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Please note that the OMB number and expiration date may not have been determined when this Information Collection Request and associated Information Collection forms were submitted to OMB. The approved OMB number and expiration date may be found by clicking on the Notice of Action link below.
View ICR - OIRA Conclusion
OMB Control No:
0920-0020
ICR Reference No:
201604-0920-005
Status:
Historical Active
Previous ICR Reference No:
201503-0920-003
Agency/Subagency:
HHS/CDC
Agency Tracking No:
16ABJ
Title:
National Coal Workers' Health Surveillance Program (CWHSP)
Type of Information Collection:
No material or nonsubstantive change to a currently approved collection
Common Form ICR:
No
Type of Review Request:
Regular
OIRA Conclusion Action:
Approved without change
Conclusion Date:
04/13/2016
Retrieve Notice of Action (NOA)
Date Received in OIRA:
04/13/2016
Terms of Clearance:
Inventory as of this Action
Requested
Previously Approved
Expiration Date
06/30/2018
06/30/2018
06/30/2018
Responses
104,158
0
104,158
Time Burden (Hours)
20,276
0
20,276
Cost Burden (Dollars)
0
0
0
Abstract:
The Coal Workers' Health Surveillance Program (CWHSP) is a congressionally-mandated medical examination program for monitoring the health of underground coal miners, established under the Federal Coal Mine Health and Safety Act of 1969. Through delegation of authority, the Act directs NIOSH to study the causes and consequences of coal-related respiratory disease, and in cooperation with the Mine Safety and Health Administration, to carry out a program for early detection and prevention of coal workers' pneumoconiosis and to provide the opportunity for an autopsy after the death of a coal miner.
Authorizing Statute(s):
PL:
Pub.L. 91 - 173 203
Name of Law: Federal Coal Mine Health and Safety Act
PL:
Pub.L. 91 - 596 20
Name of Law: Occupational Safety and Health Act
US Code:
42 USC 37
Name of Law: Specifications for Medical Exam of Coal Miners
Citations for New Statutory Requirements:
None
Associated Rulemaking Information
RIN:
Stage of Rulemaking:
Federal Register Citation:
Date:
Not associated with rulemaking
Federal Register Notices & Comments
60-day Notice:
Federal Register Citation:
Citation Date:
79 FR 74094
12/15/2014
30-day Notice:
Federal Register Citation:
Citation Date:
80 FR 14143
03/18/2015
Did the Agency receive public comments on this ICR?
No
Number of Information Collection (IC) in this ICR:
14
IC Title
Form No.
Form Name
Coal Miner Radiograph (CWHSP)
Chest Radiograph Classification (CDC/NIOSH Form 2.8)
2.8
Chest Radiograph Classification
Coal Contractor Plan CDC/NIOSH 2.18
2.18
Coal Contractor Plan
Coal Mine Operator's Plan (CDC/NOISH (M) 2.10)
2.10
Coal Mine Operator's Plan
Consent Release and History Form- Next of Kin (CDC/NIOSH 2.6)
2.6
Consent, Release and History Form for Autopsy
Invoice-Pathologist
Miner Identification Document (CDC/NIOSH 2.9)
2.9, 2.9
Miner Identification Document
,
Miner Identificaiton Document
Physician Application for Certification (CDC/NIOSH 2.12)
2.12
Physician Application for Certification
Radiographic Facility Certification (CDC/NIOSH (M) 2.11)
2.11
Radiographic Facility Certification
Report - Pathologist
Spirometry Facility Employee - Respiratory Assessment 2.13
2.13
Respiratory Assessment
Spirometry Facility Supervisor - Certification Document 2.14
2.14
Spirometry Facility Certification
Spirometry Results Notification CDC/NIOSH 2.15
2.15, 2.15
Spirometry Results Notification
,
Spirometry Results Notification Form
Spirometry Test for Coal Miners
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
104,158
104,158
0
0
0
0
Annual Time Burden (Hours)
20,276
20,276
0
0
0
0
Annual Cost Burden (Dollars)
0
0
0
0
0
0
Burden increases because of Program Change due to Agency Discretion:
No
Burden Increase Due to:
Burden decreases because of Program Change due to Agency Discretion:
No
Burden Reduction Due to:
Short Statement:
Annual Cost to Federal Government:
$2,262,097
Does this IC contain surveys, censuses, or employ statistical methods?
Yes
Part B of Supporting Statement
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]?
No
Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]?
No
Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)?
No
Is this ICR related to the Pandemic Response?
Uncollected
Agency Contact:
Thelma Sims 4046394771
Common Form ICR:
No
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:
04/13/2016
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