Document ID: EPA-HQ-ORD-2004-0023-0003
Agency: epa
Document Type: Supporting & Related Material
Title: 
Posted Date: 2005-07-14T04:00Z

Page
1
SECTION
1.

A.
SUPPORTING
STATEMENT
1.
IDENTIFICATION
OF
THE
INFORMATION
COLLECTION
1(
a)
TITLE
Health
Effects
of
Microbial
Pathogens
in
Recreational
Waters;
National
Epidemiological
and
Environmental
Assessment
of
Recreational
(
NEEAR)
Water
Study
(
Renewal).
EPA
ICR
Number
2081.02,
OMB
Control
Number
2080­
0068.

1(
b)
ABSTRACT
This
study
will
be
conducted,
and
the
information
collected,
by
the
Epidemiology
and
Biomarkers
Branch,
Human
Studies
Division,
National
Health
and
Environmental
Effects
Research
Laboratory,
Office
of
Research
and
Development,
U.
S.
Environmental
Protection
Agency
(
EPA).
Participation
of
adults
and
children
in
this
collection
of
information
is
strictly
voluntary.

This
information
is
being
collected
as
part
of
a
research
program
consistent
with
the
Section
3(
a)
(
v)
(
1)
of
the
Beaches
Environmental
Assessment
and
Coastal
Health
Act
of
2000
and
the
strategic
plan
for
EPA's
Office
of
Research
and
Development
(
ORD)
and
the
Office
of
Water
entitled
"
Action
Plan
for
Beaches
and
Recreational
Water."
The
Beaches
Act
and
ORD's
strategic
plan
have
identified
research
on
effects
of
microbial
pathogens
in
recreational
waters
as
a
high­
priority
research
area
with
particular
emphasis
on
developing
new
water
quality
indicator
guidelines
for
recreational
waters.
The
EPA
has
broad
legislative
authority
to
establish
water
quality
criteria
and
to
conduct
research
to
support
these
criteria.
This
data
collection
is
for
a
series
of
epidemiological
studies
to
evaluate
exposure
to
and
effects
of
microbial
pathogens
in
marine
and
fresh
(
Great
Lakes)
recreational
waters
as
part
of
EPA's
research
program
on
exposure
and
health
effects
of
microbial
pathogens
in
recreational
waters.

The
results
of
these
health
effects
studies
will
be
used
to
document
human
health
effects
associated
with
recreational
water
use,
correlate
these
health
effects
with
ongoing
EPA
studies
to
identify
a
new
generation
of
indicators
for
detection
of
human
pathogens
in
recreational
water
and
appropriate,
effective,
and
expeditious
testing
methods
for
these
indicators
(
addressed
separately
under
Section
3(
a)
(
v)
(
2
&
3)
of
the
Beaches
Environmental
Assessment
and
Coastal
Health
Act
of
2000).
The
epidemiological
results
will
be
used
to
develop
mathematical
relationships
that
will
generate
of
new
national
water
quality
guidelines
and
appropriate
monitoring
guidelines.
Page
2
The
beaches
will
be
selected
based
on
the
potential
number
of
beach
goers,
water
quality
parameters,
and
potential
sources
of
microbial
pathogens
in
the
water
(
domestic
sewage
vs
animals).
These
studies
will
place
the
emphasis
on
beaches
that
have
identified
point
source
contamination
(
e.
g.,
sewage
treatment
plants).
There
is
no
sampling
strategy
as
a
complete
census
(
de
facto)
at
the
beach
selection
site
will
be
utilized
for
this
data
collection.
Households
(
families/
individuals)
at
selected
beaches
will
be
interviewed
on
the
beach
about
a
variety
of
exposures
including
those
to
recreational
water
(
Appendix
C).
Ten
to
twelve
(
10­
12)
days
later,
families/
individuals
will
be
contacted
by
telephone
and
interviewed
on
the
occurrence
of
selected
symptomatology
since
swimming
at
the
beach
(
Appendix
D).
In
addition,
selected
groups
of
children
(
boy
and
girl
scouts,
church
groups,
camps)
who
are
making
day
trips
to
selected
beaches
for
recreation
will
be
asked
to
participate
in
a
special
study
to
identify
specific
microbial
pathogens.
Concurrently,
recreational
waters
will
be
monitored
with
a
selection
of
water
quality
indicators
developed
under
a
separate
EPA
research
effort.
The
epidemiologic
information
will
be
collected
electronically
and
stored
in
a
computerized
database.

The
questionnaire
health
data
will
be
compared
with
routinely
collected
water
quality
measurements.
The
information
collected
by
this
study
will
be
used
to
estimate
the
relationship
between
new
water
quality
indicators
and
health
effects.
The
analysis
will
focus
on
determining
whether
water
quality
parameters
are
associated
with
increased
prevalence
of
swimming­
related
health
effects.

The
estimated
annual
respondent
burden
for
this
study
is
5,250
hours
and
$
76,912
The
estimated
annual
agency
cost
for
conducting
this
study
is
28,116
hours
and
$
2,607,120.
This
study
requires
no
maintenance
of
records
by
the
respondents.

1(
c)
TERMS
OF
CLEARANCE
Each
data
collection
season
the
survey
tool
was
reviewed
by
the
project
team
and
modified
in
non­
substantial
ways
to
improve
design
and
vocabulary
usage.
After
the
survey
tool
was
reviewed
and
modified
by
the
project
team,
it
was
forwarded
to
Jim
Laity
with
the
Office
of
Management
and
Budget
to
receive
approval.
Additional
questions
and
modifications
received
prior
approval
through
the
study's
designated
institutional
review
board.
The
changes
made
to
the
interview
tools
are
thematically
the
same
as
the
original
questionnaires
submitted
with
the
original
Information
Collection
Request
(
ICR).
As
a
note
of
reference,
it
is
important
to
recall
that
there
was
one
questionnaire
conducted
on
the
beach
and
the
other
was
conducted
by
telephone10­
12
day
later.
This
is
important
as
some
questions
were
moved
from
the
beach
Page
3
interview
to
the
telephone
interview
to
ease
respondent
burden
in
the
beach
area.
This
change
took
place
on
the
2005
questionnaire.
This
was
the
only
change
made
to
the
telephone
questionnaire
that
was
not
grammatical.

2003
Questionnaires
For
the
2003
data
collection
season,
the
beach
questionnaire
was
only
changed
slightly
to
make
it
easier
to
read
and
understand.

2004
Questionnaires
In
the
2004
beach
questionnaire,
the
questions
concerning
cleansing
showers
and
use
of
soap
with
those
showers
were
removed
from
the
questionnaire.
They
were
not
useful
in
the
data
analysis
and
only
collected
data
that
was
extraneous
to
this
study.
Other
more
substantial
changes
included
the
following:

!
Deleted
redundant
question
Q5
asking
if
they
have
any
children
between
2
and
10
years
of
age.
This
information
is
collected
as
part
of
the
household
demographics.

!
Added
sunburn
to
Q10
for
more
accurate
environmental
exposure
!
Combined
water
related
activities
in
Q17f
to
reduce
interviewer
burden
!
Added
question
asking
about
SPF
rating
of
sunblock
and
reapplication
of
sunblock
utilized
by
participant
!
Eliminated
questions
about
use
of
soap
in
showers
!
Added
consumption
of
red
or
raw
meat,
runny
eggs
to
food
consumption
list
2005
Questionnaires
In
2005,
the
beach
questionnaire
was
modified
to
include
more
detailed
questions
about
sunburn
exposure.
This
change
allows
the
collection
of
more
accurate
data
!
Added
Q14c.
to
collect
specific
data
about
length
of
sunburn
duration
!
Eliminated
question
estimating
the
amount
of
water
swallowed
by
the
participants
!
Combined
swimming
activities
in
Q16f
and
Q16c
to
reduce
respondent
burden
!
Moved
Q17,
Q18,
and
Q19
to
telephone
interview
to
reduce
respondent
burden
Page
4
in
beach
area
!
Added
question
that
specified
where
sunblock
was
used
on
the
participants
body
!
Added
question
that
identified
skin
type
of
participants
The
2005
telephone
interview
gained
some
additional
questions
that
came
from
the
beach
interview.
As
stated
previously,
this
change
was
motivated
by
respondent
burden
in
the
beach
interview.

!
Questions
Q17,
Q18,
and
Q19
from
the
beach
interview
were
moved
to
telephone
interview
to
reduce
respondent
burden
in
beach
area
2.
NEED
FOR
AND
USE
OF
THE
INFORMATION
COLLECTION
2(
a)
NEED
/
AUTHORITY
FOR
THE
INFORMATION
COLLECTION
The
information
is
being
collected
as
a
part
of
a
research
program
to
identify
and
evaluate
exposure
to
and
effects
of
microbial
contaminants
of
recreational
water
as
part
of
the
U.
S.

Environmental
Protection
Agency's
research
program
on
exposure
and
health
effects
of
microbial
pathogens
in
recreational
waters.
The
Beaches
Act
of
2000
specifically
authorizes
such
studies
(
Appendix
A).

These
studies
will
provide
information
on
the
ability
of
water
quality
indicators
to
predict
health
effects
associated
with
recreational
exposures.
These
studies
will
also
provide
information
on
the
level
of
gastrointestinal
disease
and
other
related
illnesses
(
skin,
ear,
eye,

urinary
tract,
and
respiratory
infections)
in
adults
and
children
that
are
associated
with
marine
and
fresh
water
(
Great
Lakes)
recreational
exposures.

2(
b)
PRACTICAL
UTILITY
/
USERS
OF
THE
DATA
The
EPA's
Office
of
Research
and
Development,
the
Office
of
Water
and
the
Centers
for
Disease
Control
and
Prevention
will
use
the
information.
EPA
investigators
will
present
the
results
of
this
program
in
a
series
of
meetings
for
identified
stakeholders,
local
and
state
public
health
officials,
and
EPA
regional
scientists.
EPA
investigators
also
will
present
the
study
results
at
scientific
conferences
and
will
prepare
one
or
more
scientific
papers
for
peer­
reviewed
publications.

These
peer­
reviewed
scientific
publications
may
be
used
by
EPA's
Office
of
Water
to
develop
water
quality
criteria
or
guidelines.
Every
attempt
will
be
made
to
identify
a
wide
Page
5
range
of
marine
and
fresh
(
Great
Lakes)
water
beaches
so
the
sites
will
be
as
representative
as
is
technically
feasible.
Information
from
the
studies
may
be
useful
to
local
and
state
public
health
officials
in
the
design
and
implementation
of
a
beach
monitoring
and
closure
program.

3.
NONDUPLICATION,
CONSULTATIONS,
AND
OTHER
COLLECTION
CRITERIA.

3(
a)
NONDUPLICATION
The
questionnaires
do
not
duplicate
any
existing
information.
While
this
study
closely
follows
the
design
and
conduct
of
several
previous
studies
(
see
Appendix
E),
there
are
no
health
effects
studies
that
have
evaluated
swimming­
related
illness
and
correlated
it
with
the
current
proposed
set
of
microbial
pathogen
indicators.

