Request for Nonsubstantive Change 0920-1332

Request for Non-substantive Change

Understanding Long-term Respiratory Morbidity in Former Styrene-exposed Workers: Medical Survey

OMB Approval #0920-1332 – Expiration date 04/30/2023

Justification for Non-substantive change:

We are requesting a change request for the NOA for 0920-1332 to add an additional medical test we will be offering to a medical survey participant who report a job title with high styrene exposure and report medical symptoms or have pulmonary lung function test results consistent with small airways disease. Below are the updated burden tables with the additional medical test and burden hours and costs.

We request that the approved NOA be updated to reflect the new burden hours and costs.

Updated Estimated Annualized Burden Hours:

Type of Respondents	Form name	No. of respondents	No. of responses per respondent	Average burden per response (in hours)	Total burden (in hours)
Boatbuilder Cohort Members	Questionnaire and medical survey consent form	676	1	15/60	169
	Questionnaire	676	1	45/60	507
	Exhaled nitric oxide	676	1	5/60	56
	Impulse oscillometry	676	1	10/60	113
	Spirometry	676	1	10/60	113
	Bronchodilator test	50	1	20/60	17
	Multiple-breath washout	676	1	30/60	338
	Color vision test	676	1	5/60	56
	Blood test	676	1	5/60	56
	HRCT Scan informed consent	70	1	15/60	18
	HRCT Scan	70	1	15/60	18
Total					1461

Type of Respondents	Form name	Total burden (in hours)	Hourly wage rate	Total respondent cost
Boatbuilder Cohort Members	Questionnaire and medical survey consent form	169	$23.00	$3887.00
	Questionnaire	507	$23.00	$11,661.00
	Exhaled nitric oxide	56	$23.00	$1288.00
	Impulse oscillometry	113	$23.00	$2599.00
	Spirometry	113	$23.00	$2599.00
	Bronchodilator test	17	$23.00	$391.00
	Multiple-breath washout	338	$23.00	$7774.00
	Color vision test	56	$23.00	$1288.00
	Blood test	56	$23.00	$1288.00
	HRCT Scan informed consent	18	$23.00	$414.00
	HRCT Scan	18	$23.00	$414.00
Total				$33,603.00

Updated Estimated Annualized Burden Cost: