Biomonitoring of Great Lakes Populations Program II

Forms and Documents

Document Name	Status
Network Size Questions for Respondent-driven Sampling, Subsistence Anglers Form and Instruction	New
Biomonitoring Interview Questionnaire, Subsistence Anglers Form and Instruction	New
Informed Consent Form for Subsistence Anglers Form and Instruction	New
Eligibility Screening Survey, Subsistence Anglers Form and Instruction	New
Network Size Questions for Respondent-driven Sampling, Bhutanese and Burmese Form and Instruction	New
Biomonitoring Interview Questionnaire, Bhutanese and Burmese Form and Instruction	New
Informed Consent Form for Bhutanese and Burmese Form and Instruction	New
Eligibility Screening Survey, Bhutanese and Burmese Form and Instruction	New
4_References_SSA_SSB.docx Supplementary Document	2014-11-07
1-GLBPII 30dayFRN.docx Supplementary Document	2014-11-07
Att10_Results_Commun.docx Supplementary Document	2014-11-07
Att9e7_Cholest_Creatin.pdf Supplementary Document	2014-11-07
Att9e6_PFCs.pdf Supplementary Document	2014-11-07
Att9e5_UrineMercury.pdf Supplementary Document	2014-11-07
Att9e4_PAHs.pdf Supplementary Document	2014-11-07
Att9e3_Mirex.pdf Supplementary Document	2014-11-07
Att9e2_BloodMetals.pdf Supplementary Document	2014-11-07
Att9e1_PCBs_PBDEs_Pesticides.pdf Supplementary Document	2014-11-07
Att9d Results 201401-serum_NY.xlsx Supplementary Document	2014-11-07
Att9d Results 201401_urine_NY.xlsx Supplementary Document	2014-11-07
Att9d PCI 2014-03 Anglais.pdf Supplementary Document	2014-11-07
Att9d PCI 2014-02 Anglais.pdf Supplementary Document	2014-11-07
Att9d PCI 2014-01 Anglais.pdf Supplementary Document	2014-11-07
Att9d eptrsfc 1067 142TRELWB.pdf Supplementary Document	2014-11-07
Att9d eptrsfc 1067 142TRELU.pdf Supplementary Document	2014-11-07
Att9d eptrsfc 1067 142PB.pdf Supplementary Document	2014-11-07
Att9d AMAP 2014-01 - English.pdf Supplementary Document	2014-11-07
Att9d 2014 CAP Chemistry -A PT Evaluation (3-17-14).pdf Supplementary Document	2014-11-07
Att9c_CLIA.docx Supplementary Document	2014-11-07
Att9a b_LabProcedures.docx Supplementary Document	2014-11-07
Att8h1_NetworkQs_Subsanglers.docx Supplementary Document	2014-11-07
Att8g1_BiomQuestionnaire_Subsanglers.docx Supplementary Document	2014-11-07
Att8f1_ConsentSubsanglers.docx Supplementary Document	2014-11-07
Att8e1_ScreeningSurvey_Subsanglers.docx Supplementary Document	2014-11-07
Att8d1_NetworkQs_Bhutan_Burm.docx Supplementary Document	2014-11-07
Att8c1_BiomQuestionnaire_Bhutan_Burm.docx Supplementary Document	2014-11-07
Att8b1_ConsentBhutan_Burm.docx Supplementary Document	2014-11-07
Att8a1_ScreeningSurveyBhutan_Burm.docx Supplementary Document	2014-11-07
Att7_ProjectInfoSheet.docx Supplementary Document	2014-11-07
Att6_MapCensusTrks_poverty.docx Supplementary Document	2014-11-07
Att5_Nonresearch.docx Supplementary Document	2014-11-07
Att4_ Example_RDS_Coupon.pdf Supplementary Document	2014-11-07
Att3_Prgrm_Overview.docx Supplementary Document	2014-11-07
Att2_60DayFRN.pdf Supplementary Document	2014-11-07
Att1_AuthLegislation.docx Supplementary Document	2014-11-07
3-GLBPII_SSB_25March2015.docx Supporting Statement B	2015-04-10
2-GLBPII_SSA_20March2015FINAL.docx Supporting Statement A	2015-04-10

