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17654

Federal Register / Vol. 91, No. 66 / Tuesday, April 7, 2026 / Notices

exposure and outcome is possible.
Consequently, chance, bias, and
confounding could not be ruled out
with reasonable confidence for either
study. The known information on
mechanisms of action supports an
association between certain 9/11 agents
and hepatic steatosis. However, given
the significant limitations discussed
above, the Science Team concluded that
the available evidence is inadequate to
determine the likelihood of a causal
association between 9/11 exposures and
hepatic steatosis.
Upon review of the evidence available
in high-quality studies regarding hepatic
steatosis among 9/11-exposed
populations, the Science Team
concluded that there is inadequate
evidence to determine the likelihood of
a causal association between 9/11
exposures and hepatic steatosis
(Category V).34
E. Administrator’s Final Decision on
Whether To Propose the Addition of
Hepatic Steatosis to the List
Pursuant to the PHS Act, sec.
3312(a)(6)(B)(iv) and 42 CFR
88.16(a)(2)(iv), and in accordance with
Sec. VIII.B. of the Policy and
Procedures, the Administrator has
determined that insufficient evidence is
available to take further action at this
time, including proposing the addition
of hepatic steatosis to the List (pursuant
to the PHS Act, sec. 3312(a)(6)(B)(ii) and
42 CFR 88.16(a)(2)(ii)) or publishing a
determination not to publish a proposed
rule in the Federal Register (pursuant to
the PHS Act, sec. 3312(a)(6)(B)(iii) and
42 CFR 88.16(a)(2)(iii)). The
Administrator has also determined that
requesting a recommendation from the
STAC (pursuant to the PHS Act, sec.
3312(a)(6)(B)(i) and 42 CFR
88.16(a)(2)(i)) is unwarranted.
For the reasons discussed above, the
request in Petitions 029, 034, 035, and
062 to add hepatic steatosis to the List
of WTC-Related Health Conditions is
denied.

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F. Approval To Submit Document to the
Office of the Federal Register
The Secretary, HHS, or his designee,
the Director, Centers for Disease Control
and Prevention (CDC) and
Administrator, Agency for Toxic
Substances and Disease Registry
(ATSDR), authorized the undersigned,
the Administrator of the WTC Health
Program, to sign and submit the
document to the Office of the Federal
Register for publication as an official
34 See Policy and Procedures supra note 5 at Sec.
V.E.—Evidence is Inadequate to Determine a Causal
Association.

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document of the WTC Health Program.
Jay Bhattacharya, MD, Ph.D., Senior
Official Carrying out the Delegable
Duties of the CDC Director, approved
this document for publication on April
2, 2026.
John J. Howard,
Administrator, World Trade Center Health
Program and Director, National Institute for
Occupational Safety and Health, Centers for
Disease Control and Prevention, Department
of Health and Human Services.
[FR Doc. 2026–06728 Filed 4–6–26; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[60Day–26–0728; Docket No. CDC–2026–
0562]

Proposed Data Collection Submitted
for Public Comment and
Recommendations
AGENCY: Centers for Disease Control and

Prevention (CDC), Department of Health
and Human Services (HHS).
ACTION: Notice with comment period.
SUMMARY: The Centers for Disease

Control and Prevention (CDC), as part of
its continuing effort to reduce public
burden and maximize the utility of
government information, invites the
general public and other federal
agencies the opportunity to comment on
a continuing information collection, as
required by the Paperwork Reduction
Act of 1995. This notice invites
comment on a proposed information
collection project titled National
Notifiable Diseases Surveillance System
(NNDSS). This data collection provides
the official source of statistics in the
United States for nationally notifiable
conditions.
DATES: CDC must receive written

comments on or before June 8, 2026.
ADDRESSES: You may submit comments,

identified by Docket No. CDC–2026–
0562 by either of the following methods:
• Federal eRulemaking Portal:
www.regulations.gov. Follow the
instructions for submitting comments.
• Mail: Jeffrey M. Zirger, Information
Collection Review Office, Centers for
Disease Control and Prevention, 1600
Clifton Road NE, MS H21–8, Atlanta,
Georgia 30329.
Instructions: All submissions received
must include the agency name and
Docket Number. CDC will post, without
change, all relevant comments to
www.regulations.gov.

