Nortriptyline	1	2
Parnate,(Tranylcypromine)	1	2
Paxil (Paroxetine)	1	2
Pristiq (Desvenlafaxine)	1	2
Prozac, Sarafem, Fontex (Fluoxetine)	1	2
Remeron, Avanza, Zispin (Mirtazapine)	1	2
Savella, (Milnacipran)	1	2
Serzone, (Nefazodone)	1	2
Silenor, Prudoxin, Zonalon (Doxepin)	1	2
Surmontil (Trimipramine)	1	2
Symbyax (Olanzapine/fluoxetine)	1	2
Tofranil, (Imipramine)	1	2
Trazadone	1	2
Triptafen (amitriptyline/perphenazine)	1	2
Viibryd (Vilazodone)	1	2
Vivactil, (Protriptyline)	1	2
Wellbutrin, Zyban (Bupropion)	1	2
Zoloft, Lustral (Sertraline)	1	2
Other:
Don’t know/Not Sure	7	7
Refuse	9	9

Now I am going to ask you about medical conditions your child may have had.

30. Prior to [Reference Date_____/_____/______], were you ever told by a medical provider that your child had any of the following medical conditions? [READ LIST – including information in parentheses]

READ LIST	Yes	No	DK/NS	Refused
Congenital heart disease Specify:
Diabetes
Chronic renal (kidney) failure
If yes, is your child on dialysis or awaiting dialysis?
Chronic lung disease (BPD)
Asthma
Cystic fibrosis
Organ transplant
Bone marrow transplant
Leukemia or lymphoma
Sickle cell disease (not sickle cell trait)
Cancer (e.g. bone, liver, brain)
Short gut disease (bowel/ intestinal insufficiency)
Depression
Born by C-section?
Stay in the NICU at birth?
If yes, was your child premature? How many weeks premature?
If yes, how many weeks in the NICU?
Other illnesses:

31. What are your child’s most recent height or length and weight?

Height/ length: Ft in (or cm)

Weight: lbs (or Kg)

Don’t know/ Not Sure….7 [Prompt by saying: Sometimes children’s doctors give parents records or charts with their child’s weight and height. If you have these I can wait while you get them]

Refused ………………..9

Section 8: Demographics

Now I would like to ask you a few final questions.

32. Do you consider your child to be? [Read responses 1 & 2]

(    ) 1 Hispanic or Latino

(    ) 2 Not Hispanic or Latino

(    ) 7 Don’t Know/Not Sure (DO NOT READ)

(    ) 9 Refused (DO NOT READ)

( ) 10. Other racial category (DO NOT READ)

33. I am going to read a list of racial categories. Which one or more of the following do you consider your child to be…? [Read responses 1-5 and allow respondent to select one or more]

(   ) 1 White/Caucasian

(   ) 2 Black or African-American

(   ) 3 American Indian or Alaska Native

(   ) 4 Native Hawaiian or Other Pacific Islander

(   ) 5 Asian

(   ) 7 Don’t Know/Not Sure (DO NOT READ)

(   ) 9 Refused (DO NOT READ)

( ) 10. Other racial category (DO NOT READ)

34. What was your child’s main type of health care coverage during 12 weeks before [Reference Date_____/_____/_____] and [Reference Date_____/_____/______]? I’m going to read all the choices.

Private insurance, such as an HMO, PPO or a managed care plan 1

Public insurance, such as Medicaid, Medicare or state assistance program 2

A combination of private and public insurance 3

No health insurance 4

[DO NOT READ]: Other [specify] _________________________ 5

Don’t know or not sure 7

Refused 9

I have just a few more questions about the parent or guardian who cares for [child’s name] most often.

35. What is the highest grade or year of school that any of the household members completed? Please answer this question based on the highest level of education in your household

___1 Never attended school or kindergarten only

___2 Elementary or middle school; 1^st-8^th grade

___3 Some high school; 9^th-11^th grade

___4 High school graduate; 12^th grade or GED

___5 College or technical school for 1-3 years

___6 College for 4 years, with or without a degree

___9 Refused

36. In your child’s home, what is the household income from all sources? Read each response in order until respondent agrees.

___1 Less than $15,000	___5 Less than $70,000
___2 Less than $25,000	___6 $70,000 or more
___3 Less than $35,000	___7 Don’t know or not sure
___4 Less than $50,000	___9 Refused

That was my last interview question. Thank you very much for your time and participation!