3(
b)
FEDERAL
REGISTER
NOTICE
This
is
the
second
announcement
of
a
public
comment
period
for
this
ICR.
The
first
Federal
Register
notice,
published
on
February
14,
2005
(
70
FR
7496).
See
Appendix
B
for
Text
copy
of
the
Federal
Register
notice.
The
first
Federal
Register
may
be
found
online
via
GPO
Access
(
http://
www.
gpoaccess.
gov/
index.
html)
also
provides
a
copy.
No
responses
to
the
first
Federal
Register
notice,
"
Health
Effects
of
Microbial
Pathogens
in
Recreational
Waters;
National
Epidemiological
and
Environmental
Assessment
of
Recreational
Water
Study
(
NEEAR),"
were
received
by
April
15,
2005.

3(
c)
CONSULTATIONS
The
following
people
have
been
consulted:

Michael
Beach,
Epidemiologist,
CDC,
National
Center
for
Infectious
Diseases
Abdel
el­
Shaawari,
National
Water
Research
Institute,
Canada
Center
for
Inland
Waters,

Burlington,
Canada
David
Parkhurst,
Indiana
University,
School
of
Public
and
Environmental
Affairs,

Bloomington,
IN
Richard
O.
Gilbert,
Private
Consultant,
Rockville,
MD
Paul
Succop,
University
of
Cincinnati,
Cincinnati,
OH
Public
Meetings:
The
proposed
studies
have
been
publicly
discussed
at
the
following
meetings:

East
Coast
Regional
Beach
Conference
­
October
18­
19,
1999
West
Coast
Regional
Beach
Conference
­
August,
1999
Great
Lakes
Beach
Conference
­
February
5,
2000
The
response
from
these
individuals
and
organizations
has
been
favorable.

3(
d)
EFFECTS
OF
LESS
FREQUENT
COLLECTION
Page
6
The
questionnaire
information
may
be
collected
from
an
individual
household
once
every
28
days.
The
frequency
of
the
study
questionnaire
attempts
to
reduce
the
amount
of
information
collection
without
compromising
data
quality.
It
is
estimated
that
an
individual
household
will
be
eligible
for
the
study
a
maximum
of
three
times
in
a
study
season.
Because
some
households
visit
the
beach
frequently,
their
exposure
may
have
different
symptomatic
effects
important
to
the
study
analysis.
This
interviewing
strategy
allows
the
data
collection
of
households
that
visit
the
beach
study
site
regularly
without
duplicating
illness
cycles.

In
the
pilot
study
conducted
in
the
summer
of
2002,
there
were
a
total
of
two
telephone
interviews.
One
at
4­
7
days
followed
by
one
at
10­
14
days.
The
pilot
analysis
indicated
that
data
from
the
10­
12
day
telephone
interview
range
were
most
useful
for
the
focus
of
this
study.

The
first
telephone
interview
was
deleted
in
the
survey
process
after
the
utility
of
the
information
was
reviewed
by
panelists
in
the
2003
Study
Peer
Review.
The
remaining
telephone
interview
time­
frame
was
changed
to
10­
12
days.

3(
e)
GENERAL
GUIDELINES
We
have
adhered
to
all
of
OMB's
general
guidelines.

3(
f)
CONFIDENTIALITY
We
will
adhere
to
all
standard
steps
to
maintain
confidentiality.
These
include
the
exclusion
of
personal
identifiers
from
the
database
following
completion
of
the
phone
interviews
and
storage
of
hard
copies
in
locked
files.
Contractor
involvement
will
be
monitored
by
requiring
hard
and/
or
electronic
copies
to
be
stored
at
EPA
after
the
contractor
has
completed
data
processing.
The
contractor
has
agreed
to
observe
the
rules
of
confidentiality
regarding
the
health
information
provided
by
individuals
and
their
families.

3(
g)
SENSITIVE
QUESTIONS
No
questions
of
a
sensitive
nature
will
be
required.

4.
THE
RESPONDENTS
AND
THE
INFORMATION
REQUESTED
4(
a)
RESPONDENTS
/
SIC
CODES
This
study
will
be
conducted
among
households
who
are
at
the
selected
beaches
around
the
country.
Based
on
previous
studies,
it
is
anticipated
a
maximum
of
7,000
households
will
be
enrolled
from
all
sites
in
a
single
recreational
season.

Children
constitute
a
susceptible
subpopulation
due
to
the
immaturity
of
their
immune
system
and
their
lack
of
lifetime
exposure
experience.
Pregnant
women
also
constitute
a
susceptible
subpopulation
for
severe
disease
due
to
dehydration
associated
with
gastroenteritis.
Page
7
4(
b)
INFORMATION
REQUESTED
(
viii)
Data
Items:

Each
questionnaire
will
ask
a
single
adult
member
of
the
household
to
provide
the
information
listed
for
all
members
of
the
household.
The
questionnaires
can
be
found
in
Appendix
C
and
D.
The
requested
information
includes
questions
specific
to
past
illnesses,

recreational
experience,
other
risk
information
and
general
household
characteristics.

This
study
will
use
water
quality
monitoring
data
and
meteorologic
data
that
will
be
routinely
collected
by
EPA
and
EPA
contractors
under
separate
EPA
research
efforts.

There
are
no
maintenance
of
records
by
respondents
required
for
this
study.

(
ii)
Respondent
Activities
The
representative
member
of
the
family
will
be
given
a
brochure
describing
the
study's
risks
and
benefits
and
will
be
asked
for
verbal
consent
to
enroll
them
in
the
study.
The
households
will
be
interviewed
on
the
beach
and
then
will
be
interviewed
via
telephone
ten
to
twelve
(
10­
12)
days
later.

5.
THE
INFORMATION
COLLECTED
­­
AGENCY
ACTIVITIES,
COLLECTION
METHODOLOGY,
AND
INFORMATION
MANAGEMENT
5(
a)
AGENCY
ACTIVITIES
EPA's
Epidemiology
and
Biomarkers
Branch
and
an
EPA
contractor
will
be
responsible
for
administering
the
questionnaire,
answering
respondent
questions,
reviewing
respondent
answers,
developing
and
maintaining
the
database,
analyzing
the
data
and
storing
and
reviewing
the
data.

5(
b)
COLLECTION
METHODOLOGY
AND
MANAGEMENT
The
initial
interview
questionnaire
that
contains
household
demographics
and
usual
beach
activities
will
be
collected
using
computer­
assisted
personal
interviews
(
CAPI).
The
telephone
interview
that
collect
illness
information
about
the
household
ten
to
twelve
(
10­
12)
days
later
will
utilize
computer­
assisted
telephone
interviews
(
CATI).

The
water
quality
measurements
will
be
collected
under
the
same
EPA
research
project
in
concurrence
with
the
health
data
collection.
The
water
quality
parameters
will
include
real­
time
measurement
of
fecal
indicators
(
e.
g.,
enterococci,
E.
coli,
chemical
indicators)
and/
or
measurement
of
fecal
indicators
and/
or
microbial
pathogens
with
methods
that
give
results
in
two
hours
or
less.
Beach
monitoring
sites
will
be
selected
to
support
a
regulatory
program
and
are
located
in
areas
representative
of
geographic
differences
and
a
range
of
exposures
Page
8
associated
with
point
source
fecal
contamination
of
recreational
waters.
These
sites
are
intended
to
support
an
epidemiological
study
and
therefore
have
been
designed
to
provide
sufficient
information
on
the
gradient
of
exposures
to
fecal
contamination
found
in
recreational
waters.
No
additional
burden
will
be
placed
on
the
local
water
pollution
agencies
in
the
selected
areas.

All
data
will
be
reviewed
for
unusual
or
unacceptable
values.
The
CAPI/
CATI
questionnaire
data
will
be
verified
through
the
daily
data
verification
programs.
Statistical
data
will
be
maintained
in
electronic
format
using
the
Statistical
Analysis
System
(
SAS).
Two
backup
data
files
will
be
stored
separately
from
data
that
is
used
to
create
the
analytical
database.

These
back­
up
files
will
contain
unedited
raw
data
and
will
be
write­
protected.
We
will
control
access
to
the
data
in
accordance
with
Federal
privacy
regulations
and
OMB
Circular
A­
110.

5(
c)
IMPACT
ON
SMALL
BUSINESSES
OR
OTHER
SMALL
ENTITIES
The
procedures
for
beach
interview
and
follow­
up
telephone
interview
have
been
designed
to
minimize
the
burden
to
the
households
who
agree
to
participate
in
the
study.

5(
d)
COLLECTION
SCHEDULE
The
study
has
currently
completed
3
years
of
data
collection.

Pilot
Study
°
West
Beach,
Indiana
Dunes
National
Lakeshore,
Portage,
Indiana
 
2002
Full­
Scale
Study
 
Freshwater
°
West
Beach,
Indiana
Dunes
National
Lakeshore,
Portage,
Indiana
 
2003
°
Huntington
Beach,
Bay
Village,
Ohio
 
2003
°
Washington
Park,
Michigan
City,
Indiana
 
2004
°
Silver
Beach,
St.
Joseph,
Michigan
 
2004
The
marine
full­
scale
study
will
be
conducted
in
the
summers
of
2005­
2011.
Water
quality
samples
for
measurement,
will
be
collected
at
the
same
beaches
concurrently
with
beach
interviews.
Preliminary
data
sets
will
be
delivered
to
the
EPA
by
December
for
each
recreational
season.
These
preliminary
data
sets
will
be
extensively
reviewed
for
quality
assurance
prior
to
any
analysis.

6.
ESTIMATING
THE
BURDEN
AND
COST
OF
THE
COLLECTION
Page
9
6(
a).
ESTIMATING
RESPONDENT
BURDEN
Beach
Interview
&
Telephone
Follow­
up:
Based
on
consultation
with
the
individuals
listed
in
Section
3(
c),
and
our
experience
with
similar
types
of
information
collection,
we
estimate
that
each
household
will
spend
an
average
of
30
minutes
completing
both
parts
of
the
beach
interview
and
will
require
no
record
keeping.
This
includes
the
time
for
reviewing
the
information
pamphlet
and
answering
the
questions.
We
estimate
that
each
family
will
spend
an
average
of
15
minutes
completing
the
home
telephone
interview.
The
telephone
inteviews
will
require
no
record
keeping.