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Please note: Submit all comments
through the Federal eRulemaking portal
(www.regulations.gov) or by U.S. mail to
the address listed above.
FOR FURTHER INFORMATION CONTACT: To
request more information on the
proposed project or to obtain a copy of
the information collection plan and
instruments, contact Jeffrey M. Zirger,
Information Collection Review Office,
Centers for Disease Control and
Prevention, 1600 Clifton Road NE, MS
H21–8, Atlanta, Georgia 30329;
Telephone: 404–639–7570; Email: omb@
cdc.gov.
SUPPLEMENTARY INFORMATION: Under the
Paperwork Reduction Act of 1995 (PRA)
(44 U.S.C. 3501–3520), federal agencies
must obtain approval from the Office of
Management and Budget (OMB) for each
collection of information they conduct
or sponsor. In addition, the PRA also
requires federal agencies to provide a
60-day notice in the Federal Register
concerning each proposed collection of
information, including each new
proposed collection, each proposed
extension of existing collection of
information, and each reinstatement of
previously approved information
collection before submitting the
collection to the OMB for approval. To
comply with this requirement, we are
publishing this notice of a proposed
data collection as described below.
The OMB is particularly interested in
comments that will help:
1. Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
2. Evaluate the accuracy of the
agency’s estimate of the burden of the
proposed collection of information,
including the validity of the
methodology and assumptions used;
3. Enhance the quality, utility, and
clarity of the information to be
collected;
4. Minimize the burden of the
collection of information on those who
are to respond, including through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submissions
of responses; and
5. Assess information collection costs.
Proposed Project
National Notifiable Diseases
Surveillance System (NNDSS) (OMB
Control No. 0920–0728, Exp. 11/30/
2028)—Revision—Office of Public
Health Data, Surveillance, and

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17655

Federal Register / Vol. 91, No. 66 / Tuesday, April 7, 2026 / Notices
Technology (OPHDST), Centers for
Disease Control and Prevention (CDC).
Background and Brief Description
The Public Health Services Act (42
U.S.C. 241) authorizes CDC to
disseminate nationally notifiable
condition information. The National
Notifiable Diseases Surveillance System
(NNDSS) is based on data collected at
the state, territorial and local levels
because of legislation and regulations in
those jurisdictions that require health
care providers, medical laboratories,
and other entities to submit healthrelated data on reportable conditions to
public health departments. These
reportable conditions, which include
infectious and non-infectious diseases,
vary by jurisdiction depending upon
each jurisdiction’s health priorities and
needs. Each year, the Council of State
and Territorial Epidemiologists (CSTE),
supported by CDC, determines which
reportable conditions should be
designated nationally notifiable or
under standardized surveillance.
CDC requests a three-year approval for
a Revision for the NNDSS (OMB Control
No. 0920–0728, Expiration Date 11/30/
2028). This Revision includes requests
for approval to: (1) receive case
notification data for two new conditions
under standardized surveillance (CSS):
flea-borne typhus and soil-transmitted
helminth infections; (2) receive new
disease-specific data elements for
leprosy (Hansen’s disease); and (3)
receive additional data elements for all
conditions.
The NNDSS currently facilitates the
submission and aggregation of case
notification data voluntarily submitted
to CDC from 60 jurisdictions: public
health departments in every U.S. state,

Federal Information Systems and
Organizations. Weekly tables of
nationally notifiable diseases are
available through CDC WONDER and
data.cdc.gov. Annual summaries of
finalized nationally notifiable disease
data are published on CDC WONDER
and data.cdc.gov and disease-specific
data are published by individual CDC
programs.
The burden estimates include the
number of hours that the public health
department uses to process and send
case notification data from their
jurisdiction to CDC. Specifically, the
burden estimates include separate
burden hours incurred for automated
and non-automated transmissions,
separate weekly burden hours incurred
for modernizing surveillance systems as
part of CDC’s Data Modernization
Initiative (DMI) implementation,
separate burden hours incurred for
annual data reconciliation and
submission, and separate one-time
burden hours incurred for the addition
of new diseases and data elements. The
burden estimates for the one-time
burden for reporting jurisdictions are for
the addition of case notification data for
flea-borne typhus and soil-transmitted
helminth infections, new conditions
under standardized surveillance; the
addition of new disease-specific data
elements for leprosy (Hansen’s disease);
and new data elements for all
conditions.
The estimated annual burden for the
257 respondents is 18,354 hours. The
estimated annual burden hours remain
unchanged from the previous approval
because the number of new data
elements and conditions added in this
revision is comparable to those that
were previously approved.

