OMB control number
Periodic Medical Surveillance Examinations for Coal Miners
OMB 1219-0152 · DOL/MSHA.
OMB 1219-0152
Section 72.100(d) requires that each mine operator must develop and submit for approval to NIOSH a plan in accordance with 42 CFR part 37 for providing miners with the required periodic examinations specified in 72.100(a) and a roster specifying the name and current address of each miner covered by the plan. Section 72.100(e) requires that each mine operator must post on the mine bulletin board at all times the approved plan for providing the examinations specified in 72.100(a). Section 72.100(d) and (e) are requirements that mirror NIOSH information collection requirements under 42 CFR 37.4 (existing OMB No. 0920-0020). Including these requirements allows MSHA to use its inspection and enforcement authority to ensure that operators comply with these provisions.
The latest form for Periodic Medical Surveillance Examinations for Coal Miners expires 2026-10-31 and is listed under ICR 202303-1219-006.
Latest Forms, Documents, and Supporting Material
| Document | Type |
|---|---|
 1219-0152 Published 60-Day FRN 3-21-2023.pdf | Supplementary Document |
 1219-0152 Supporting Statement 2023.docx | Supporting Statement A |
 Periodic Medical Surveillance Examinations for Coal Miners |
Information collection |
All Historical Document Collections
| Reference | Filing | Received | Concluded | Action |
|---|---|---|---|---|
| 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 |