TABLE
1.
ESTIMATED
ANNUAL
RESPONDENT
BURDEN
Type
of
Respondent
Respondent
Activities
Estimated
Number
of
Respondents
Burden
Hours
Frequency
Annual
Reporting
Burden
Annual
Cost
X
14.65
Head
of
household
Beach
Interview
Part
A
7000
0.25
hr.
1
1750
hr
$
25,638
a
Head
of
household
Beach
Interview
Part
B
7000
0.25
hr.
1
1750
hr
$
25,638
a
Head
of
household
Home
Telephone
Interview
7000
0.25
hr.
1
1750
hr
$
25,638
a
Totals
5,250
hr
$
76,912
a
$
14.65/
hour
(
average
hourly
wage
for
women)

ANNUAL
REPORTING
BURDEN:
5,250
hours
ANNUAL
RESPONDENT
COST:
$
76,912
NO
ANNUAL
RECORD
KEEPING
BURDEN
6(
b)
ESTIMATING
RESPONDENT
COSTS
Beach
Interview
Part
A:
The
wage
estimate
for
the
parental
respondent
is
based
on
the
average
salary
for
women
who
work
full
time
reported
by
the
US
Bureau
of
Labor
and
Statistics
Employment
Cost
Trends
(
January
2005)
at
$
14.65
per
hour.
Given
the
0.25
hour
burden,
the
respondent
cost
for
each
family
is
$
3.66.
Beach
Interview
Part
B:
The
wage
estimate
for
the
parental
respondent
is
based
on
average
salary
for
women
who
work
full
time
reported
by
the
US
bureau
of
Labor
and
Statistics
employment
Cost
Trends
(
January
2005)
at
$
14.65
per
hour.
Given
the
0.25
hour
burden,
the
respondent
cost
for
each
family
is
$
3.66.
Home
Telephone
Interview:
The
wage
estimate
for
the
parental
respondent
is
based
on
average
salary
for
women
who
work
full
time
reported
by
the
US
bureau
of
Labor
and
Statistics
employment
Cost
Trends
(
January
2005)
at
$
14.65
per
hour.
Given
the
0.25
hour
burden,
the
respondent
cost
for
each
family
is
$
3.66.
Page
10
NO
CAPITAL
COSTS
ARE
INVOLVED.

NO
O&
M
COSTS
ARE
INVOLVED.

6(
c)
ESTIMATING
AGENCY
BURDEN
AND
COST
TABLE
2.
AGENCY
COST
ANNUAL
BURDEN
Burden
Hours
Cost
($)

AGENCY
ACTIVITIES
Contractor
EPA
Total
Hours
Contractor
$
79/
hr
EPA
$
39.00/
hr*

Prepare
and
format
questionnaires
600.00
80.00
680
$
47,400
$
3,120
Prepare
computers
2400.00
8.00
2408
$
189,600
$
312
Plan
logistics
&
coordination
2000.00
120.00
2120
$
158,000
$
4,680
Recruit
and
interview
on
beach
11000.00
0.00
11000
$
869,000
$
0
Telephone
interview
I
5000.00
0.00
5000
$
395,000
$
0
IRB
package
preparation
&
submission
80.00
10.00
90
$
6,320
$
390
Quality
Assurance
&
Quality
Control
800.00
10.00
810
$
63,200
$
390
Convert
database
2600.00
0.00
2600
$
205,400
$
0
Contractor
$
198/
hr
EPA
$
39.00/
hr
Collect/
analyze
water
quality
data
3400.00
8.00
3408
$
673,200
$
312
28116
$
2,607,120
$
9,204
*
Average
hourly
pay
for
Human
Studies
Division
Health
Scientist
(
Information
provided
by
Barbara
Howard
of
OARM­
RTP
AGENCY
TOTAL
ANNUAL
BURDEN:
28,116
hours
AGENCY
TOTAL
ANNUAL
COST:
$
2,607,120
+$
9,204
=$
2,616,324
These
agency
burden
estimates
were
based
on
our
prior
experience
in
developing
and
gathering
information
for
research
purposes.
The
agency
costs
have
been
based
on
a
GS­
13(
6)
for
the
primary
investigator
and
include
benefits.
The
contractor
costs
are
based
on
a
composite
cost
given
the
people
needed
to
conduct
this
study.
Estimated
annualized
hours
and
costs
could
be
over­
estimated
by
33%.

6(
d)
ESTIMATING
THE
RESPONDENT
UNIVERSE
AND
TOTAL
BURDEN
AND
COST
Based
on
current
studies
conducted
in
the
2003
and
we
estimated
that
the
maximum
respondent
universe
for
each
recreational
water
season
is
7000
households
for
beach
interview
Part
A,
7000
households
for
beach
interview
Part
B,
and
7000
for
telephone
follow­
up.
Thus
the
total
estimated
respondent
burden
for
this
study
is
5,250
hours
from
7000
families
and
$
76,912.
Page
11
Total
number
of
responses
for
this
document
reflect
a
change
in
how
the
responses
were
calculated
in
the
previous
supporting
statement.
The
calculation
in
this
supporting
statement
reflects
maximum
number
of
responses
possible
at
each
stage
of
the
interviewing
process
rather
than
the
original
estimation
of
attrition
in
participants.
Additionally,
the
original
response
time
(.
9
hours)
was
estimated
higher
than
the
actual
average
time
(.
75
hours)
experienced
during
the
current
interview
process.

Because
of
increased
pressure
to
expeditiously
complete
the
study,
the
study
team
may
complete
more
than
one
beach
per
year,
thus
increasing
the
number
of
participants
enrolled
in
the
study
annually.
The
tables
in
Sections
6(
a)
and
6(
c)
reflect
the
estimated
respondent
burden
and
agency
burden
and
cost
for
two
beaches,
whereas
the
original
supporting
statement
estimates
(
EPA
ICR
Number
2081.01)
these
items
for
only
one
beach.
This
change
substantially
increased
the
number
of
respondents
expected
annually.

Although
there
is
an
increase
of
2,500
annual
respondents,
there
is
only
an
increase
of
250
burden
hours
in
the
total
estimated
burden
currently
identified
in
the
OMB
Inventory
of
Approved
ICR
Burdens.
This
is
due
to
the
fact
that
the
original
ICR
(
EPA
ICR
Number
2081.01)
included
a
second
telephone
survey
which
has
been
eliminated
in
this
renewal
ICR
and
consequently
has
reduced
the
total
burden
hours
for
each
respondent.

6(
e)
BOTTOM
LINE
BURDEN
HOURS
AND
COSTS
/
BURDEN
TABLES
The
estimated
respondent
burden
for
this
study
is
5,250
hours
and
$
76,912.
The
estimated
agency
cost
for
conducting
this
study
is
28,116
hours
and
$
2,607,120.

6(
f)
BURDEN
STATEMENTS
Beach
Interview:
Parental
reporting
burden
for
this
collection
of
information
is
estimated
to
average
30
minutes
for
Parts
A
and
B
and
will
require
no
record
keeping.
This
includes
two
15
minute
(.
25
hours)
responses.
This
includes
the
time
for
reviewing
the
informational
brochure,
obtaining
verbal
consent,
and
answering
the
questions.

Telephone
Interview
Follow­
up:
The
respondent's
reporting
burden
for
this
collection
of
information
is
estimated
to
average
15
minutes
(.
25
hours)
per
family.
This
includes
time
for
reviewing
information
collected
on
the
beach
interview
and
answering
questions.

Burden
Statement:
The
annual
public
reporting
and
recordkeeping
burden
for
this
collection
of
information
is
estimated
to
average
.38
hours
per
response.
Burden
means
the
total
time,
effort,
or
financial
resources
expended
by
persons
to
generate,
maintain,
retain,
or
disclose
or
provide
information
to
or
for
a
Federal
agency.
This
includes
the
time
needed
to
review
instructions;
develop,
acquire,
install,
and
utilize
technology
and
systems
for
the
purposes
of
collecting,
validating,
and
verifying
information,
processing
and
maintaining
information,
and
disclosing
and
providing
information;
adjust
the
existing
ways
to
comply
with
Page
12
any
previously
applicable
instructions
and
requirements;
train
personnel
to
be
able
to
respond
to
a
collection
of
information;
search
data
sources;
complete
and
review
the
collection
of
information;
and
transmit
or
otherwise
disclose
the
information.
An
agency
may
not
conduct
or
sponsor,
and
a
person
is
not
required
to
respond
to,
a
collection
of
information
unless
it
displays
a
currently
valid
OMB
control
number.
The
OMB
control
numbers
for
EPA's
regulations
are
listed
in
40
CFR
part
9
and
48
CFR
chapter
15.

To
comment
on
the
Agency's
need
for
this
information,
the
accuracy
of
the
provided
burden
estimates,
and
any
suggested
methods
for
minimizing
respondent
burden,
including
the
use
of
automated
collection
techniques,
EPA
has
established
a
public
docket
for
this
ICR
under
Docket
ID
No.
ORD­
2004­
0023,
which
is
available
for
public
viewing
at
the
Office
of
Research
and
Development
(
ORD)
Docket
in
the
EPA
Docket
Center
(
EPA/
DC),
EPA
West,
Room
B102,
1301
Constitution
Ave.,
NW,
Washington,
DC.
The
EPA
Docket
Center
Public
Reading
Room
is
open
from
8:
30
a.
m.
to
4:
30
p.
m.,
Monday
through
Friday,
excluding
legal
holidays.

The
telephone
number
for
the
Reading
Room
is
(
202)
566­
1744,
and
the
telephone
number
for
the
Office
of
Research
and
Development
Docket
is
(
202)
566­
1752.
An
electronic
version
of
the
public
docket
is
available
through
EPA
Dockets
(
EDOCKET)
at
http://
www.
epa.
gov/
edocket.
Use
EDOCKET
to
submit
or
view
public
comments,
access
the
index
listing
of
the
contents
of
the
public
docket,
and
to
access
those
documents
in
the
public
docket
that
are
available
electronically.
Once
in
the
system,
select
"
search,"
then
key
in
the
docket
ID
number
identified
above.
Also,
you
can
send
comments
to
the
Office
of
Information
and
Regulatory
Affairs,
Office
of
Management
and
Budget,
725
17th
Street,
NW,
Washington,

DC
20503,
Attention:
Desk
Office
for
EPA.
Please
include
the
EPA
Docket
ID
No.
(
ORD­

2004­
0023)
and
OMB
control
number
(
2080­
0068)
in
any
correspondence.
Page
13
B.
STATISTICAL
APPROACH
1.
SURVEY
OBJECTIVES,
KEY
VARIABLES,
AND
OTHER
PRELIMINARIES
1(
a)
SURVEY
OBJECTIVES
The
objective
of
the
study
is
to
conduct
health
effects
studies
to
evaluate
exposure
to
microorganisms
in
recreational
waters
and
their
subsequent
health
effects.
The
beaches
will
be
chosen
to
consider
a
range
of
exposures
and
will
primarily
consider
fecal
contamination
from
point
sources
(
e.
g.,
sewage
treatment
plants).
Current
estimates
are
that
a
minimum
of
three
marine
beaches
will
be
evaluated
with
a
potential
for
six
marine
beaches.
Four
freshwater
beaches
have
been
previously
included
and
are
currently
being
evaluated.
We
do
not
expect
to
do
any
further
freshwater
beaches
as
we
have
reached
the
number
of
individuals
required
to
complete
analysis.
The
results
of
these
health
effects
studies
will
be
used
to
document
human
health
effects
associated
with
recreational
water
use
and
correlate
these
health
effects
with
ongoing
EPA
studies
to
identify
a
new
generation
of
indicators
for
detection
of
human
pathogens
in
recreational
water
and
appropriate,
effective,
and
expeditious
testing
methods
for
these
indicators
(
addressed
separately
under
Section
3(
a)
(
v)
(
2
&
3)
of
the
Beaches
Environmental
Assessment
and
Coastal
Health
Act
of
2000).
The
results
will
be
used
to
develop
mathematical
relationships
that
will
be
used
for
the
generation
of
new
national
water
quality
guidelines
and
appropriate
monitoring
guidelines.

