[Federal Register Volume 89, Number 190 (Tuesday, October 1, 2024)]
[Notices]
[Pages 79919-79920]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2024-22472]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Agency for Toxic Substances and Disease Registry

[30Day-24-0051]


Agency Forms Undergoing Paperwork Reduction Act Review

    In accordance with the Paperwork Reduction Act of 1995, the Agency 
for Toxic Substances and Disease Registry (ATSDR) has submitted the 
information collection request titled ``Assessment of Chemical 
Exposures (ACE) Investigations'' to the Office of Management and Budget 
(OMB) for review and approval. ATSDR previously published a ``Proposed 
Data Collection Submitted for Public Comment and Recommendations'' 
notice on June 25, 2024, to obtain comments from the public and 
affected agencies. ATSDR received one comment related to the previous 
notice. This notice serves to allow an additional 30 days for public 
and affected agency comments.
    ATSDR will accept all comments for this proposed information 
collection project. The Office of Management and Budget 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. Comments and recommendations for the proposed 
information collection should be sent within 30 days of publication of 
this notice to www.reginfo.gov/public/do/PRAMain. Find this particular 
information collection by selecting ``Currently under 30-day Review--
Open for Public Comments'' or by using the search function. 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

    Assessment of Chemical Exposures (ACE) Investigations (OMB Control 
No. 0923-0051, Exp. 10/31/2024)--Revision--Agency for Toxic Substances 
and Disease Registry (ATSDR).

Background and Brief Description

    The Agency for Toxic Substances and Disease Registry (ATSDR) is 
requesting to revise the Assessment of Chemical Exposures (ACE) 
Investigations information collection project and seeks a three-year 
OMB approval to assist state and local health departments after toxic 
substance spills or other acute environmental incidents. The current 
OMB approval for this information collection expires 10/31/2024. ATSDR 
has successfully completed three investigations to date. With the uses 
of this valuable mechanism, ATSDR would like to continue this impactful 
information collection. See below for a brief summary of information 
collections approved under this tool:
    <bullet> During 2015, in U.S. Virgin Islands there was a methyl 
bromide exposure at a condominium resort. Under this ACE investigation, 
awareness among pest control companies that methyl bromide is currently 
prohibited in homes and other residential settings. Additionally, 
clinicians were made aware of the toxicologic syndrome caused by 
exposure to methyl bromide and the importance of notifying first 
responders immediately when they have encountered contaminated 
patients.
    <bullet> During 2016, ACE Investigations teams conducted a rash 
investigation in Flint, Michigan. Persons exposed to Flint municipal 
water who had current or worsening rashes surveyed were referred too 
free dermatologist screening if desired. Findings revealed that when 
the city was using water from the Flint River, where there were large 
swings in chorine, pH, and hardness, which could be one possible 
explanation for the eczema-related rashes.
    <bullet> During 2016, ACE Investigations teams also conducted a 
follow-up investigation for people who were exposed to the Flint 
municipal water and sought care from the free dermatology exam. The 
follow-up interviews resulted in improving the exam and referral 
processes that were still ongoing at the time.
    ACE Investigations have focused on performing rapid epidemiological 
assessments to assist state, regional, local, or tribal health 
departments (the requesting agencies) to respond to or prepare for 
acute environmental incidents. The main objectives for performing these 
rapid assessments are to:
    <bullet> Characterize exposure and acute health effects of the 
affected community to inform health officials and the community;
    <bullet> Identify needs (i.e., medical, mental health, and basic) 
of those exposed during the incidents to aid in planning interventions 
in the community;
    <bullet> Determine the sequence of events responsible for the 
incident so that actions can be taken to prevent future incidents;
    <bullet> Assess the impact of the incidents on the emergency 
response and health services used and share lessons learned for use in 
hospital, local, and state planning for environmental incidents; and
    <bullet> Identify cohorts that may be followed and assessed for 
persistent

