OMB control number

Supplemental Measurements for Exploratory Research regarding Exposure during Activities Conducted on Synthetic Turf Fields with Tire Crumb Rubber Infill

OMB 0923-0062 · HHS/TSDR.

OMB 0923-0062

The research protocol, Collections Related to Synthetic Turf Fields with Crumb Rubber Infill, has been conducted previously under two information collection requests (ICRs): Activity 1 under OMB Control No. 0923-0054 (expiration date 01/31/2017) and Activities 2 and 3 under OMB Control No. 0923-0058 (expiration date 08/13/2018), which were limited to collections from August to October, 2017. Activities 2 and 3 aim to evaluate and characterize the human exposure potential to constituents in crumb rubber infill among a convenience sample of 60 field users (Activity 2) and to collect biological specimens (blood and urine) from 45 participants (Activity 3). Due to the limited enrollment and collection period, the target Activity 2 and Activity 3 samples sizes were not met in 2017. The current request seeks to conduct supplemental measurements to expand the exploratory analysis conducted under OMB 0923-0058. The current request allows for further investigation of patterns observed in the preliminary data from the 2017 pilot-scale exposure measurements of individuals playing on synthetic turf fields with crumb rubber infill and collecting data from a small number of individuals who are playing on grass fields.

The latest form for Supplemental Measurements for Exploratory Research regarding Exposure during Activities Conducted on Synthetic Turf Fields with Tire Crumb Rubber Infill expires 2021-10-31 and is listed under ICR 201904-0923-001.

View the official OMB control history on Reginfo.gov.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0923-0062 Exposure Measurement FormForm and Instruction
Form 0923-0062 Exposure Measurement FormForm and Instruction
Form 0923-0062 Youth/Child Field QuestionnaireForm and Instruction
Form 0923-0062 Youth an Child QuestionnaireForm and Instruction
Form 0923-0062 Adult/Ado Field QuestionnaireForm and Instruction
Form 0923-0062 Adult and Adolescent QuestionnaireForm and Instruction
Form 0923-0062 Eligibility ScreenerForm and Instruction
Form 0923-0062 Eligibility Screening FormForm and Instruction
P_AppxN8 Synthetic Turf COVID-19 PrecautnPln 20210222 cln.docx Supplementary Document
P_AppxN7 SiteHlthSafety Plan 20210222 cln.docx Supplementary Document
Att4 IRB 6881 Amendment6 Approval.docx Supplementary Document
P_Protocol 6881_Amendment 6 20210222 cln.docx Supplementary Document
Att3_Privacy Threshold Analysis.pdf Supplementary Document
P_AppxN5b_ExpMsrtmtFormNoticePost 20210222 cln.docx Supplementary Document
P_AppxN5a_ExpMsrtmtFormNoticePre 20210222 cln.docx Supplementary Document
P_AppxN3_ConsentAssentForms 20210222 cln.docx Supplementary Document
P_AppxN1b_FacilityOwnerFactSheet 20210222 cln.docx Supplementary Document
P_AppxN1a_FieldUserFactSheet 20210222 cln.docx Supplementary Document
Att2 60-day FRN ST3.pdf Supplementary Document
Att1 AuthLegsl.docx Supplementary Document
1 - SSB_Synthetic Turf Extension_cln.docxSupporting Statement B
1 - SSA_Synthetic Turf Extension cln_final.docxSupporting Statement A
Exposure Measurement Form Form and Instruction
Exposure Measurement Form Form and Instruction
Youth an Child Questionnaire Form and Instruction
Youth an Child Questionnaire Form and Instruction
Adult and Adolescent Questionnaire Form and Instruction
Adult and Adolescent Questionnaire Form and Instruction
Eligibility Screening Form Form and Instruction
Eligibility Screening Form Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202106-0923-001 Extension without change of a currently approved collection 2021-06-24 Approved without change
202012-0923-002 No material or nonsubstantive change to a currently approved collection 2021-01-13 Approved without change
201904-0923-001 New collection (Request for a new OMB Control Number) 2019-04-29 Approved with change

OMB Details

Eligibility Screening Form

Federal Enterprise Architecture: Health - Public Health Monitoring

Information collection instruments
FormNameElectronic accessType
Form 0920-19GWEligibility ScreenerFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.