1(
b)
KEY
VARIABLES
There
are
four
key
variables
considered
in
this
study;
health
status,
water
quality
measures,

environmental
exposures
and
potential
confounders.
Each
of
these
variables
were
considered
in
the
development
of
the
study
objectives.

Health
status
of
the
household
accounts
for
illness
prior,
during,
and
after
the
beach
visit
(
10­
12
days).
This
includes
both
acute
and
chronic
illness
for
household
members
present
or
absent
at
the
beach.
Acute
illness
may
include
diarrhea,
urinary
tract
infection,
vomiting,
sore
throat
earache,
eye
infection,
rash,
sunburn,
and
fever.
Chronic
illness
may
include
Crohn's
disease,
asthma,
non­
drug
allergies,
and
eczema.
These
conditions
may
indicate
illness
not
related
to
the
environmental
exposure.

Water
quality
measures
will
be
collected
in
the
same
beach
areas
on
the
same
days
as
the
health
data
collection.
These
are
new
tests
and
indicators
that
require
correlation
modeling
prior
to
use
as
a
water
quality
indicator.
These
are
rapid
measurement
tests
(
2
hours
or
less).

Environmental
exposures
include
activities
in
the
designated
beach
area.
These
include
digging
in
the
sand,
swimming
in
the
water,
snorkeling,
collecting
seashells,
or
length
of
time
in
the
water.
These
exposures
will
be
used
to
develop
mathematical
relationships
between
health
status
of
households
after
their
beach
visit
and
water
quality
measurements
taken
at
the
same
beach.

Potential
confounders
are
possible
other
symptom
determinants
that
are
not
related
to
the
Page
14
environmental
exposure
of
interest
(
coastal
recreational
water).
These
include
acute
and
chronic
conditions
as
mentioned
in
the
health
status.
Acute
illness
may
include
diarrhea,
urinary
tract
infection,

vomiting,
sore
throat
earache,
eye
infection,
rash,
sunburn,
and
fever.
Chronic
illness
may
include
Crohn's
disease,
asthma,
non­
drug
allergies,
and
eczema.
These
also
include
other
exposures
not
related
to
recreational
water
exposure
such
as
food
consumption,
other
water
exposures
outside
this
study
and
household
size,

1(
c)
STATISTICAL
APPROACH
The
health
status
of
the
study
population
will
be
evaluated
along
with
the
water
quality
in
the
local
beach
area
in
which
they
will
be
visiting.
Statistical
associations
between
health
effects
and
water
quality
parameters
will
be
calculated.
The
targeted
population
will
all
eligible
household
groups
within
an
identified
beach
area.
The
beach
area
is
defined
according
to
the
criteria
outlined
in
A.
1.(
b).
The
sampling
base
may
change
for
each
beach
depending
on
size.
The
households
will
be
identified
as
such
by
the
beach
interviewers.
A
single
respondent
that
is
an
adult
member
of
the
household
(
e.
g.,
mother)

will
be
asked
to
participate
in
the
study.

The
proposed
data
collection
is
designed
as
a
multilevel
analytic
study
(
also
called
semi­
ecological
or
semi­
individual)
using
both
ecological
level
information
on
environmental
exposures
and
individual
level
information
on
health
status
and
potential
confounders.
The
multilevel
design
has
particular
utility
whenever
a
common
environmental
exposure
is
shared
by
individuals
clustered
within
a
geographic
area.

The
questionnaire
obtains
individual
level
information
on
health
status
and
potential
confounders,
such
as
age,
sex,
race,
Hispanic
status,
housing
characteristics,
family
characteristics
and
behaviors,
and
other
variables.
Environmental
exposures
are
to
be
independently
measured
for
each
beach­
based
cluster.

1(
d)
FEASIBILITY
Obstacles:
Based
on
previous
experience
with
beach
studies,
the
major
problem
has
been
nonresponse
primarily
related
to
catching
families
just
prior
to
leaving
the
beach
area.
This
is
usually
improved
by
providing
a
minimal
incentive
to
participate
such
as
a
beach
ball,
cooler,
or
tote
bag.

Sufficient
funds:
This
study
has
been
budgeted
with
sufficient
funds
for
the
first
year
of
pilot
work.

Remaining
years
of
funding
have
been
requested
and
is
pending
the
budget
process.
In
the
event
a
dramatic
cut
in
the
beaches
research
program
were
to
take
place,
the
study
could
be
downsized
to
fewer
beaches.

Time
line:
The
beach
studies
will
be
completed
by
the
end
of
September
of
the
appropriate
recreational
season.
Processing
of
recreational
season
data
sets
will
be
completed
by
December
of
the
same
calendar
year.
The
marine
beaches
are
expected
to
be
completed
2005­
2009
with
a
potential
of
6
beaches.
Page
15
2.
SURVEY
DESIGN
2(
a)
Target
Population
and
Coverage
The
target
population
will
all
eligible
household
groups
within
an
identified
beach
area
exposed
to
various
levels
of
water
pollutants
from
point
sources
fresh
(
Great
Lakes)
and
marine
beaches
in
the
continental
United
States.
At
this
time,
no
further
freshwater
coastal
areas
are
planned
for
data
collection.

2(
b)
Sample
Design
(
i)
Sampling
frame.

The
sampling
frame
will
be
households
on
the
beach
currently
being
monitored.
The
beaches
that
will
be
monitored
must
have
historical
data
suggesting
the
appropriate
population
size
to
support
household
sampling.
It
is
estimated
80­
125
households
per
weekend
per
site
will
be
needed.

(
ii)
Sample
size.

The
sample
size
for
this
study
is
constrained
by
the
numbers
of
households
visiting
the
beach
under
consideration.
From
earlier
studies,
we
estimate
that
this
sample
size
will
provide
90%
power
to
detect,

with
95%
confidence,
the
expected
association
between
water
quality
indicators
and
associated
gastrointestinal
health
effects.

(
iii)
Stratification
variables.

The
primary
variables
used
for
stratification
will
be
demographic
variables.
Additional
stratification
may
be
assessed
by
beach,
by
level
of
water
exposure,
and
by
level
of
water
quality
indicator
if
the
data
is
robust
enough
for
such
analysis.
Our
experience
to
date
is
limited
with
the
new
water
quality
indicators.
Current
assumptions
are
that
they
will
be
at
a
minimum
as
good
as,
if
not
better,
than
current
EPA
or
state
indicators
(
e.
g.,
enterococci,
E.
coli,
and
fecal
coliforms).

(
iv)
Sampling
method.

A
complete
sample
of
all
eligible
families
for
each
day
and
beach
under
study
will
be
attempted.

(
v)
Multi­
stage
sampling.

Not
applicable.

2(
c)
PRECISION
REQUIREMENTS
(
i)
Precision
targets.

The
survey
is
designed
to
show,
with
80%
confidence,
the
statistical
relationship
associated
specifically
with
a
water
quality
indicator.

(
ix)
Non­
sampling
error.

Most
health
and
epidemiology
studies
are
concerned
with
errors
resulting
from
misclassification
of
both
disease
and
exposure.
Exposure
misclassification
will
be
minimized
by
collecting
water
quality
measurements
on
new
indicators.
The
precision
or
predictability
of
the
new
indicators
is
estimated
to
Page
16
be
at
least
as
good
as
the
previous
indicators.
There
is
some
concern
over
misclassification
of
gastrointestinal
symptoms
and
illness
since
we
are
relying
on
self­
reporting.
The
standard
practice
to
account
for
this
potential
error
has
been
to
weigh,
or
place
the
reporting
of
symptoms,
in
categories
of
credibility.
Groups
of
symptoms
reported
together
are
more
credible,
and
symptoms
that
require
a
person
to
alter
their
normal
routine
(
stay
home,
stay
in
bed
or
seek
medical
care)
are
the
most
credible.

Although
some
parents
may
fail
to
fully
report
gastrointestinal
symptoms
and
illness
among
their
children,
the
propensity
to
report
should
not
be
associated
with
the
exposures
of
interest.
Parental
underreporting
of
gastrointestinal
conditions
that
are
not
associated
with
the
exposures
of
interest
(

nondifferential
misclassification)
will
reduce
the
statistical
power
of
the
study,
and
bias
the
observed
association
of
interest
towards
the
null
(
no
difference)
and
therefore
increase
the
variance
in
the
modeled
relationship
between
illness
and
water
quality
indicator.

Confounding
of
the
association
of
interest
is
always
an
important
issue
in
observational
studies.

Any
determinant
of
the
health
outcome
of
interest
that
is
non­
causally
associated
with
the
exposure
of
interest
may
confound
the
association
under
study.
Since
the
children
in
this
study
have
not
been
randomly
assigned
to
differing
recreational
water
exposures,
differences
in
the
distribution
of
various
independent
determinants
of
gastrointestinal
disease,
across
the
study
area,
may
be
potential
confounders.

As
detailed
below,
a
substantial
portion
of
the
questionnaire
is
devoted
to
the
determination
of
information
on
potential
confounders.

2(
d)
QUESTIONNAIRE
DESIGN
The
two
data
collection
instruments
in
this
study
each
serve
a
unique
purpose.
The
first
is
the
beach
interview
which
establishes
eligibility
to
participate
in
the
study,
recreational
habits
at
the
beach,

background
demographic
information
and
current
or
historical
health
status.
The
telephone
interview
is
to
verify
key
pieces
of
information
in
the
beach
interview,
obtain
symptom
and
illness
information
and
determine
other
exposures
that
may
confound
the
association
(
e.
g.,
other
recreational
exposures).

Questions
contained
in
the
beach
interview
and
the
telephone
follow­
up
survey
are
included
in
Appendix
C
and
D
respectively.
The
interview
forms
may
be
modified
based
on
use
in
previous
survey
seasons.

The
questionnaires
are
comprised
of
five
main
components;
personal
identifying/
demographic
information,
health
status,
environmental
exposure,
other
potential
confounders
and
health
burden.
The
questionnaire
was
designed
to
reduce
respondent
time
in
the
beach
area.

