Protocol, PFAS/viral infection, v1.0
Last Revised: August 23, 2021
Reading Level: 7.2
LETTERHEAD/DATE
Dear [Insert Name],
The Centers for Disease Control and Prevention’s (CDC) National Center for Environmental Health (NCEH) and the Agency for Toxic Substances and Disease Registry (ATSDR) are conducting a research study from [insert dates here]. It is called Evaluating the Association between Serum Concentrations of Per- and Polyfluoroalkyl Substances (PFAS) and Symptoms and Diagnoses of Selected Acute Viral Illnesses.
You may recall that PFAS are chemicals that were widely used in the United States. They include personal care and cleaning products; oil, stain and grease-repelling coatings on carpet, textiles, leather, and paper; and in fire-fighting foams. PFAS are found in the air, soil, and water. They can stay in the human body for years. Scientists and doctors continue to study how PFAS affect human health. They are examining the impact of PFAS on the immune system. The purpose of this NCEH/ATSDR study is to see if PFAS in people’s blood may affect if they get viral illnesses. This can include becoming infected with the COVID-19 virus.
We are inviting [you/your child] to take part in this new study because [you/your child] took part in an earlier ATSDR study. ATSDR measured PFAS in [your/your child’s] blood and you agreed to be contacted again about new studies. This package contains this letter of invitation, two consent forms (one for you to sign and return and one to keep for your records), a Privacy Act Statement, the initial survey, a pre-paid addressed return envelope, and a Symptom Diary for you to use and keep. If you are missing any of the forms described, please contact the study team at xxx-xxx-xxxx or pfasviralstudy@cdc.gov.
These are the Steps to Enroll in the Study:
Carefully read the Consent/Permission/Assent Form
Choose how you want to take the Follow-up Surveys (online or paper)
Sign the Consent/Permission/Assent Form
Complete the 30-minute Initial Survey
Mail the completed Consent Form and Initial Survey (paper)
You are enrolled.
These are the Steps to Complete the Study:
Use the Symptom Diary as a memory aid to track your health
Get the four Follow-up Surveys every three months
Complete and return the 30-minute Follow-up Surveys
After all five Surveys are complete, you are done.
This study will not require any visits in person or any collection of laboratory samples such as blood or urine. Participants will receive a $10 gift card for each completed survey. If a participant completes all five surveys, he or she will receive an additional $25 gift card, for a total of $75 in gift cards. [If you and your child each participate, you can each receive up to $75 in gift cards.]
We appreciate you considering taking part in this study. Your participation will help advance our knowledge about possible health effects associated with PFAS exposure. If you have any questions about this study or the forms you received, please contact us at xxx-xxx-xxxx or pfasviralstudy@cdc.gov.
Thank you,
XXXXXXXXX
File Type | application/vnd.openxmlformats-officedocument.wordprocessingml.document |
Author | Buser, Melanie |
File Modified | 0000-00-00 |
File Created | 2022-02-11 |