National Coal Workers' Autopsy Study (42 cfr 37.204)

Forms and Documents

Document Name	Status
Form none assigned National Coal Workers' Autopsy Study (42 CFR 37.204) Form	New
0021 NCWAS Attachment A and B.pdf Supplementary Document	2006-11-07
NIOSH 0920-0021 Support State changes Oct 06.doc Supporting Statement A	2006-11-06

IC Document Collections

IC ID	Document Title	Status
6623	National Coal Workers' Autopsy Study (42 cfr 37.204) Other-Other	Modified
46043	National Coal Workers' Autopsy Study (42 CFR 37.204) Other-Other	New
46042	National Coal Workers' Autopsy Study (42 CFR 37.204) Form	New

ICR Details

OMB Control No: 0920-0021	ICR Reference No: 200611-0920-003
Status: Historical Active	Previous ICR Reference No: 200303-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Coal Workers' Autopsy Study (42 cfr 37.204)
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 01/09/2007
	Date Received in OIRA: 11/16/2006
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	01/31/2010	36 Months From Approved	01/31/2007
Responses	150	0	50
Time Burden (Hours)	21	0	21
Cost Burden (Dollars)	0	0	0

---

Abstract: The Federal Coal Mine Health and Safety Act of 1977, PL91-173, (amended the Federal Coal Mine and Safety Act of 1969) provides in Title II, Section 203(d) that "If the death of any active miner occurs in any coal mine, or if the death of any active or inactive miner occurs in any other place, the Secretary of Health and Human Services is authorized to provide for any autopsy to be performed on such miner, with the consent of his surviving widow or, if he has no such widow, then with the consent of his surviving next of kin. The results of such autopsy shall be submitted to the Secretary of Health and Human Services and, with the consent of such survivor, to the miner's physician or other interested person. Such autopsy shall be paid for by the Secretary of Health and Human Services." The regulations concerning the authority for the program were published in Title 42 CFR, Chapter 1, Subchapter C, Part 37. Through delegation of authority, the National Institute for Occupational Safety and Health (NIOSH) is authorized to make the necessary arrangements for providing this service to the next-of-kin of the deceased miner through the National Coal Workers' Autopsy Study (NCWAS) which is a component of the Coal Workers' Health Surveillance Program (CWHSP). The Consent, Release and History form (CDC/NIOSH 2.6) is used to obtain written authorization from the next of kin to perform an autopsy on the deceased miner. The NCWAS post-mortem examinations are used for research purposes (both epidemiological and clinical). A minimum of essential information regarding the deceased miner, his occupational history, and his smoking history is collected. The latter is included because of the strong association between chronic lung diseases and smoking. Medical evidence obtained from the autopsy may also be used by the next-of-kin in support of Black Lung Benefits claims.

---

Authorizing Statute(s): US Code: 42 USC 37 Name of Law: Specifications for Medical Examinations of Underground 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:
	71 FR 28702	05/17/2006
30-day Notice:	Federal Register Citation:	Citation Date:
	71 FR 65116	11/07/2006
Did the Agency receive public comments on this ICR? No

---

Number of Information Collection (IC) in this ICR: 3

IC Title	Form No.	Form Name
National Coal Workers' Autopsy Study (42 cfr 37.204)
National Coal Workers' Autopsy Study (42 CFR 37.204)	none assigned	Consent, History, and Release Form
National Coal Workers' Autopsy Study (42 CFR 37.204)

---

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	150	50	0	100	0	0
Annual Time Burden (Hours)	21	21	0	0	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: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The burden hours requested remain the same (21 hours) as previously approved by OMB. However, CDC has calculated costs to the Federal Government in this ICR, which were not included in the previous ICR.

---

Annual Cost to Federal Government: $12,158

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

---

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: 11/14/2006

---