The
personal
identifying/
demographic
information
in
the
beach
interview
(
name,
address,
phone
number,
prescheduled
telephone
interview)
are
required
to
ensure
efficient
follow­
up.
Verbal
consent
is
documented
through
the
electronic
collection
of
these
data.
This
information
will
be
recorded
electronically
and
allows
preservation
of
confidentiality
through
limited
access
data
files.
The
personal
identifying
information
will
be
physically
separated
and
not
become
part
of
the
statistical
database.
Page
17
Because
they
are
not
part
of
the
statistical
database,
they
are
not
assigned
questionnaire
enumeration.

For
each
member
of
the
family
it
is
important
to
determine
the
members
of
the
family,
their
age,
sex
,
ethnic
status,
race
and
recreational
and
beach
activities.
These
variables
are
all
potential
confounders
of
the
association
of
interest.
The
information
on
the
beach
visit
date
and
the
participant
birth
dates
will
allow
us
to
check
the
direct
parental
report
of
all
family
member
ages.
Previous
work
has
suggested
little
association
between
gastrointestinal
illness
and
race
or
ethnicity,
however
these
studies
will
be
collecting
information
on
non­
gastrointestinal
illness
(
e.
g.,
urinary
tract,
skin,
respiratory,
eye
and
ear)
associated
with
recreational
water
exposures
and
there
has
been
some
reporting
of
racial
differences
associated
with
those
illnesses.

The
health
status
of
each
household
member
is
important
in
the
quality
of
the
data.
Existing
illness
before
and
during
the
beach
visit
is
a
potential
confounder
for
illness
that
may
be
associated
with
swimming
exposures.
Both
acute
and
chronic
illness
are
identified
in
this
survey.
They
include
diarrhea,
urinary
tract
infection,
vomiting,
sore
throat,
earache,
eye
infection,
rash,
sunburn,
Crohn's
disease,
asthma,
non­
drug
allergies,
and
psoriasis.

The
health
status
of
each
of
the
household
members
is
also
collected
during
the
telephone
survey.

These
data
enable
US
EPA
scientists
to
ascertain
credible
illnesses
and
symptoms
that
become
apparent
after
participants
have
visited
the
beach
area.

Environmental
exposure
at
the
beach
study
area
is
the
main
focus
of
this
study.
The
study
participant
is
asked
about
the
family's
activities
at
the
beach
and
specific
details
about
the
extent
of
water
contact
and
the
amount
of
time
allotted
to
swimming
activities.
Other
factors
such
as
sand
and
sun
exposure
are
included.

Information
for
other
potential
confounders
such
as
consumption
of
food,
collection
of
seashells
and
animal
contact
are
also
collected.

Health
Burden
found
in
telephone.
The
telephone
follow­
up
requests
information
about
several
common
gastrointestinal,
urinary
tract,
respiratory,
eye,
ear
and
skin
conditions
(
diarrhea,
vomiting,

respiratory
problems,
runny
nose,
ear
infections
and
skin
infections).
Data
such
physician
visits,
missed
employment,
and
reduction
in
daily
activities
as
are
collected
to
represent
health
burden
effects
associated
with
swimming­
associated
illness.

Style
of
questions
Most
questions
have
initial
forced
choice
between
multiple
responses
or
two
choices
(
Yes,
No).
The
secondary
level
of
response
for
most
questions
includes
choices
for
"
Don't
Know"
and
"
Refuse."
Most
questions
The
number
of
free
form
questions
are
limited
to
facilitate
the
CATI
process.
Page
18
Purpose
of
questions
The
outcomes
of
interest
are
determined
by
questions
on
common
gastrointestinal,
urinary
tract,

respiratory,
eye,
ear
and
skin
conditions.

Potential
confounders
include
age,
sex,
ethnic
status
and
race
;
severe
preexisting
health
conditions
of
participants.
We
also
examine,
as
potential
confounders,
other
recreational
exposures,
eating
out,

contact
with
animals,
children
in
diapers
and
other
ill
individuals.

3.
PRETESTS
AND
PILOT
TESTS
The
beach
interview
is
based
on
previous
questionnaires
used
in
the
studies
conducted
by
EPA
in
the
1970s
and
1980s.
In
addition,
the
questions
have
been
compared
to
and
when
possible
modifications
made
to
be
compatible
with
the
Centers
for
Disease
Control
and
Prevention,
National
Center
for
Infectious
Diseases
FoodNet
survey.
In
addition,
similar
questions
have
been
used
in
drinking
water
studies
(
ref
Payment
1,
Payment
2,
Calderon,
Colford).
Respiratory
symptoms
have
been
adapted
from
the
Epidemiology
Standardization
Project
of
the
American
Thoracic
Society
and
the
Division
of
Lung
Diseases.
The
questionnaire
was
evaluated
after
the
beach
trials
in
2002.
Modifications
of
questionnaire
wording
were
made
based
on
that
experience.
It
is
anticipated
that
questionnaire
modifications
after
this
date
will
not
vary
from
the
current
format.

4.
COLLECTION
METHODS
AND
FOLLOW­
UP
4(
a)
COLLECTION
METHODS
An
informational
meeting
will
be
held
at
each
beach
site
to
explain
the
study.
It
will
include
EPA
regional
scientist(
s),
identified
state
officials,
the
local
public
health
officer
(
if
the
beach
is
not
federal
or
state
managed),
and
other
interested
persons.
After
the
meeting,
a
letter
of
endorsement
will
be
requested
from
the
party
charged
with
managing
the
recreational
site.
In
the
stakeholder
meetings
held
by
EPA,
many
potential
beaches
have
expressed
an
interest
in
having
their
beaches
chosen
for
study.

Beach
interviews
will
be
done
on
Saturday
and
Sunday
(
Friday
and
Monday
considered
on
holiday
weekends)
during
the
recreational
season
(
April
to
mid
September
depending
on
the
geographic
location).

Trained
interviewers
will
be
deployed
on
the
beach
and
will
visually
identify
households
eligible
to
participate.
Interviews
will
begin
late
morning
to
late
afternoon
to
try
and
catch
households
just
prior
to
their
leaving
the
beach
for
the
day.
Partial
recruitment
(
enrollment)
occurs
on
the
beach
and
exposure
data
collection
is
completed
when
the
household
stops
by
an
interview
center
near
the
parking
area
as
they
are
leaving
the
beach.

Ten
to
fourteen
days
from
leaving
the
beach,
households
will
be
recontacted
by
telephone
at
the
Page
19
most
convenient
times
for
the
household.
Health
status
and
confirmation
of
recreational
and
other
potential
exposures
will
be
obtained
over
the
phone.

4(
b)
SURVEY
RESPONSE
AND
FOLLOW­
UP
Response
rates
to
the
beach
interview
have
historically
ranged
from
60
to
80%
among
those
families
eligible.
The
follow­
up
response
rate
is
estimated
to
average
90%
for
the
whole
study.
Similar
studies
in
the
United
Kingdom,
Hong
Kong
and
Canada
have
had
similar
response
rates
using
a
similar
study
design
and
methodology.

5.
ANALYZING
AND
REPORTING
SURVEY
RESULTS
5(
a)
DATA
PREPARATION
The
completed
interviews
will
verify
that
data
submitted
is
internally
consistent,
as
entered.
The
CATI
program
will
flag
missing
items
prior
to
terminating
the
interview
and
will
also
flag
erroneous
responses
as
well
to
allow
the
interviewer
to
obtain
the
correct
information
while
interviewing
the
family.

The
CATI
system
will
also
eliminate
errors
associated
with
data
entry.

5(
b)
ANALYSIS
The
analysis
of
a
multilevel
study
is
conducted
in
two
stages.
In
the
first
stage,
the
adjusted
prevalence
of
the
health
outcome
of
interest
is
estimated
for
swimmers
and
non­
swimmers.
The
symptom
rate
as
a
difference
between
the
two
groups
is
calculated.
This
rate
difference
value
is
used
to
develop
a
statistical
relationship
with
water
quality
indicators.
In
the
second
stage
of
the
analysis,
the
uncertainty
of
the
beach­
specific
estimates
of
illness
rates
for
swimmers
and
for
the
rate
difference
between
swimmers
and
non­
swimmers
will
be
evaluated
by
considering
linear
and
nonlinear
statistical
models
that
will
consider
adjustment
for
potential
confounders
such
as
age,
beach,
gender
and
race.

Analyses
will
be
conducted
by
comparing
gastrointestinal
symptoms
and
illness
to
water
quality
parameters.
Regression
analysis
will
be
conducted
in
a
similar
manner
as
in
previous
studies
and
will
use
a
two­
step
analysis
to
correct
for
beach
variability.
In
the
first
step,
swimming
associated
illnessspecific
adjusted
logits
of
symptom
prevalence
will
be
calculated
from
a
logistic
regression
model
for
the
gastrointestinal
symptoms
of
interest
controlling
for
age,
sex,
other
potential
confounders
(
other
recreational
exposures)
and
family
size.
In
the
second
step,
these
beach­
specific
adjusted
logits
will
be
regressed
against
the
beach­
specific
water
pollutant
concentrations.

Water
quality
indicator
concentrations
for
each
methodology
would
be
entered
as
continuous
variables
into
the
model.
Water
pollution
concentrations
would
be
based
on
actual
measurements
at
each
beach.
Direct
measurements
of
water
quality
pollution
concentrations
at
all
beaches
will
be
conducted.
Page
20
It
is
expected
the
monitoring
scheme
may
allow
the
development
of
models
to
consider
upper
and
lower
bound
parameters
for
inclusion
in
the
model.

In
our
subsequent
publications,
we
will
explicitly
report
the
results
for
associations
between
health
characteristics
and
(
a)
the
directly
measured
concentrations
for
all
beaches
and
(
b)
the
modeled
concentrations
as
a
summary
for
all
marine
beaches
together
and
all
fresh
water
beaches
together.
This
will
allow
an
assessment
of
the
role
of
the
modeling
of
water
quality
indicator
concentrations
on
our
results.

5(
c)
REPORTING
RESULTS
A
report
on
each
of
the
beaches
water
quality
monitoring
data
will
be
developed
and
available
to
the
managers
of
the
beach,
as
well
as
appropriate
state
authorities
if
the
beach
is
not
a
state
managed
beach.
At
the
completion
of
the
entire
program,
an
overall
report
will
be
produced
that
synthesizes
all
the
information.
An
EPA
report
will
be
produced
for
Agency
and
public
use.
A
manuscript
for
each
recreational
season
will
be
submitted
for
publication
in
a
peer­
reviewed
scientific
journal.
Page
21
APPENDIX
A:
Clean
Water
Act
Beaches
Environmental
Assessment
and
Coastal
Health
Act
of
2000
(
Public
Law
106­
284
 
October
10,
2000)

TITLE
42
­
PUBLIC
HEALTH
CHAPTER
85
­
FEDERAL
WATER
POLLUTION
CONTROL
ACT
Section
303.
Revisions
to
water
quality
criteria
(
a)
STUDIES
CONCERNING
PATHOGEN
INDICATORS
IN
COASTAL
RECREATION
WATERS.
­
Section
104
of
the
Federal
Water
Pollution
Control
Act
(
33
U.
S.
C.
1254)
is
amended
by
adding
at
the
end
the
following:

(
v)
STUDIES
CONCERNING
PATHOGEN
INDICATORS
IN
COASTAL
RECREATION
WATERS.
 
