Information Collection Request

National Coal Workers' Health Surveillance Program (CWHSP)

ICR 202109-0920-001 · OMB 0920-0020 · Received in OIRA

Forms and Documents
DocumentTypeStatusAvailability
Form 2.8 Chest Radiograph Classification (CDC/NIOSH Form 2.8) Form Unchanged Repair queued
Form 2.18 Coal Contractor Plan CDC/NIOSH 2.18 Form Unchanged Repair queued
Form 2.15 Spirometry Results Notification CDC/NIOSH 2.15 Form Unchanged Repair queued
Form 2.14 Spirometry Facility Supervisor - Certification Document 2.14 Form Unchanged Repair queued
Form 2.13 Spirometry Facility Employee - Respiratory Assessment 2.13 Form Unchanged Repair queued
Form 2.6 Consent Release and History Form- Next of Kin (CDC/NIOSH 2.6) Form Unchanged Repair queued
Form 2.12 Physician Application for Certification (CDC/NIOSH 2.12) Form and Instruction Unchanged Repair queued
Form 2.11 Radiographic Facility Certification (CDC/NIOSH (M) 2.11) Form Unchanged Repair queued
Form 2.10 Coal Mine Operator's Plan (CDC/NOISH (M) 2.10) Form Unchanged Repair queued
Form 2.9 Miner Identification Document (CDC/NIOSH 2.9) Form Unchanged Repair queued
Emergency Request Memo CWHSP.docx Supplementary Document Uploaded 2021-09-08 Repair queued
Request for Nonsubstantive Changes OMB #0920-0020_2021MAR17.docx Justification for No Material/Nonsubstantive Change Uploaded 2021-04-22 Repair queued
Request for Nonsubstantive Change 2019.docx Justification for No Material/Nonsubstantive Change Uploaded 2019-03-26 Repair queued
Attachment 27 Public Comments .docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 25 OCISO PII.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 24 OCISO SSN.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 18 Sample Letter Spiro Results.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 14 Sample Letter B Reader Due to Recertify.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 13 Sample Letters B Reader Exam Results.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 10 Sample Letter Results.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 9 Sample Letter Participation.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 7 Sample Letter Rad Fac Approval.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 5 Sample Letters.docx Supplementary Document Uploaded 2018-06-25 Repair queued
Attachment 2 42 CFR Part 37.docx Supplementary Document Uploaded 2018-06-20 Available
Attachment 23 Stakeholder Information.docx Supplementary Document Uploaded 2018-06-20 Repair queued
Attachment 26 IRB Determination.docx Supplementary Document Uploaded 2018-06-20 Repair queued
60 day FRN.pdf Supplementary Document Uploaded 2018-06-19 Repair queued
Attachment 2.docx Supplementary Document Uploaded 2015-03-18 Repair queued
SupSta B_0920-0020 CWHSP 03 05 2018.docx Supporting Statement B Uploaded 2018-06-19 Repair queued
SupSta A_0920-0020_ICRO edits formatting.docx Supporting Statement A Uploaded 2018-06-28 Repair queued
Attachment 1- revised.docx Supplementary Document Uploaded 2014-07-30 Repair queued
Att 1_Medical Exam excerpt.docx Supplementary Document Uploaded 2014-03-07 Repair queued
ICR Details
0920-0020 202109-0920-001
Received in OIRA 202104-0920-005
HHS/CDC 0920-0020
National Coal Workers' Health Surveillance Program (CWHSP)
Extension without change of a currently approved collection   No
Emergency 09/29/2021
09/09/2021
  Requested Previously Approved
6 Months From Approved 09/30/2021
104,126 104,126
20,274 20,274
0 0

The Coal Workers' Health Surveillance Program (CWHSP) is a congressionally-mandated medical examination program for monitoring the health of underground coal miners, established under the Federal Coal Mine Health and Safety Act of 1969. Through delegation of authority, the Act directs NIOSH to study the causes and consequences of coal-related respiratory disease, and in cooperation with the Mine Safety and Health Administration, to carry out a program for early detection and prevention of coal workers' pneumoconiosis and to provide the opportunity for an autopsy after the death of a coal miner.
CDC requests an Emergency Extension of 0920-0020 -National Coal Workers' Health Surveillance Program (CWHSP). As the collection is associated with a mandated/required Program,the standard clearance processing time will prevent the CDC/NIOSH from being in compliance with the statue. CDC requests approval for this Emergency Extension in order to prevent a lapse in collection activities.

US Code: 42 USC 37 Name of Law: Specifications for Medical Exam of Coal Miners
   PL: Pub.L. 91 - 173 203 Name of Law: Federal Coal Mine Health and Safety Act
   PL: Pub.L. 91 - 596 20 Name of Law: Occupational Safety and Health Act
  
None

Not associated with rulemaking

No

  Total Request 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 104,126 104,126 0 0 0 0
Annual Time Burden (Hours) 20,274 20,274 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No

$2,499,239
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [email protected]

  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.
09/09/2021