Follow-Up Activities for Product-Related Injuries

Forms and Documents

Document Name	Status
Form 182 Follow-Up Activities for Product-Related Injuries-Interviews Form	Modified
Form OMB0029_2013_PCNEI NEISS Form and Instruction	Modified
OMB0029_NEISS_Supporting_Statement_2016_final.docx Supporting Statement B	2016-09-27
OMB0029_NEISS_Supporting_Statement_2016_final.docx Supporting Statement A	2016-09-27
followupactivitiesFR30.pdf Supplementary Document	2016-09-27
followupactivitiesFR60.pdf Supplementary Document	2016-09-27
Form 182 from 2011 Field Manual for Investigations.pdf Supplementary Document	2013-07-18
PIA_National Electronic Injury Surveillance System (NEISS).pdf Supplementary Document	2010-03-31
OMB(40)MedicalExaminerCoronerReport.pdf Supplementary Document	2006-11-07
OMB(38)HealthCareProfessional.pdf Supplementary Document	2006-11-07
OMB(37)FirePoliceInsuranceInvestigator.pdf Supplementary Document	2006-11-07
OMB(35).pdf Supplementary Document	2006-11-07
OMB(34).pdf Supplementary Document	2006-11-07
OMB(33).pdf Supplementary Document	2006-11-07
OMB(32).pdf Supplementary Document	2006-11-07
OMB(31).pdf Supplementary Document	2006-11-07
OMB(30).pdf Supplementary Document	2006-11-07
OMB(29).pdf Supplementary Document	2006-11-07
OMB(28).pdf Supplementary Document	2006-11-07
OMB(27).pdf Supplementary Document	2006-11-07
OMB(25).pdf Supplementary Document	2006-11-07
OMB(26).pdf Supplementary Document	2006-11-07
OMB(24).pdf Supplementary Document	2006-11-07
OMB(23).pdf Supplementary Document	2006-11-07
OMB(22).pdf Supplementary Document	2006-11-07
OMB(21).pdf Supplementary Document	2006-11-07
OMB(20).pdf Supplementary Document	2006-11-07
OMB(19).pdf Supplementary Document	2006-11-07
OMB(18).pdf Supplementary Document	2006-11-07
OMB(17).pdf Supplementary Document	2006-11-07
OMB(16).pdf Supplementary Document	2006-11-07
OMB(15).pdf Supplementary Document	2006-11-07
OMB(14).pdf Supplementary Document	2006-11-07
OMB(13).pdf Supplementary Document	2006-11-07
OMB(12).pdf Supplementary Document	2006-11-07
OMB(11).pdf Supplementary Document	2006-11-07
OMB(10).pdf Supplementary Document	2006-11-07
OMB(9).pdf Supplementary Document	2006-11-07
OMB(8).pdf Supplementary Document	2006-11-07
OMB(7).pdf Supplementary Document	2006-11-07
OMB(6).pdf Supplementary Document	2006-11-07
OMB(5).pdf Supplementary Document	2006-11-07
OMB(4).pdf Supplementary Document	2006-11-07
OMB(3).pdf Supplementary Document	2006-11-07
OMB(1).pdf Supplementary Document	2006-11-07
OMB(2).pdf Supplementary Document	2006-11-07

IC Document Collections

IC ID	Document Title	Status
29149	Follow-Up Activities for Product-Related Injuries-Interviews Form	Modified
207798	NEISS Form and Instruction	Modified

ICR Details

OMB Control No: 3041-0029	ICR Reference No: 201609-3041-002
Status: Historical Active	Previous ICR Reference No: 201307-3041-001
Agency/Subagency: CPSC	Agency Tracking No:
Title: Follow-Up Activities for Product-Related Injuries
Type of Information Collection: Revision of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/23/2017
	Date Received in OIRA: 09/27/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2020	36 Months From Approved	01/31/2017
Responses	741,853	0	404,250
Time Burden (Hours)	82,853	0	45,008
Cost Burden (Dollars)	0	0	0

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Abstract: Persons who have been injured in or who have witnessed safety- related incidents involving consumer products are an important source of safety information. The Commission uses information obtained from these persons and hospital emergency rooms to support activities to eliminate or reduce unreasonable risks of injury associated with consumer products.

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Authorizing Statute(s): US Code: 15 USC 2054 Name of Law: Consumer Product Safety 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
60-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 40677	06/22/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 64878	09/21/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
NEISS	OMB0029_2013_PCNEISS_Screenshots	PCNEISS
Follow-Up Activities for Product-Related Injuries-Interviews	182	Epidemiologic Investigation Report

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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	741,853	404,250	0	378,128	-40,525	0
Annual Time Burden (Hours)	82,853	45,008	0	39,678	-1,833	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: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: This request for the approval of an estimated 82,853 (81,210 NEISS and 1,643 other) burden hours per year is an increase of 37,845 hours since this collection of information was last approved by OMB in 2013. The increase in the burden hours is largely due to the inclusion of information collected through NEISS for other federal agencies through Interagency Agreements (CDC, NHTSA), which were not otherwise accounted for by those agencies. In order to account for all the burden hours associated with the NEISS information collection, we have added those hours to the collection of information. The increase in burden hours also includes the increase associated with offering internet-based questionnaires in addition to in-person and telephone interviews.

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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? 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: 09/27/2016

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