Not
later
than
18
months
after
the
date
of
the
enactment
of
this
subsection,
after
consultation
and
in
cooperation
with
appropriate
Federal,
State,
tribal,
and
local
officials
(
including
local
health
officials),
the
Administrator
shall
initiate,
an,
not
later
than
3
years
after
the
date
of
the
enactment
of
this
subsection,
shall
complete,
in
cooperation
with
the
heads
of
other
Federal
agencies,
studies
to
provide
additional
information
for
use
in
developing:

(
1)
an
assessment
of
potential
human
health
risks
resulting
from
exposure
to
pathogens
in
coastal
recreation
waters,
including
nongastrointestinal
effects;

(
2)
appropriate
and
effective
indicators
for
improving
detection
in
a
timely
manner
in
coastal
recreation
waters
of
the
presence
of
pathogens
that
are
harmful
to
human
health;

(
3)
appropriate,
accurate,
expeditious,
and
cost­
effective
methods
(
including
predictive
models)

for
detecting
in
a
timely
manner
in
coastal
recreation
waters
the
presence
of
pathogens
that
are
harmful
to
human
health;
and
(
4)
guidance
for
State
application
of
criteria
for
pathogens
and
pathogen
indicators
to
be
published
under
Section
304(
a)(
9)
to
account
for
the
diversity
of
geographic
and
aquatic
conditions.
Page
22
APPENDIX
B:
Federal
Register
1
[
Federal
Register:
February
14,
2005
(
Volume
70,
Number
29)]
[
Notices]
[
Page
7496­
7498]
From
the
Federal
Register
Online
via
GPO
Access
[
wais.
access.
gpo.
gov]
[
DOCID:
fr14fe05­
52]

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­

ENVIRONMENTAL
PROTECTION
AGENCY
[
ORD­
2004­
0023,
FRL­
7872­
5]

Agency
Information
Collection
Activities:
Proposed
Collection;
Comment
Request;
Health
Effects
of
Microbial
Pathogens
in
Recreational
Waters;
National
Epidemiological
and
Environmental
Assessment
of
Recreational
(
NEEAR)
Water
Study,
EPA
ICR
Number
2081.02,
OMB
Control
Number
2080.0086
AGENCY:
Environmental
Protection
Agency.

ACTION:
Notice.

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­

SUMMARY:
In
compliance
with
the
Paperwork
Reduction
Act
(
44
U.
S.
C.
3501
et
seq.),
this
document
announces
that
EPA
is
planning
to
submit
a
continuing
Information
Collection
Request
(
ICR)
to
the
Office
of
Management
and
Budget
(
OMB).
This
is
a
request
to
renew
an
existing
approved
collection.
This
ICR
is
scheduled
to
expire
on
August
31,
2005.
Before
submitting
the
ICR
to
OMB
for
review
and
approval,
EPA
is
soliciting
comments
on
specific
aspects
of
the
proposed
information
collection
as
described
below.

DATES:
Comments
must
be
submitted
on
or
before
April
15,
2005.

ADDRESSES:
Submit
your
comments,
referencing
docket
ID
number
ORD­
2004­
0023,
to
EPA
online
using
EDOCKET
(
our
preferred
method),
by
e­
mail
to
oei.
docket@
epa.
gov,
or
by
mail
to:
EPA
Docket
Center,
Environmental
Protection
Agency,
Office
of
Environmental
Information
Docket,
Mail
Code
2822T,
1200
Pennsylvania
Ave.,
NW.,
Washington,
DC
20460.

FOR
FURTHER
INFORMATION
CONTACT:
Susan
Auby,
Environmental
Protection
Agency,
Office
of
Information
Collection,
Office
of
Environmental
Information,
Environmental
Protection
Agency,
1200
Pennsylvania
Ave.,
NW.,
Washington,
DC
20460;
telephone
number:
(
202)
566­
1672;
fax
number:
(
202)
566­
1753;
e­
mail
address:
auby.
susan@
epa.
gov.

SUPPLEMENTARY
INFORMATION:
EPA
has
established
a
public
docket
for
this
ICR
under
Docket
ID
number
ORD­
2004­
0023,
which
is
available
for
public
Page
23
viewing
at
the
Office
of
Research
and
Development
Docket
in
the
EPA
Docket
Center
(
EPA/
DC),
EPA
West,
Room
B102,
1301
Constitution
Ave.,
NW.,
Washington,
DC.
The
EPA
Docket
Center
Public
Reading
Room
is
open
from
8:
30
a.
m.
to
4:
30
p.
m.,
Monday
through
Friday,
excluding
legal
holidays.
The
telephone
number
for
the
[[
Page
7497]]

Reading
Room
is
(
202)
566­
1744,
and
the
telephone
number
for
the
Docket
is
(
202)
566­
1752.
An
electronic
version
of
the
public
docket
is
available
through
EPA
Dockets
(
DOCKET)
at
http://
www.
epa.
gov/
dOCKET.

Use
DOCKET
to
obtain
a
copy
of
the
draft
collection
of
information,
submit
or
view
public
comments,
access
the
index
listing
of
the
contents
of
the
public
docket,
and
to
access
those
documents
in
the
public
docket
that
are
available
electronically.
Once
in
the
system,
select
  
search,''
then
key
in
the
docket
ID
number
identified
above.
Any
comments
related
to
this
ICR
should
be
submitted
to
EPA
within
60
days
of
this
notice.
EPA's
policy
is
that
public
comments,
whether
submitted
electronically
or
in
paper,
will
be
made
available
for
public
viewing
in
DOCKET
as
EPA
receives
them
and
without
change,
unless
the
comment
contains
copyrighted
material,
CBI,
or
other
information
whose
public
disclosure
is
restricted
by
statute.
When
EPA
identifies
a
comment
containing
copyrighted
material,
EPA
will
provide
a
reference
to
that
material
in
the
version
of
the
comment
that
is
placed
in
DOCKET.
The
entire
printed
comment,
including
the
copyrighted
material,
will
be
available
in
the
public
docket.
Although
identified
as
an
item
in
the
official
docket,
information
claimed
as
CBI,
or
whose
disclosure
is
otherwise
restricted
by
statute,
is
not
included
in
the
official
public
docket,
and
will
not
be
available
for
public
viewing
in
DOCKET.
For
further
information
about
the
electronic
docket,
see
EPA's
Federal
Register
notice
describing
the
electronic
docket
at
67
FR
38102
(
May
31,
2002),
or
go
to
http://
www.
epa.
gov./
dOCKET.

Affected
entities:
Entities
potentially
affected
by
this
action
are
families
frequenting
fresh
and
marine
water
beaches
in
the
continental
United
States.
Title:
Health
Effects
of
Microbial
Pathogens
in
Recreational
Waters.
Abstract:
The
purpose
of
this
study
is
to
examine
the
health
effects
of
families
in
recreational
water
beach
areas.
This
study
will
be
conducted,
and
the
information
collected,
by
the
Epidemiology
and
Biomarkers
Branch,
Human
Studies
Division,
National
Health
and
Environmental
Effects
Research
Laboratory,
Office
of
Research
and
Development,
U.
S.
Environmental
Protection
Agency
(
EPA).
Participation
of
adults
and
children
in
this
collection
of
information
is
strictly
voluntary.
This
information
is
being
collected
as
part
of
a
research
program
consistent
with
the
Section
3(
a)(
v)(
1)
of
the
Beaches
Environmental
Assessment
and
Coastal
Health
Act
of
2000
and
the
strategic
plan
for
EPA's
Office
of
Research
and
Development
(
ORD)
and
the
Office
of
Water
entitled
  
Action
Plan
for
Beaches
and
Recreational
Water.''
The
Beaches
Act
and
ORD's
strategic
plan
has
identified
research
on
effects
of
microbial
pathogens
in
recreational
waters
as
a
high­
priority
research
area
with
particular
emphasis
on
developing
new
water
quality
indicator
guidelines
for
recreational
waters.
The
EPA
has
broad
legislative
authority
to
establish
water
quality
criteria
and
to
conduct
research
to
support
these
criteria.
This
data
collection
is
for
a
series
of
epidemiological
studies
to
evaluate
exposure
to
and
effects
of
microbial
pathogens
in
marine
and
fresh
recreational
waters
as
part
of
the
EPA's
research
program
on
exposure
and
health
effects
of
microbial
pathogens
in
recreational
waters.
Health
effects
data
collection
was
previously
conducted
in
a
pilot
study
and
four
freshwater
coastal
sites
under
OMB
number
2080.0068
(
expires
August
31,
Page
24
2005),
ICR
number
2081.01.
The
results
will
be
used
to
develop
mathematical
relationships
that
will
be
used
for
the
generation
of
new
national
water
quality
and
monitoring
guidelines.
The
questionnaire
health
data
will
be
compared
with
routinely
collected
water
quality
measurements.
The
analysis
will
focus
on
determining
whether
any
water
quality
parameters
are
associated
with
increased
prevalence
of
swimming­
related
health
effects.
An
agency
may
not
conduct
or
sponsor,
and
a
person
is
not
required
to
respond
to,
a
collection
of
information
unless
it
displays
a
currently
valid
OMB
control
number.
The
OMB
control
numbers
for
EPA's
regulations
in
40
CFR
are
listed
in
40
CFR
part
9.
The
EPA
would
like
to
solicit
comments
to:
(
i)
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;
(
ii)
Evaluate
the
accuracy
of
the
Agency's
estimate
of
the
burden
of
the
proposed
collection
of
information,
including
the
validity
of
the
methodology
and
assumptions
used;
(
iii)
Enhance
the
quality,
utility,
and
clarity
of
the
information
to
be
collected;
and
(
iv)
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.
Burden
Statement:
Burden
means
the
total
time,
effort,
or
financial
resources
expended
by
persons
to
generate,
maintain,
retain,
or
disclose
or
provide
information
to
or
for
a
Federal
agency.
This
includes
the
time
needed
to
review
instructions;
develop,
acquire,
install,
and
utilize
technology
and
systems
for
the
purposes
of
collecting,
validating,
and
verifying
information,
processing
and
maintaining
information,
and
disclosing
and
providing
information;
adjust
the
existing
ways
to
comply
with
any
previously
applicable
instructions
and
requirements;
train
personnel
to
be
able
to
respond
to
a
collection
of
information;
search
data
sources;
complete
and
review
the
collection
of
information;
and
transmit
or
otherwise
disclose
the
information.
The
annual
public
reporting
and
recordkeeping
burden
for
this
collection
of
information
is
estimated
to
average
about
fifteen
minutes
per
response.
If
a
participant
completes
all
portions
of
the
data
collection,
a
total
45
minutes.
Beach
Interviews
&
Telephone
Followups
Based
on
consultation
with
the
individuals
listed
in
Section
3(
c)
of
the
ICR,
and
our
experience
with
similar
types
of
information
collection,
we
estimate
that
each
family
will
spend
an
average
of
30
minutes
completing
the
beach
interview
and
will
require
no
recordkeeping.
This
includes
the
time
for
reviewing
the
information
pamphlet
and
answering
the
questions.
We
estimate
that
each
family
spends
an
average
of
15
minutes
completing
the
home
telephone
interview.
The
telephone
interviews
will
require
no
recordkeeping.
All
human
health
data
collection
will
be
recorded
utilizing
computer­
assisted
personal
interviews
(
CAPI).
The
telephone
interview
incorporates
the
same
concept
of
direct
data
collection
in
a
desk
personal
computer
(
PC)
setting.
The
tablet
notebooks
and
desk
PCs
are
used
by
interviewers
to
collect
human
health
data.
Screens
on
these
tablets
and
PCs
only
display
current
activated
questions.
All
human
health
data
is
stored
in
secured
locations
to
maintain
confidentiality.

