Household Recruitment Script for Environmental Sampling

Appendix A4: Household Recruitment Script for Environmental Sampling

Form Approved

OMB No. 0923-0059

Exp. Date 06/30/2022

PFAS Exposure Assessment, environmental sampling

Household Recruitment Script for Environmental Sampling

ATSDR estimates the average public reporting burden for this collection of information as 5 minutes per response, including the time for reviewing instructions, searching existing data/information sources, gathering and maintaining the data/information needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB Control Number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0923-0059).

Reading Level: 10.1

Note: Ten percent of household recruited into the exposure assessment that report drinking tap water in the home will be randomly selected for environmental sampling. This script will be used to contact and invite these selected households to participate in environmental sampling.

Hello, I am ______________________ from [insert affiliation], calling on behalf of the Agency for Toxic Substances and Disease Registry. May I please speak to someone who can make decisions about participating in our study?

As I’m sure you remember, your household recently agreed to participate in an exposure assessment to measure chemicals called per- and polyfluoroalkyl substances, or PFAS, in the bodies of people living in your area. A small subset of households participating in the exposure assessment has been selected for additional environmental sampling of PFAS in the home.

We would like to collect tap water and indoor dust samples from some homes to understand if people living in your area are exposed to PFAS while at home. To do this, we need households in this community to participate in environmental sampling as well as blood and urine testing.

For this part of the exposure assessment, we will collect a drinking water sample from the source in your home you and your family most often drink water (e.g. kitchen tap). Then, we will collect indoor dust samples from up to three locations inside your home. The time required for us to collect these samples is estimated to be about 20 minutes. The environmental sampling will be in addition to collection of blood and urine from you and others in your household.

ATSDR will take COVID-19 prevention measures at every step of our work in your community. Would you like me to tell you about those?

If the resident says “no”, move on with the script.

If the resident says “yes”, tell them the following:

The exposure assessment will be conducted following all state, local, and CDC guidelines in place at the time the EA is conducted. ATSDR team members will be monitored twice daily for fever and any COVID-19-related symptoms and will wear surgical masks and gloves to ensure the protection of participants. ATSDR team members who will enter your home will wear personal protective equipment, or PPE, that includes a full body coverall, an N95 respirator and gloves. Participants will be monitored for fever and COVID-19-related symptoms prior to exposure assessment staff entering the home. Participants will be asked to always wear a face covering or mask when interacting with exposure assessment personnel. If you do not have a mask, one will be provided to you before we enter your home. If you are unable to wear a mask for medical reasons, please let us know.

Are you willing to participate in the environmental sampling part of the exposure assessment?

Yes No Refused to Answer

If No: Okay, thank you for your time. Goodbye.

If Yes: Thank you very much. We will be in your community to collect samples [insert dates]. Your blood and urine sampling appointment is at [insert date and time]. When would be a good time for us to schedule a home visit to collect your environmental samples?