FARM FAMILY HEALTH AND HAZARD SURVEILLANCE -- COLORADO

Forms and Documents

Document Name	Status

No forms / supporting documents in this ICR. Check IC Document Collections.

IC Document Collections

IC ID	Document Title	Status
111045	FARM FAMILY HEALTH AND HAZARD SURVEILLANCE -- COLORADO	Migrated

ICR Details

OMB Control No: 0920-0309	ICR Reference No: 199207-0920-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: FARM FAMILY HEALTH AND HAZARD SURVEILLANCE -- COLORADO
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 10/15/1992
	Date Received in OIRA: 07/21/1992
Terms of Clearance: Pursuant to the Paperwork Reduction Act, we have approved the use of this information collection instrument in Colorado. Due to the limited control group available in this study (existing information from the Colorado Behavioral Risk Factor Survey), this instrument will serve on to identify morbidity and mortality rates among farmers. NIOSH should refrain from linking illnesses and disease to farm exposures except in cases where clear linkages may be discerned (as in cases where such ailments are only caused by a specific exposure or where medical dianoses have been made). However, this survey will permit the reporti of farm-related injuries, due to the proximate nature of their cause a effect. Only if NIOSH develops more case-control epidemiologic evidenc will the Agency be able to link illnesses to exposures on the farm.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	10/31/1995	10/31/1995
Responses	2,300	0	0
Time Burden (Hours)	1,770	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: RESPONDENTS WILL INCLUDE FARMERS AND THEIR FAMILIES TO OBTAIN PREVALEN AND INCIDENCE DATA ON THE ILLNESSES, INJURIES, AND EXPOSURES TO WORK PLACE HAZARDS. CDC/NIOSH STAFF INVESTIGATORS WILL USE THE INFORMATION FROM THESE SURVEYS FOR RESEARCH AND PREVENTION PROGRAMS DESIGNED TO REDUCE THE HIGH LEVEL OF WORK-RELATED INJURIES AND ILLNESSES NOW BEING EXPERIENCED BY FARMERS AND THEIR FAMILY MEMBERS.

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Authorizing Statute(s): None

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
FARM FAMILY HEALTH AND HAZARD SURVEILLANCE -- COLORADO

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ICR Summary of Burden

	Total Approved	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	2,300	0	0	2,300	0	0
Annual Time Burden (Hours)	1,770	0	0	1,770	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:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $0

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? Uncollected

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? Uncollected

Is this ICR related to the Pandemic Response? Uncollected

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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: 07/21/1992

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