[[
Page
7498]]

­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­
­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­
Page
25
Estimated
Respondent
activities
number
of
Burden
Frequency
Total
burden
Total
burden
respondents
hours
hours
cost
­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­
­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­
Beach
Interview
and
Phone
Interview.....
7,000
0.25
1
1,750
a
25,760
Beach
Interview
(
Part
A)................
7,000
0.25
1
1,750
a
25,760
Phone
Interview.........................
7,000
0.25
1
1,750
a
25,760
­­­­­­­­­­­­­­­­­
Total...............................
21,000
0.75
3
5,250
a
77,280
­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­
­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­­
a
$
14.72/
hour.

There
is
no
direct
respondent
costs
for
this
data
collection.
Estimated
Total
Annualized
Capital,
O&
M
Cost
Burden:
$
0.

Dated:
January
27,
2005.
Harold
Zenick,
Associate
Director
of
Health.
[
FR
Doc.
05­
2793
2­
11­
05;
8:
45
am]
BILLING
CODE
6560­
50­
P
26
APPENDIX
C:
Beach
Interview
BEACH
INTERVIEW
OMB
Control
No.:
2080­
0068
Expiration
Date:
xx/
xx/
xxxx
Site
ID
______

Friday
_______
Saturday
_______
Sunday______
Monday
_________
Date:__­__­____
Time:
_________

1.
Have
you
been
interviewed
by
the
National
Beaches
Survey
in
the
last
28
days?

2.
Would
you
be
willing
to
participate
in
a
study
on
illnesses
associated
with
recreation
at
the
beach?

Yes
(
give
brochure
with
consent
form,
inform
about
2
follow­
up
calls)
No
(
Terminate
Interview)

2a.
Our
survey
is
primarily
for
households
of
one
or
more
persons
that
live
together
at
the
same
address;
Do
you
all
live
at
the
same
address?

3.
How
many
members
in
your
party
are
at
the
beach
today
including
yourself?

4.
What
time
did
you
and
your
household
arrive
at
the
beach
today?

5.
We
are
interested
in
asking
about
the
health
of
your
household
during
the
few
weeks
following
your
beach
visit.
Could
you
please
give
me
your
telephone
number
so
we
can
get
in
touch
with
you
in
10­
12
days
from
now?

5a.
If
"
NO"
Is
it
fro
one
of
the
following
reasons?
Too
busy,
no
longer
interested,
will
not
be
available,
specify
other
reason?

5b.
10­
12
days
from
now
which
phone
number(
s)
should
we
call?

5c.
Is
this
your
home,
vacation,
or
cell
phone
number?

6.
What
are
the
best
times
to
reach
you
during
week
days?

6a.
Can
I
please
have
your
mailing
address
so
that
we
can
send
you
your
$
25
Thank
you
check?
We
will
destroy
your
identifying
information
after
we
mail
the
check.

7.
Please
tell
me
the
first
name
of
the
members
of
your
household
at
the
beach
today,
their
birth
dates,
gender
race
ethnicity,
and
whether
they
are
in
diapers.

8.
Will
(
you/
all
these
people
with
you
at
the
beach
today)
be
living
(
with
you)
at
the
same
address
(
es)
during
the
next
two
weeks?

9.
Have
any
of
these
household
members
at
the
beach
today
been
ill
in
the
past
3
days
with
Diarrhea
or
loose
bowels
27
Urinary
tract
infection
or
burning
sensation
Throwing­
up
or
vomiting
Sore
throat
or
cough
Earache,
ear
infection
or
runny
ears
Eye
infection
Rash
or
itchy
skin
Sunburn
Ask
for
all
persons
in
household.

10.
Are
there
any
household
members
NOT
present
at
the
beach
today?

11.
Have
any
household
members
NOT
present
at
the
beach
today
been
ill
in
the
past
3
days
with
Diarrhea
or
loose
bowels
Urinary
tract
infection
or
burning
sensation
Throwing­
up
or
vomiting
Sore
throat
or
cough
Earache,
ear
infection
or
runny
ears
Eye
infection
Rash
or
itchy
skin
Sunburn
12.
How
many
times
do
you
usually
come
to
this
beach
each
summer
(
Memorial
Day
to
Labor
Day)

13.
How
may
miles
did
you
travel
to
the
beach
today?

14.
During
the
past
two
weeks,
did
you
(
anyone
in
your
household
at
the
beach
today)
go
bathing
or
swimming
anywhere
­
at
this
or
some
other
beach,
pool
or
lake?

14a.
Did
you
go
bathing
or
swimming
anywhere
in
the
past
one
week
(
Monday
through
Friday)
at
this
or
some
other
beach,
pool
or
lake?

14b.
Did
you
actually
get
your
head
or
face
wet?

14c.
During
the
past
2
weeks,
did
you
get
a
sunburn
that
lasted
more
that
12
hours?

Please
go
to
the
exit
station
when
you
leave
the
beach
today,
before
5:
30
PM,
to
complete
Part
B
of
the
Beach
Interview
and
pick­
up
your
beach
gift.
Thank
you
for
participating
n
this
portion
of
the
study.

PART
B
B
Exit
Beach
Interview
15.
Were
you
the
person
that
we
interview
on
the
beach
or
earlier
today?

16.
Did
you
or
anyone
in
your
household
wade,
swim,
or
play
in
the
water
today?

16a1.
Did
you
immerse
your
body,
not
necessarily
you
head,
in
the
water
today?
Ask
for
all
persons
in
household.
28
16a2.
Did
you
put
your
face
in
the
water
or
submerge
head
in
the
water
today?
Ask
for
all
persons
in
household.

16a3.
Did
you
get
water
in
the
mouth
today?
Ask
for
all
persons
in
household.

16b.
Did
you
swallow
the
water?
Ask
for
all
persons
in
household.

16c.
Were
you
in
the
water
at
the
following
times
today?
If
"
YES"
what
part
of
the
beach
did
you
swim
in?
Ask
for
all
persons
in
household.

16d.
What
total
time
did
you
stay
in
the
water?
We
are
only
interested
in
time
actually
in
the
water,
not
the
total
time
at
the
beach?
Ask
for
all
persons
in
household.

16e.
Did
you
engage
in
any
of
the
following
water­
related
activities
while
at
the
beach
today?
Ask
for
all
persons
in
household.

Body
surfing,
rafting/
tubing/
floating
on
an
air
mattress?
Swimming,
swimming
laps,
snorkeling?
Surfing,
windsurfing?
Non­
circulating
pool
or
tidal
pool?

17b.
What
would
you
estimate
your
total
time
in
direct
sunlight
was?
This
does
not
include
being
indoors
or
under
umbrellas,
etc.?
Ask
for
all
persons
in
household.

18.
Did
you
engage
in
any
of
the
following
activities
while
at
the
beach
today?
Ask
for
all
persons
in
household.
Collecting
sea
shells,
rocks,
feathers,
etc?
Digging
in
sand
or
building
sand
castles?
Had
their
body
buried
in
the
sand?
Playing
with
algae
or
seaweed?

19.
Did
yo
cut
yourself
today
or
have
an
open
cut
when
you
came
to
beach
today?
Ask
for
all
persons
in
household.

20.
Did
you
wear
sunscreen/
sunblock
today?
Ask
for
all
persons
in
household.

21.
What
was
the
SPF
rating
of
the
sunscreen/
sunblock
you
used
most
often
today?
Ask
for
all
persons
in
household.

21a.
When
you
used
sunscreen/
sunblock
today,
how
did
you
apply
it?
Only
to
certain
areas
of
my
body?
All
exposed
skin?
Ask
for
all
persons
in
household.

22.
Did
you
reapply
at
least
once
today?
Ask
for
all
persons
in
household.

23.
Did
you
wear
a
hat
today?
Ask
for
all
persons
in
household.

23a.
Did
the
hat
have
a
wide
brim
or
another
way
to
shade
face,
ears,
and
back
of
the
neck
from
the
sun?
Ask
for
all
persons
in
household.
29
23a1.
Did
you
use
protective
equipment
such
as
a
canopy,
umbrella
or
other
type
of
sunshade
today?
Ask
for
all
persons
in
household.

23b.
Did
you
wear
protective
clothing,
such
as
a
long­
sleeved
shirt
or
cover­
up?
Ask
for
all
persons
in
household.

24.
During
the
summer,
if
you
go
out
in
the
sun
repeatedly
without
sunscreen
or
protective
clothing
which
one
of
these
things
most
usually
happens
to
your
skin?
Ask
for
all
persons
in
household.
A
dark
tan
Some
tanning
No
tan,
maybe
some
freckles
Repeated
sunburns
Other
(
specify)
Never
go
out
in
the
sun
25.
Did
you
wear
insect
repellant
today?
Ask
for
all
persons
in
household.

26.
Did
your
or
any
member
of
your
household
consume
food
while
at
the
beach
today?
Ask
for
all
persons
in
household.

Thank
you
for
your
assistance.
You
can
contact
us
regarding
information
about
the
study
at
the
toll
free
number
in
the
booklet.

Burden
Statement:
The
annual
public
reporting
and
recordkeeping
burden
for
this
collection
of
information
is
estimated
to
average
about
a
30
minutes
per
response.
Burden
means
the
total
time,
effort,
or
financial
resources
expended
by
persons
to
generate,
maintain,
retain,
or
disclose
or
provide
information
to
or
for
a
Federal
agency.
This
includes
the
time
needed
to
review
instructions;
develop,
acquire,
install,
and
utilize
technology
and
systems
for
the
purposes
of
collecting,
validating,
and
verifying
information,
processing
and
maintaining
information,
and
disclosing
and
providing
information;
adjust
the
existing
ways
to
comply
with
any
previously
applicable
instructions
and
requirements;
train
personnel
to
be
able
to
respond
to
a
collection
of
information;
search
data
sources;
complete
and
review
the
collection
of
information;
and
transmit
or
otherwise
disclose
the
information.

