Breast Cancer Incidence in Occupational Cohorts Exposed to Ethylene Oxide and Polychlorinated Biphenyls

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
111104	Breast Cancer Incidence in Occupational Cohorts Exposed to Ethylene Oxide and Polychlorinated Biphenyls	Migrated

ICR Details

OMB Control No: 0920-0366	ICR Reference No: 199504-0920-003
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Breast Cancer Incidence in Occupational Cohorts Exposed to Ethylene Oxide and Polychlorinated Biphenyls
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: 07/21/1995
	Date Received in OIRA: 04/25/1995
Terms of Clearance: OMB approves a pre-test of the questionnaire as descibed in the agency's letter of July 18, 1995, as well as other changes set forth in that letter and the letter of July 11, 1995. In addition, HHS has agreed to establish a Science Advisory Panel to review the entire study, including the pre-test results, the comparison groups, the methodology, and the study design, for both the ethylene oxide and polychlorinated biphenyls cohorts. HHS has agreed to invite the public to these proceedings. Upon conclusion of the pre-testing and the deliberations of the SAP, HHS shall provide a pre-test report along with a summary of the SAP's findings, and shall re-submit the study, reflecting any changes, for PRA review.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/1998	07/31/1998
Responses	30	0	0
Time Burden (Hours)	15	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: The primary purpose of the study questionnaire is to collect information from individuals regarding incidence of breast cancer and critical factors, such as family history and parity, that may increase the risk of breast cancer in an occupational cohort independent of chemical exposure. The data collected in these studies will assist in recommendations regarding the safe level of exposure to the specific chemicals of interest.

---

Authorizing Statute(s): None

Citations for New Statutory Requirements: None

---

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

---

Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

---

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

IC Title	Form No.	Form Name
Breast Cancer Incidence in Occupational Cohorts Exposed to Ethylene Oxide and Polychlorinated Biphenyls

---

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	30	0	0	30	0	0
Annual Time Burden (Hours)	15	0	0	15	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:

---

Annual Cost to Federal Government: $0

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]? 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

---

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: 04/25/1995

---