37. Comments: _____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

_____________________________________________________________________________________

38. Interview Completed?  Yes  No

39. Date of interview: ____/____/______

(mm/dd/yyyy)

40. Interviewer initials: ______________

Health Interview Appendix—Job Codes

OFFICE OF MANAGEMENT AND BUDGET - 1998 Standard Occupational Classification

29-0000 Healthcare Practitioners and Technical Occupations

29-1000 Health Diagnosing and Treating Practitioners

29-1010 Chiropractors

29-1020 Dentists

29-1021 Dentists, General

29-1022 Oral and Maxillofacial Surgeons

29-1023 Orthodontists

29-1024 Prosthodontists

29-1029 Dentists, All Other Specialists

29-1030 Dietitians and Nutritionists

29-1040 Optometrists

29-1050 Pharmacists

29-1060 Physicians and Surgeons

29-1061 Anesthesiologists

29-1062 Family and General Practitioners

29-1063 Internists, General

29-1064 Obstetricians and Gynecologists

29-1065 Pediatricians, General

29-1066 Psychiatrists

29-1067 Surgeons

29-1069 Physicians and Surgeons, All Other

29-1070 Physician Assistants

29-1080 Podiatrists

29-1110 Registered Nurses

29-1120 Therapists

29-1121 Audiologists

29-1122 Occupational Therapists

29-1123 Physical Therapists

29-1124 Radiation Therapists

29-1125 Recreational Therapists

29-1126 Respiratory Therapists

29-1127 Speech-Language Pathologists

29-1129 Therapists, All Other

29-1130 Veterinarians

29-1190 Miscellaneous Health Diagnosing and Treating Practitioners

29-1199 Health Diagnosing and Treating Practitioners, All Other

29-2000 Health Technologists and Technicians

29-2010 Clinical Laboratory Technologists and Technicians

29-2011 Medical and Clinical Laboratory Technologists

29-2012 Medical and Clinical Laboratory Technicians

29-2020 Dental Hygienists

29-2030 Diagnostic Related Technologists and Technicians

29-2031 Cardiovascular Technologists and Technicians

29-2032 Diagnostic Medical Sonographers

29-2033 Nuclear Medicine Technologists

29-2034 Radiologic Technologists and Technicians

29-2040 Emergency Medical Technicians and Paramedics

29-2050 Health Diagnosing and Treating Practitioner Support Technicians

29-2051 Dietetic Technicians

29-2052 Pharmacy Technicians

29-2053 Psychiatric Technicians

29-2054 Respiratory Therapy Technicians

29-2055 Surgical Technologists

29-2056 Veterinary Technologists and Technicians

29-2060 Licensed Practical and Licensed Vocational Nurses

29-2070 Medical Records and Health Information Technicians

29-2080 Opticians, Dispensing

29-2090 Miscellaneous Health Technologists and Technicians

29-2091 Orthotists and Prosthetists

29-2099 Health Technologists and Technicians, All Other

29-9000 Other Healthcare Practitioners and Technical Occupations

29-9010 Occupational Health and Safety Specialists and Technicians

29-9011 Occupational Health and Safety Specialists

29-9012 Occupational Health and Safety Technicians

29-9090 Miscellaneous Health Practitioners and Technical Workers

29-9091 Athletic Trainers

29-9099 Healthcare Practitioners and Technical Workers, All Other

31-0000 Healthcare Support Occupations

31-1000 Nursing, Psychiatric, and Home Health Aides

31-1010 Nursing, Psychiatric, and Home Health Aides

31-1011 Home Health Aides

31-1012 Nursing Aides, Orderlies, and Attendants

31-1013 Psychiatric Aides

31-2000 Occupational and Physical Therapist Assistants and Aides

31-2010 Occupational Therapist Assistants and Aides

31-2011 Occupational Therapist Assistants

31-2012 Occupational Therapist Aides

31-2020 Physical Therapist Assistants and Aides

31-2021 Physical Therapist Assistants

31-2022 Physical Therapist Aides

31-9000 Other Healthcare Support Occupations

31-9010 Massage Therapists

31-9090 Miscellaneous Healthcare Support Occupations

31-9091 Dental Assistants

31-9092 Medical Assistants

31-9093 Medical Equipment Preparers

31-9094 Medical Transcriptionists

31-9095 Pharmacy Aides

31-9096 Veterinary Assistants and Laboratory Animal Caretakers

31-9099 Healthcare Support Workers, All Other

Public reporting burden of this collection of information is estimated to average 30 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-1013).

1