New York City, Washington DC, five
U.S. territories (American Samoa, the
Commonwealth of Northern Mariana
Islands, Guam, Puerto Rico, and the U.S.
Virgin Islands), and three freely
associated states (Federated States of
Micronesia, the Republic of the
Marshall Islands, and the Republic of
Palau). This information is shared
across jurisdictional boundaries and
both surveillance and prevention and
control activities are coordinated at
regional and national levels.
Approximately 90% of case
notifications are encrypted and
submitted to NNDSS electronically from
already existing databases by automated
electronic messages. When automated
transmission is not possible, case
notifications are faxed, emailed,
uploaded to a secure network or entered
into a secure website. All case
notifications that are faxed or emailed
are done so in the form of an aggregate
weekly or annual report, not individual
cases. These different mechanisms used
to send case notifications to CDC vary
by the jurisdiction and the disease or
condition. Jurisdictions remove most
personally identifiable information (PII)
before data are submitted to CDC, but
some data elements (e.g., date of birth,
date of diagnosis, county of residence)
could potentially be combined with
other information to identify
individuals. Private information is not
disclosed unless otherwise compelled
by law. All data are treated in a secure
manner consistent with the technical,
administrative, and operational controls
required by the Federal Information
Security Management Act of 2002
(FISMA) and the 2010 National Institute
of Standards and Technology (NIST)
Recommended Security Controls for

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ESTIMATED ANNUALIZED BURDEN HOURS
Type of respondent

Form name

States .............................
States .............................
States .............................
States .............................
States .............................

Weekly (Automated) ............................................
Weekly (Non-automated) .....................................
Weekly (DMI Implementation) .............................
Annual ..................................................................
One-time Addition of Diseases and Data Elements.
Weekly (Automated) ............................................
Weekly, Quarterly (Non-automated) ....................
Weekly (DMI Implementation) .............................
Annual ..................................................................
One-time Addition of Diseases and Data Elements.
Weekly (Automated) ............................................
Weekly, Quarterly (Non-automated) ....................
Annual ..................................................................
One-time Addition of Diseases and Data Elements.
Weekly (Automated) ............................................

Territories .......................
Territories .......................
Territories .......................
Territories .......................
Territories .......................
Freely Associated States
Freely Associated States
Freely Associated States
Freely Associated States
Cities ..............................

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Average
burden per
response
(in hours)

Number of
respondents

Number of
responses per
respondent

50
10
50
50
50

52
52
52
1
1

20/60
2
4
75
2

867
1,040
10,400
3,750
100

5
5
5
5
5

52
56
52
1
1

20/60
20/60
4
5
2

87
93
1,040
25
10

3
3
3
3

52
56
1
1

20/60
20/60
5
2

52
56
15
6

2

52

20/60

35

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Total burden
(in hours)

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Federal Register / Vol. 91, No. 66 / Tuesday, April 7, 2026 / Notices
ESTIMATED ANNUALIZED BURDEN HOURS—Continued
Average
burden per
response
(in hours)

Total burden
(in hours)

Form name

Cities ..............................
Cities ..............................
Cities ..............................
Cities ..............................

Weekly (Non-automated) .....................................
Weekly (DMI Implementation) .............................
Annual ..................................................................
One-time Addition of Diseases and Data Elements.

2
2
2
2

52
52
1
1

2
4
75
2

208
416
150
4

Total ........................

..............................................................................

........................

........................

........................

