Information Collection Request

Blood Lead Surveillance System (BLSS)

ICR 201805-0920-004 · OMB 0920-0931 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Form 0920-0931 ABLES Aggregate Records Form and Brief Narrative Report Form and Instruction New Available
Form 0920-0931 ABLES Case Records Form and Brief Narrative Report Form and Instruction New Available
Form 0920-0931 CBLS Variables - FY18 State or Local Health Departments Form and Instruction New Available
Form 0920-0931 CBLS Variables - FY17 State or Local Health Departments Form and Instruction New Available
Form 0920-0931 CBLS Aggregate Records - FY14/FY17 State or Local Health Departments Form and Instruction New Repair queued
Form 0920-0931 CBLS Variables - FY14/FY17 State or Local Health Departments Form and Instruction New Available
Form 0920-0931 HHLPSS Variables Form and Instruction New Available
Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS) Variables Form and Instruction Removed Repair queued
Att11 2015 HHLPSS Notice of Action & Terms of Clearance.pdf Supplementary Document Uploaded 2018-05-15 Available
ABLES website pre-clearance draft.docx Supplementary Document Uploaded 2018-05-15 Available
Att10 OMBCntrlNoHstry for BLSurvllnce 20180511 clean.DOCX Supplementary Document Uploaded 2018-05-15 Available
Att9b NIOSH ABLES Research Determination.pdf Supplementary Document Uploaded 2018-05-15 Available
Att9a NCEH CBLS Research Determination.pdf Supplementary Document Uploaded 2018-05-15 Available
Att8b ABLES PIA_Determination 2018Apr04.pdf Supplementary Document Uploaded 2018-05-15 Available
Att8a NCEH CBLS PIA Recert 2016.pdf Supplementary Document Uploaded 2018-05-15 Available
Att7c ABLES Changes in Data Elements.xlsx Supplementary Document Uploaded 2018-05-15 Repair queued
Att6d CBLS Differences in Variable Reporting Requirements.xlsx Supplementary Document Uploaded 2018-05-15 Repair queued
Att5a NCEH CBLS Program Summary & Accomplishments.docx Supplementary Document Uploaded 2018-05-15 Available
Att4b NCEH NOFO CDC-RFA-EH14-1408.pdf Supplementary Document Uploaded 2018-05-15 Available
Att4a NCEH NOFO CDC-RFA-EH17-1701.pdf Supplementary Document Uploaded 2018-05-15 Available
Att3 NIOSH ABLES Inclusion History in NCEH ICRs.xlsx Supplementary Document Uploaded 2018-05-15 Available
Att2a 60-dyFRN CBLS-ABLES new ICR.pdf Supplementary Document Uploaded 2018-05-15 Available
Att1b NIOSH Authority.pdf Supplementary Document Uploaded 2018-05-15 Available
Att1a NCEH Authority (combined).pdf Supplementary Document Uploaded 2018-05-15 Available
BLSS_SSB_FINAL 15MAY2018.DOCX Supporting Statement B Uploaded 2018-05-15 Available
BLSS_SSA_FINAL 15MAY2018.docx Supporting Statement A Uploaded 2018-05-15 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
231454 ABLES Aggregate Records Form and Brief Narrative Report Form and Instruction New
231453 ABLES Case Records Form and Brief Narrative Report Form and Instruction New
231451 CBLS Variables - FY18 State or Local Health Departments Form and Instruction New
231450 CBLS Variables - FY17 State or Local Health Departments Form and Instruction New
231449 CBLS Aggregate Records - FY14/FY17 State or Local Health Departments Form and Instruction New
231448 CBLS Variables - FY14/FY17 State or Local Health Departments Form and Instruction New
231447 HHLPSS Variables Form and Instruction New
215085 Healthy Homes and Lead Poisoning Prevention Surveillance System (HHLPPSS) Variables Form and Instruction Removed

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
05/31/2021 36 Months From Approved 05/31/2018
409 0 160
1,226 0 640
0 0 15,000





table that charts list 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 409 160 0 249 0 0
Annual Time Burden (Hours) 1,226 640 0 586 0 0
Annual Cost Burden (Dollars) 0 15,000 0 -15,000 0 0


Reginfo record details
  No