[NIOSH] Occupational Exposures to Waste Anesthetic Gases in Healthcare Professionals

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Post Shift Questionnaire (acute symptoms focused) Vet Hospital	Form and Instruction	New	Available
Post Shift Questionnaire (full) Vet Hospital	Form and Instruction	New	Available
Questionnaire Informed Consent	Form and Instruction	New	Available
Exposure Assessment Informed Consent	Form and Instruction	New	Available
Post Shift Questionnaire (acute symptoms focused) PACUs	Form and Instruction	New	Available
Post Shift Questionnaire (full) PACUs	Form and Instruction	New	Available
Questionnaire Informed Consent	Form and Instruction	New	Available
Exposure Assessment Informed Consent	Form and Instruction	New	Available
Att.4-Docket No. CDC-2025-0022_ NIOSH Response to comment.pdf	Public Comments	Uploaded 2025-07-29	Available
Att.3-60d FRN Comment.pdf	Public Comments	Uploaded 2025-07-29	Available
Att.15-PRA PIA.pdf	Supplementary Document	Uploaded 2026-06-20	Available
Att.14-IRB Approval Letter.pdf	Supplementary Document	Uploaded 2026-06-20	Available
Att.2-60-Day FRN.pdf	Supplementary Document	Uploaded 2026-06-20	Available
Att.1–Authorizing Legislation.docx	Supplementary Document	Uploaded 2026-06-20	Available
WAG_ICR_SupportingStatement_B_v2_final.docx	Supporting Statement B	Uploaded 2026-06-20	Available
WAG_ICR_SupportingStatement_A_v3_Cleaned_final.docx	Supporting Statement A	Uploaded 2026-06-20	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
281131	Post-shift questionnaire (acute symptoms focused) Vet Hospital	Form and Instruction	New	Post Shift Questionnaire (acute symptoms focused) Vet Hospital
281130	Post-shift questionnaire (full) Vet Hospital	Form and Instruction	New	Post Shift Questionnaire (full) Vet Hospital
281129	Donning/Doffing sampling devices Vet Hospital	Other-OMB Header and Burden Statement	New
281128	Informed Consent (Questionnaire) Vet Hospital	Form and Instruction	New	Questionnaire Informed Consent
281127	Informed Consent (Exposure assessment) Vet Hospitals	Form and Instruction	New	Exposure Assessment Informed Consent
281126	Post-shift questionnaire (acute symptoms focused) PACUs	Form and Instruction	New	Post Shift Questionnaire (acute symptoms focused) PACUs
281125	Post-shift questionnaire (full) PACUs	Form and Instruction	New	Post Shift Questionnaire (full) PACUs
281124	Donning/Doffing sampling devices PACUs	Other-OMB Header and Burden Statement	New
281123	Informed Consent (Questionnaire) PACUs	Form and Instruction	New	Questionnaire Informed Consent
281122	Informed Consent (Exposure assessment) PACUs	Form and Instruction	New	Exposure Assessment Informed Consent

ICR Details

OMB Control No:	ICR Reference No: 202606-0920-008
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-26-0222
Title: [NIOSH] Occupational Exposures to Waste Anesthetic Gases in Healthcare Professionals
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 06/22/2026

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	626	0
Time Burden (Hours)	124	0
Cost Burden (Dollars)	0	0

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Abstract: The purpose of the proposed data collection is to assess occupational exposures and adverse acute health effects of waste anesthetic gases (WAG) and recommend control measures to reduce WAG exposures for healthcare workers in postanesthetic care units and veterinary hospitals. We will focus on sevoflurane, desflurane, and isoflurane.

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Authorizing Statute(s): PL: Pub.L. 91 - 596 20 [a][1] Name of Law: Occupational Safety and Health (OSH) Act of 1970
  

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:
	90 FR 25281	06/16/2025
30-day Notice:	Federal Register Citation:	Citation Date:
	91 FR 35687	06/12/2026
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 10

table that charts list of burden

IC Title	Form No.	Form Name
Donning/Doffing sampling devices PACUs
Donning/Doffing sampling devices Vet Hospital
Informed Consent (Exposure assessment) PACUs	n/a	Exposure Assessment Informed Consent
Informed Consent (Exposure assessment) Vet Hospitals	n/a	Exposure Assessment Informed Consent
Informed Consent (Questionnaire) PACUs	n/a	Questionnaire Informed Consent
Informed Consent (Questionnaire) Vet Hospital	n/a	Questionnaire Informed Consent
Post-shift questionnaire (acute symptoms focused) PACUs	n/a	Post Shift Questionnaire (acute symptoms focused) PACUs
Post-shift questionnaire (acute symptoms focused) Vet Hospital	n/a	Post Shift Questionnaire (acute symptoms focused) Vet Hospital
Post-shift questionnaire (full) PACUs	n/a	Post Shift Questionnaire (full) PACUs
Post-shift questionnaire (full) Vet Hospital	n/a	Post Shift Questionnaire (full) Vet Hospital

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ICR Summary of Burden

table that charts list of burden

	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	626	0	0	626	0	0
Annual Time Burden (Hours)	124	0	0	124	0	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: No

Burden Reduction Due to:

Short Statement: This is a New collection.

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Annual Cost to Federal Government: $285,980

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     Yes

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     Yes

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? No

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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: 06/22/2026

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