OMB control number
Periodic Medical Surveillance Examinations for Coal Miners
OMB 1219-0152 · DOL/MSHA.
OMB 1219-0152
MSHA regulations require that each operator of a coal mine provide to each miner periodic examinations including chest x-rays, spirometry, symptom assessment, and occupational history at no cost to the miner, provide the opportunity to have the examinations at least every 5 years for all miners employed at a coal mine, develop and submit for approval to NIOSH a plan for providing miners with the required periodic examinations and a roster specifying the name and current address of each miner covered by the plan, and post on the mine bulletin board at all times the approved plan for providing the medical examinations as specified.
The latest form for Periodic Medical Surveillance Examinations for Coal Miners expires 2029-10-31 and is listed under ICR 202512-1219-004.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 Comment 1 - American Public Healh Association (APHA).pdf | Public Comments |
| Comment 1 - American Public Health Association.pdf | Public Comments |
| 1219-0152 60-Day FRN Published 3-25-2026.pdf | Supplementary Document |
 1219-0152 Supporting Statement 2026.docx | Supporting Statement A |
 Periodic Medical Surveillance Examinations for Coal Miners |
Information collection |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 202512-1219-004 | Extension without change of a currently approved collection | 2026-08-26 | ||
| 202303-1219-006 | Extension without change of a currently approved collection | 2023-09-14 | Approved without change | |
| 202003-1219-002 | Extension without change of a currently approved collection | 2020-07-17 | Approved with change | |
| 201406-1219-003 | Revision of a currently approved collection | 2017-06-01 | Approved without change | |
| 201210-1219-002 | New collection (Request for a new OMB Control Number) | 2014-02-19 | Approved with change |