Federal Register / Vol. 83, No. 241 / Monday, December 17, 2018 / Notices 64577 

(0920–0960, Expiration Date 08/31/ 

2018)—Reinstatement with Change— 

National Center for Emerging and 

Zoonotic Infectious Diseases (NCEZID), 

Centers for Disease Control and 

Prevention (CDC). 

Background and Brief Description 

CDC is seeking a three year 

reinstatement of OMB Control No. 

0920–0960, Epidemiologic Study of 

Health Effects Associated With Low 

Pressure Events in Drinking Water 

Distribution Systems. 

In the United States (U.S.), drinking 

water distribution systems are designed 

to deliver safe, pressurized drinking 

water to our homes, hospitals, schools 

and businesses. However, the water 

distribution infrastructure is 50–100 

years old in much of the U.S. and an 

estimated 240,000 water main breaks 

occur each year. Failures in the 

distribution system such as water main 

breaks, cross-connections, back-flow, 

and pressure fluctuations can result in 

potential intrusion of microbes and 

other contaminants that can cause 

health effects, including acute 

gastrointestinal and respiratory illness. 

Approximately 200 million cases of 

acute gastrointestinal illness occur in 

the U.S. each year, but we lack reliable 

data to assess how many of these cases 

are associated with drinking water. 

Further, data are even more limited on 

the human health risks associated with 

exposure to drinking water during and 

after the occurrence of low pressure 

events (such as water main breaks) in 

drinking water distribution systems. 

Studies in both Norway and Sweden 

found that people exposed to low 

pressure events in the water distribution 

system had a higher risk for 

gastrointestinal illness. A similar study 

is needed in the United States. 

The purpose of this data collection is 

to conduct an epidemiologic study in 

the U.S. to assess whether individuals 

exposed to low pressure events in the 

water distribution system are at an 

increased risk for acute gastrointestinal 

or respiratory illness. This study would 

be, to our knowledge, the first U.S. 

study to systematically examine the 

association between low pressure events 

and acute gastrointestinal and 

respiratory illnesses. Study findings will 

inform the Environmental Protection 

Agency (EPA), CDC, and other drinking 

water stakeholders of the potential 

health risks associated with low 

pressure events in drinking water 

distribution systems and whether 

additional measures (e.g., new 

standards, additional research, or policy 

development) are needed to reduce the 

risk for health effects associated with 

low pressure events in the drinking 

water distribution system. 

We will conduct a cohort study 

among households that receive water 

from seven water utilities across the 

U.S. The water systems will be 

geographically diverse and will include 

both chlorinated and chloraminated 

systems. These water utilities will 

provide information about low pressure 

events that occur during the study 

period using a standardized form 

(approximately 13 events per utility). 

Utilities will provide address listings of 

households in areas exposed to the low 

pressure event and comparable 

households in an unexposed area to 

CDC staff, who will randomly select 

participants and send them a 

questionnaire. Consenting household 

respondents will be asked about 

symptoms and duration of any recent 

gastrointestinal or respiratory illness, 

tap water consumption, and other 

exposures including international 

travel, daycare attendance or 

employment, animal contacts, and 

recreational water exposures. Study 

participants may choose between two 

methods of survey response: A mail-in 

paper survey and a web-based survey. 

Participation in this study will be 

voluntary. No financial compensation 

will be provided to study participants. 

The study duration is anticipated to last 

36 months. The annualized burden is 

estimated to be 199 hours. There are no 

costs to respondents other than their 

time. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Water Utility customer ..................................... Paper-based questionnaire ............................ 240 1 12/60 

Web-based questionnaire .............................. 160 1 12/60 

Water Utility maintenance worker ................... LPE form, ultrafilter and grab samples .......... 5 3 145/60 

LPE form, grab samples ................................ 5 2 45/60 

Water Utility Environmental Engineer ............. Line listings .................................................... 5 5 2 

Water Utility Billing clerk ................................. Line listings .................................................... 5 5 1 

Jeffrey M. Zirger, 

Acting Lead, Information Collection Review 

Office, Office of Scientific Integrity, Office 

of Science, Centers for Disease Control and 

Prevention. 

[FR Doc. 2018–27222 Filed 12–14–18; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Disease Control and 

Prevention 

[30Day–19–18AJJ] 

Agency Forms Undergoing Paperwork 

Reduction Act Review 

In accordance with the Paperwork 

Reduction Act of 1995, the Centers for 

Disease Control and Prevention (CDC) 

has submitted the information 

collection request titled Knowledge, 

Attitudes, and Practices of U.S. Large 

Animal Veterinarians Concerning 

Common Veterinary Infection Control 

Measures When Working with Animal 

Obstetric Cases to the Office of 

Management and Budget (OMB) for 

review and approval. CDC previously 

published a ‘‘Proposed Data Collection 

Submitted for Public Comment and 

Recommendations’’ notice on July 20, 

2018 to obtain comments from the 

public and affected agencies. CDC did 

not receive comments related to the 

previous notice. This notice serves to 

allow an additional 30 days for public 

and affected agency comments. 

CDC will accept all comments for this 

proposed information collection project. 