[[Page 79920]]

health effects resulting from environmental releases.
    Because each incident is different, it is not possible to predict 
in advance exactly what type of, and how many respondents will be 
consented and interviewed to effectively evaluate the incident. 
Respondents typically include, but are not limited to, emergency 
responders such as police, fire, hazardous material technicians, 
emergency medical services, and personnel at hospitals where patients 
from the incident were treated. Incidents may occur at businesses or in 
the community setting; therefore, respondents may also include business 
owners, managers, workers, customers, community residents, and those 
passing through the affected area.
    The multidisciplinary ACE Investigations Team--consisting of staff 
from ATSDR, the Centers for Disease Control and Prevention (CDC), and 
the requesting agencies will be collecting data. ATSDR has developed a 
tailored series of draft survey forms used in the field to collect data 
that will meet the goals of each investigation. ATSDR collections will 
be administered based on time permitted and urgency. For example, it is 
preferable to administer the General Survey to as many respondents as 
possible. However, if there are time constraints, the shorter 
Epidemiologic Contact Assessment Symptom Exposure (Epi CASE) Survey, 
may be administered, instead. The individual surveys collect 
information about exposure, acute health effects, health services use, 
medical history, needs resulting from the incident, communication 
during the release, health impact on children, and demographic data. 
Hospital personnel are asked about the surge, response and 
communication, decontamination, and lessons learned. Depending on the 
situation, data collected by face-to-face interviews, telephone 
interviews, written surveys, mailed surveys, or on-line self-
administered surveys can be collected. Medical charts may also be 
considered for review. In rare situations, an investigation might 
involve collection of clinical specimens.
    ATSDR is proposing to increase the utility of this Generic ICR in 
response to stakeholder requests. We would also like to broaden who we 
may assist to include other federal public health agencies. ATSDR 
proposes revisions to select information collection forms, which will 
be deployed online or using handheld devices whenever possible to 
reduce burden, and to adjust the number of responses and time per 
response for several forms. Because of this, addition of online self-
administration method, ATSDR expects to be able to survey many more 
people than during previous large disasters. A brief Eligibility 
Screener will be conducted before the General or Epi CASE survey to 
make sure respondents were in the area at the time of the incident, 
before consenting them to be surveyed. The number of people to be 
screened will be increased to 2,500 responses per year. The shorter Epi 
CASE survey has been modified to incorporate the symptom checker 
showcard into the survey so that it can be easily self-administered 
online, and questions on functional disabilities were added as 
requested by stakeholders adding two minutes (now 17 minutes and 1,000 
respondents). The General survey will also have an online option. For 
simplicity, adolescents will no longer be eligible to take the General 
Survey and the Child Survey will become a module of the General survey 
for adults to answer for their minor children. At stakeholder direction 
we have added modules to the General Survey for responder, pets and 
livestock health, and a community resilience qualitative question bank. 
The General Survey has also added questions requested by stakeholders 
on functional disabilities and maternal and child health. The two 
existing long mental health screeners are replaced by three shorter 
ones and the Race/Ethnicity questions are now consistent with OMB 
guidance. Qualitative questions were added to several sections 
throughout the survey. These changes add to the time of the survey and 
the online self-administration option allows for an increase in 
respondents (now 60 minutes, 1000 responses annually). The Household 
Survey will be removed because of little use. The Hospital Survey for 
Emergency Department (ED) nurses and other health professionals on how 
they handled the response is unchanged (40 responses per year; 17 
hours). ATSDR is modifying the Medical Chart Abstraction Form with 
slight question changes suggested by a medical toxicologist, and by 
adding functional disability questions and modifying the Race/Ethnicity 
questions to the new OMB standards. This will have no effect on overall 
burden (250 responses per year; 125 hours).
    ATSDR anticipates approximately one ACE investigation per year. 
ATSDR requests approval 1,508 annual burden hours. Participation in ACE 
investigations is voluntary and there are no anticipated costs to 
respondents other than their time.

                                        Estimated Annualized Burden Hours
----------------------------------------------------------------------------------------------------------------
                                                                                                      Average
                                                                     Number of       Number of      burden per
          Type of respondents                   Form name           respondents    responses per   response  (in
                                                                                    respondent        hours)
----------------------------------------------------------------------------------------------------------------
Residents, first responders, business   Eligibility Screener....           2,500               1            2/60
 owners, employees, customers.          Epi CASE Survey.........           1,000               1           17/60
                                        General survey..........           1,000               1           60/60
Hospital staff........................  Hospital Survey.........              40               1           25/60
Staff from state, local, or tribal      Medical Chart                         25              10           30/60
 health agencies.                        Abstraction Form.
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Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Public Health 
Ethics and Regulations, Office of Science, Centers for Disease Control 
and Prevention.
[FR Doc. 2024-22472 Filed 9-30-24; 8:45 am]
BILLING CODE 4163-18-P