IC Document Collections

IC ID	Document Title	Status
213781	Network Size Questions for Respondent-driven Sampling, Subsistence Anglers Form and Instruction	New
213780	Biomonitoring Interview Questionnaire, Subsistence Anglers Form and Instruction	New
213778	Informed Consent Form for Subsistence Anglers Form and Instruction	New
213777	Eligibility Screening Survey, Subsistence Anglers Form and Instruction	New
213776	Network Size Questions for Respondent-driven Sampling, Bhutanese and Burmese Form and Instruction	New
213775	Biomonitoring Interview Questionnaire, Bhutanese and Burmese Form and Instruction	New
213774	Informed Consent Form for Bhutanese and Burmese Form and Instruction	New
213772	Eligibility Screening Survey, Bhutanese and Burmese Form and Instruction	New

ICR Details

OMB Control No: 0923-0052	ICR Reference No: 201411-0923-001
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/TSDR	Agency Tracking No: 14ATA
Title: Biomonitoring of Great Lakes Populations Program II
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 04/10/2015
	Date Received in OIRA: 11/17/2014
Terms of Clearance: Approved consistent with the understanding that the primary purpose of this project is to document the exposure distribution within each target population living in Syracuse, NY. The design does not support the ability to draw conclusions about the statistical significance of differences between either of the RDS samples and the data from nationally representative populations (e.g., NHANES), as the underlying assumptions in the samples are very different.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2017	24 Months From Approved
Responses	942	0	0
Time Burden (Hours)	188	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: In 2009, the federal Great Lakes Restoration Initiative (GLRI) was established under the stewardship of the U.S. Environmental Protection Agency (US EPA) to protect, restore, and maintain the Great Lakes ecosystem in partnership with 15 other federal agencies. Under an interagency agreement with the US EPA, the Agency for Toxic Substances and Disease Registry (ATSDR) established the Biomonitoring of Great Lakes Populations Program II under its 1980 Comprehensive Environmental Response Compensation and Liability Act (CERCLA) authority. The ATSDR Biomonitoring of Great Lakes Populations Program II aims to provide a human exposure assessment to Great Lakes contaminants among targeted subpopulations concurrent with the onset of restoration activities. Specifically, the purpose of the current program is to evaluate exposure in an area that was not addressed in the FY2010 CDC-RFA TS10-1001 cooperative agreement program. The CDC-RFA-TS10-1001 cooperative agreement program received OMB approval on 10/12/2012 (OMB Control No: 0923-0044 ICR Reference No. 201203-0923-001).

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Authorizing Statute(s): PL: Pub.L. 111 - 88 1 Name of Law: Department of Interior, Environment, and Related Agencies Appropriations Act, 2010
   US Code: 42 USC 9604 Name of Law: Comprehensive Environmental Response, Compensation and Liability Act of 1980 (CERCLA)
   US Code: 42 USC 9626 Name of Law: Superfund Amendments and Reauthorization Act of 1986 (SARA)
  

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
60-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 50649	08/25/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	79 FR 66378	11/07/2014
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 8

IC Title	Form No.	Form Name
Biomonitoring Interview Questionnaire, Bhutanese and Burmese	None	Biomonitoring Interview Questionnaire, Bhutanese and Burmese
Network Size Questions for Respondent-driven Sampling, Bhutanese and Burmese	None	Network Size Questions for Respondent-driven Sampling, Bhutanese and Burmese
Network Size Questions for Respondent-driven Sampling, Subsistence Anglers	None	Network Size Questions for Respondent-driven Sampling, Subsistence Anglers
Informed Consent Form for Bhutanese and Burmese	None	Informed Consent Form for Bhutanese and Burmese
Eligibility Screening Survey, Bhutanese and Burmese	None	Eligibility Screening Survey, Bhutanese and Burmese
Eligibility Screening Survey, Subsistence Anglers	None	Eligibility Screening Survey, Subsistence Anglers
Informed Consent Form for Subsistence Anglers	None	Informed Consent Form for Subsistence Anglers
Biomonitoring Interview Questionnaire, Subsistence Anglers	None	Biomonitoring Interview Questionnaire, Subsistence Anglers

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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	942	0	0	942	0	0
Annual Time Burden (Hours)	188	0	0	188	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

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

Burden Reduction Due to:

Short Statement: The submission is a New ICR

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Annual Cost to Federal Government: $631,000

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? No

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: 11/17/2014

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