The Office of Management and Budget 


amozie on DSK3GDR082PROD with NOTICES1
64578 Federal Register / Vol. 83, No. 241 / Monday, December 17, 2018 / Notices 

is particularly interested in comments 

that: 

(a) Evaluate whether the proposed 

collection of information is necessary for the 

proper performance of the functions of the 

agency, including whether the information 

will have practical utility; 

(b) Evaluate the accuracy of the agencies 

estimate of the burden of the proposed 

collection of information, including the 

validity of the methodology and assumptions 

used; 

(c) Enhance the quality, utility, and clarity 

of the information to be collected; 

(d) Minimize the burden of the collection 

of information on those who are to respond, 

including, through the use of appropriate 

automated, electronic, mechanical, or other 

technological collection techniques or other 

forms of information technology, e.g., 

permitting electronic submission of 

responses; and 

(e) Assess information collection costs. 

To request additional information on 

the proposed project or to obtain a copy 

of the information collection plan and 

instruments, call (404) 639–7570 or 

send an email to omb@cdc.gov. Direct 

written comments and/or suggestions 

regarding the items contained in this 

notice to the Attention: CDC Desk 

Officer, Office of Management and 

Budget, 725 17th Street NW, 

Washington, DC 20503 or by fax to (202) 

395–5806. Provide written comments 

within 30 days of notice publication. 

Proposed Project 

Knowledge, Attitudes, and Practices 

of U.S. Large Animal Veterinarians 

Concerning Common Veterinary 

Infection Control Measures When 

Working with Animal Obstetric Cases— 

New—National Center for Emerging and 

Zoonotic Infectious Diseases (NCEZID), 

Centers for Disease Control and 

Prevention (CDC). 

Background and Brief Description 

Veterinarians are particularly at risk 

of contracting zoonotic infectious 

diseases due to their close proximity to 

animals, especially during times of 

injury or illness. Some veterinarians 

may be unaware of recommended 

personal protection measures or opt not 

to participate in measures that would 

decrease their risk of contracting a 

zoonotic disease. In 1977, a survey 

conducted of 1182 veterinarians showed 

that approximately 43% of the 

respondents had contracted an 

infectious zoonotic disease. Today, this 

elevated zoonotic disease risk persists; 

the seroprevalence of Q fever in U.S. 

veterinarians is 22% and the 

seroprevalence of leptospirosis is 2.5%. 

Within the veterinary profession, large 

animal practitioners might have an 

increased risk of occupational exposure 

to infectious zoonotic diseases for many 

reasons, including decreased biosecurity 

measures available in the field and the 

limited space available on a mobile 

practice for personal protective 

equipment (PPE). 

The goals of this study are to describe 

veterinarians’ knowledge of zoonotic 

infectious disease, identify 

veterinarians’ attitudes towards 

zoonotic infectious disease and personal 

risk, and determine practices to 

decrease personal risk of infection. By 

identifying knowledge gaps in personal 

protective equipment (PPE) use, 

transmission risk factors, and disease 

identification/diagnosis, we aim to 

determine the best methods for 

education of veterinarians on relevant 

abortion-associated zoonotic infectious 

diseases. 

The purpose of this study is to better 

describe veterinarians’ current 

knowledge of zoonotic diseases that 

cause abortion in large animals, 

determine common veterinary infection 

control practices when working up 

obstetric cases, and identify common 

barriers to PPE use. In order to develop 

effective messaging strategies, a deeper 

understanding of the attitudes and 

barriers to PPE use is needed. 

Information will be collected through 

a web-based ‘‘Livestock abortionassociated zoonoses’’ survey. The 

estimated burden per response is 15 

minutes. Respondents will be 

veterinarians interested in bovine, small 

ruminant, or swine medicine. 

Collaborating veterinary specialty 

organizations will distribute 

announcements about the survey to 

their memberships along with a link to 

the electronic survey. CDC anticipates 

that data analysis will be conducted on 

approximately 500 de-identified survey 

responses. 

Findings will be used to improve and 

enhance zoonotic disease education and 

PPE guidance targeted to veterinarians. 

OMB approval is requested for one year. 

Participation is voluntary and there are 

no costs to respondents other than their 

time. The total estimated annualized 

burden hours are 125. 

ESTIMATED ANNUALIZED BURDEN HOURS

Type of respondents Form name Number of 

respondents 

Number of 

responses per 

respondent 

Average 

burden per 

response 

(in hours) 

Veterinarian ..................................................... Livestock abortion-associated zoonoses ....... 500 1 15/60 

Jeffrey M. Zirger, 

Acting Lead, Information Collection Review 

Office, Office of Scientific Integrity, Office 

of Science, Centers for Disease Control and 

Prevention. 

[FR Doc. 2018–27221 Filed 12–14–18; 8:45 am] 

BILLING CODE 4163–18–P 

DEPARTMENT OF HEALTH AND 

HUMAN SERVICES 

Centers for Medicare & Medicaid 

Services 

[CMS–7056–N] 

Medicare and Medicaid Programs, and 

Other Program Initiatives, and 

Priorities; Request for Nominations to 

the Advisory Panel on Outreach and 

Education (APOE) 

AGENCY: Centers for Medicare & 

Medicaid Services (CMS), HHS. 

ACTION: Notice. 

SUMMARY: This notice requests 

nominations for individuals to serve on 

the Advisory Panel on Outreach and 

Education (APOE). 

DATES: Nominations will be considered 

if we receive them at the appropriate 

address, provided in the ADDRESSES

section of this notice, no later than 5 

p.m., Eastern Savings Time (e.s.t.) on 

January 16, 2019. 

ADDRESSES: Mail or deliver nominations 

to the following address: Lynne 

Johnson, Acting Designated Federal 

Official, Office of Communications, 

CMS, 7500 Security Boulevard, Mail 

Stop S1–05–06, Baltimore, MD 21244– 


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