18,354

Jeffrey M. Zirger,
Lead, Information Collection Review Office,
Office of Public Health Ethics and
Regulations, Office of Science, Centers for
Disease Control and Prevention.
[FR Doc. 2026–06668 Filed 4–6–26; 8:45 am]
BILLING CODE 4163–18–P

DEPARTMENT OF HEALTH AND
HUMAN SERVICES
Centers for Disease Control and
Prevention
[30Day–26–0004]

Agency Forms Undergoing Paperwork
Reduction Act Review

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Number of
responses per
respondent

Number of
respondents

Type of respondent

In accordance with the Paperwork
Reduction Act of 1995, the Centers for
Disease Control and Prevention (CDC)
has submitted the information
collection request titled ‘‘National
Disease Surveillance Program II—
Disease Summaries’’ to the Office of
Management and Budget (OMB) for
review and approval. CDC previously
published a ‘‘Proposed Data Collection
Submitted for Public Comment and
Recommendations’’ notice on January
13, 2026 to obtain comments from the
public and affected agencies. CDC
received one comment related to the
previous notice. This notice serves to
allow an additional 30 days for public
and affected agency comments.
CDC will accept all comments for this
proposed information collection project.
The Office of Management and Budget
is particularly interested in comments
that:
(a) Evaluate whether the proposed
collection of information is necessary
for the proper performance of the
functions of the agency, including
whether the information will have
practical utility;
(b) Evaluate the accuracy of the
agencies estimate of the burden of the
proposed collection of information,

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including the validity of the
methodology and assumptions used;
(c) Enhance the quality, utility, and
clarity of the information to be
collected;
(d) Minimize the burden of the
collection of information on those who
are to respond, including, through the
use of appropriate automated,
electronic, mechanical, or other
technological collection techniques or
other forms of information technology,
e.g., permitting electronic submission of
responses; and
(e) Assess information collection
costs.
To request additional information on
the proposed project or to obtain a copy
of the information collection plan and
instruments, call (404) 639–7570.
Comments and recommendations for the
proposed information collection should
be sent within 30 days of publication of
this notice to www.reginfo.gov/public/
do/PRAMain. Find this particular
information collection by selecting
‘‘Currently under 30-day Review—Open
for Public Comments’’ or by using the
search function. Direct written
comments and/or suggestions regarding
the items contained in this notice to the
Attention: CDC Desk Officer, Office of
Management and Budget, 725 17th
Street NW, Washington, DC 20503 or by
fax to (202) 395–5806. Provide written
comments within 30 days of notice
publication.
Proposed Project
National Disease Surveillance
Program II. Disease Summaries (OMB
Control No. 0920–0004, Exp. 4/30/
2026)—Revision—National Center for
Immunization and Respiratory Diseases
(NCIRD), Centers for Disease Control
and Prevention (CDC).
Background and Brief Description
CDC requests a three-year approval for
a Revision with minimal modifications
of the National Disease Surveillance
Program II. Disease Summaries (OMB

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Control No. 0920–0004) information
collection. As with previous approvals,
these data are essential for measuring
trends in diseases, evaluating the
effectiveness of current preventive
strategies, and determining the need to
modify current preventive measures.
Diseases included in this surveillance
program are Influenza Virus,
Caliciviruses, Respiratory and Enteric
Viruses, Enteroviruses, Adenoviruses,
Arthropod-Borne Diseases (Non-Human
Data), and Pediatric Hepatitis of
Unknown Etiology. Data will be used to
determine the prevalence of disease and
planning and evaluating programs for
prevention and control of infectious
diseases. Disease incidence is needed to
study present and emerging disease
problems.
The request for an Revision with
minimal modifications includes: 11
Influenza forms, Suspect Respiratory
Virus Patient Form, Middle East
Respiratory Syndrome Coronavirus
(MERS) Patient Under Investigation
(PUI) Form, Viral Gastroenteritis
Outbreak Submission Form, National
Respiratory and Enteric Virus
Surveillance System (NREVSS)
Laboratory Assessment and National
Enterovirus Surveillance Report,
National Adenovirus Type Reporting
System (NATRS) Form, Pediatric
Hepatitis of Unknown Etiology Medical
Record Abstraction Form (CRF) and
Pediatric Hepatitis of Unknown Etiology
Medical Record Abstraction short form
version, and Arthropod (Vector)-Borne
Diseases (Non-Human Data). These
forms will have minor edits with very
little burden change from last OMB
approval. The data from these forms
will enable rapid detection and
characterization of outbreaks of known
pathogens, as well as potential newly
emerging viral pathogens.
CDC requests OMB approval for an
estimated 27,517 annual burden hours.
There is no cost to respondents other
than their time to participate.

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