Beach
Interviews:
Based
on
consultation
with
the
individuals
listed
in
Section
3(
c)
of
the
ICR,
and
our
experience
with
similar
types
of
information
collection,
we
estimate
that
each
family
will
spend
an
average
of
15
minutes
each
for
Part
A
and
Part
B
for
the
beach
interview
and
will
require
no
record
keeping.
This
includes
the
time
for
reviewing
the
information
pamphlet
and
answering
the
questions.

Send
comments
on
the
Agency's
need
for
this
information,
the
accuracy
of
the
provided
burden
estimates,
and
any
suggested
methods
for
minimizing
respondent
burden,
including
through
the
use
of
automated
collection
techniques
to
the
Director,
Collection
Strategies
Division,
U.
S.
Environmental
Protection
Agency
(
2822T),
1200
Pennsylvania
Ave.,
NW,
Washington,
D.
C.
20460.
Include
the
OMB
Control
number
2080­
0068
in
any
correspondence.
Do
not
send
the
completed
survey
to
this
address.
Page
30
APPENDIX
D:
Telephone
Interview
Telephone
Interview
­
follow­
up
(
10­
12
days)

Is
this
person
(
primary
respondent
from
beach
interview)?

Yes
(
continue)

No
(
reschedule
or
continue)

Were
you
at
the
beach
on
(
give
date)
with
(
primary
respondent)?

Yes
­
Continue
I'm
going
to
ask
questions
about
any
swimming
you've
done
and
illnesses
you've
experienced
in
the
last
week
for
the
following
people:

A1.
May
I
have
your
first
name
please?

During
your
beach
visit
where
you
enrolled
in
this
study
on
__________

A2.
Did
you
wear
ear
plugs
while
in
the
water?
Ask
for
all
household
members
at
the
beach.

A3.
Did
you
wear
nose
plugs
while
in
the
water?
Ask
for
all
household
members
at
the
beach.

A4.
Did
you
wear
eye
goggles
while
in
the
water?
Ask
for
all
household
members
at
the
beach.

A5.
During
the
beach
interview,
did
you
have
contact
with
an
animal?
Ask
for
all
household
members
at
the
beach.

A6.
Between
your
beach
visit
on
______
date
and
today
were
you
menstruating
or
pregnant?
Ask
for
all
household
members
at
the
beach.

We
are
now
going
to
switch
and
ask
you
questions
about
activities
that
have
occurred
since
the
Beach
Interview.

B1.
Have
you,
or
any
of
the
people
I
just
mentioned,
gone
bathing
or
swimming
anywhere
since
we
talked
to
you
at
the
beach
interview
on
______?
Please
include
any
bathing
or
swimming
such
as
at
a
beach,
waterpark,
public
pool,
private
pool,
or
wading
pool.

B2.
Who
was
it
that
went
bathing
or
swimming?
A2.
Ask
for
all
household
members
at
the
beach.

Ask
B3
through
B5
about
each
person
who
was
marked
in
B2.
Begin
with
the
first
person
in
the
list
who
was
marked
and
continued
with
all
other
marked.
Page
31
B3a.
Did
you
go
bathing
or
swimming
at
the
beach
(
where
the
interview
was
taken)
since
the
beach
interview
on
this
date
{
BEACH
INTERVIEW
DATE}.

B3b.
Did
you
go
bathing
or
swimming
at
any
other
beach
since
the
beach
interview
on
this
date
{
BEACH
INTERVIEW
DATE}.

B3c.
Was
this
beach
at
a:

Lake
River
Ocean
Other,
specify
B3d.
Did
you
go
bathing
or
swimming
at
a
waterpark?

B3e.
Did
you
go
bathing
or
swimming
at
a
public
pool?

B3f.
Did
you
go
bathing
or
swimming
at
a
private
pool?

B3g.
Did
you
go
bathing
or
swimming
in
a
wading
pool?

B3h.
Did
you
go
bathing
or
swimming
any
other
place?

B3i.
Swim
location
of
any
other
place?

B4.
Did
you
actually
get
your
face
wet
while
bathing
or
swimming?
Ask
for
all
household
members
at
the
beach.

B5.
On
which
days
did
you
go
bathing
or
swimming?
Ask
for
all
household
members
at
the
beach.

B6.
Have
you
or
anyone
else
had
a
stomachache
or
abdominal
cramping
since
the
interview
at
{
STUDY
BEACH}

ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B6a.
Who
had
a
stomachache
or
abdominal
cramping
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B7.
Have
you
or
anyone
else
had
diarrhea
or
loose
bowels
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.
Page
32
B7a.
Who
had
diarrhea
or
loose
bowels
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B8.
Have
you
or
anyone
else
had
nausea
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B8a.
Who
had
nausea
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B9.
Have
you
or
anyone
else
had
throwing­
up
or
vomiting
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B9a.
Who
had
throwing­
up
or
vomiting
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B10.
Have
you
or
anyone
else
had
urinary
tract
infection
or
burning
sensation
when
urinating
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B10a.
Who
had
urinary
tract
infection
or
burning
sensation
when
urinating
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B11.
Have
you
or
anyone
else
had
fever
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B11a.
Who
had
fever
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B12.
Have
you
or
anyone
else
had
headache
lasting
more
than
a
few
hours
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B12a.
Who
had
headache
lasting
more
than
a
few
hours
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B13.
Have
you
or
anyone
else
had
sore
throat
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B13a.
Who
had
sore
throat
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.
Page
33
B14.
Have
you
or
anyone
else
had
a
bad
cough
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B14a.
Who
had
a
bad
cough
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B15.
Have
you
or
anyone
else
had
a
cold
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B15a.
Who
had
a
cold
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B16.
Have
you
or
anyone
else
had
a
runny
or
stuffy
nose
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B16a.
Who
had
a
runny
or
stuffy
nose
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B17.
Have
you
or
anyone
else
had
an
earache,
ear
infection,
or
runny
ears
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B17a.
Who
had
an
earache,
ear
infection,
or
runny
ears
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B18.
Have
you
or
anyone
else
had
watery
eyes
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B18a.
Who
had
watery
eyes
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B19.
Have
you
or
anyone
else
had
an
eye
infection
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B19a.
Who
had
an
eye
infection
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?

Ask
for
all
household
members
at
the
beach.

B20.
Have
you
or
anyone
else
had
an
infected
cut
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.
Page
34
B20a.
Who
had
an
infected
cut
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B21.
Have
you
or
anyone
else
had
a
rash
or
itchy
skin
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B21a.
Who
had
a
rash
or
itchy
skin
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?

Ask
for
all
household
members
at
the
beach.

B22.
Have
you
or
anyone
else
had
a
sunburn
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B22a.
Who
had
a
sunburn
since
the
interview
at
{
STUDY
BEACH}
ON
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

We
will
now
ask
about
some
activities
people
may
have
done
since
the
day
of
the
beach
interview
on
the
{
BEACH
INTERVIEW
DATE}

B23a.
Since
the
day
of
the
beach
interview,
have
you
or
anyone
else
come
in
contact
wit
any
animals?
Ask
for
all
household
members
at
the
beach.

B23b.
Who
came
into
contact
with
animals
since
{
BEACH
INTERVIEW
DATE}?
Ask
for
all
household
members
at
the
beach.

B23c.
ASK
FOR
EACH
PERSON
IN
A23a.
Was
this
animal
or
any
of
these
animals
unfamiliar
to
you?

B23d.
What
kind
of
animals
were
they?

Dropdown
list
B24a.
Since
the
day
of
the
beach
interview
has
anyone
come
into
contact
with
someone
who
has
complained
of
diarrhea,
vomiting,
or
stomach
illness?

B24b.
Who
had
contact
with
someone
complaining
of
diarrhea,
vomiting,
or
stomach
illness
since
{
BEACH
INTERVIEW
DATE}?

B25a.
Since
the
day
of
the
beach
interview
has
anyone
eaten
raw
shell
fish,
such
as
oysters,
clams,
mussels,
crabs?

B25b.
Who
has
eaten
raw
shell
fish,
such
as
oysters,
clams,
mussels,
crabs
since
{
BEACH
INTERVIEW
DATE}?
Page
35
B26a.
Since
the
day
of
the
beach
interview
has
anyone
rare
or
raw
meat?
This
includes
pink
in
the
center
for
fish,

beef,
chicken,
and
pork.

B26b.
Who
has
eaten
rare
or
raw
meat
since
{
BEACH
INTERVIEW
DATE}?
This
includes
pink
in
the
center
for
fish,
beef,
chicken,
and
pork.

B27a.
Since
the
day
of
the
beach
interview
has
anyone
eaten
raw
or
runny
eggs?

B27b.
Who
has
eaten
raw
or
runny
eggs
since
{
BEACH
INTERVIEW
DATE}?

SECTION
C
This
section
is
for
all
persons
that
experience
symptoms.

C1.
On
what
day
did
your
stomachache
or
abdominal
cramping
start?

C1a.
Do
you
still
have
a
stomachache
or
abdominal
cramping?

C1b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
stomachache
or
abdominal
cramping?

C2.
On
what
day
did
your
diarrhea
or
loose
bowels
start?

C2a.
Do
you
still
have
a
diarrhea
or
loose
bowels
cramping?

C2b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
diarrhea
or
loose
bowels
cramping?

C2c.
What
was
the
maximum
number
of
bouts
or
episodes
of
diarrhea
experienced
in
a
24­
hour
period?
Ask
for
each
person
with
symptom.

C3.
On
what
day
did
your
nausea
start?

C3a.
Do
you
still
have
a
nausea?

C3b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
nausea?

C4.
On
what
day
did
your
throwing­
up
or
vomiting
start?
Page
36
C4a.
Do
you
still
have
throwing­
up
or
vomiting
?

C4b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
throwing­
up
or
vomiting?

C4c.
What
was
the
maximum
number
of
bouts
or
episodes
of
throwing­
up
or
vomiting
experienced
in
a
24­
hour
period?
Ask
for
each
person
with
symptom.

C5.
On
what
day
did
your
urinary
tract
infection
or
burning
sensation
start?

C5a.
Do
you
still
have
a
urinary
tract
infection
or
burning
sensation?

C5b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
urinary
tract
infection
or
burning
sensation?

C6.
On
what
day
did
your
fever
start?

C6a.
Do
you
still
have
a
fever?

C6b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
fever?

C6c.
Was
your
temperature
taken
using
a
thermometer?

C6a.
What
is
the
highest
temperature
that
you
had
since
your
beach
interview
on
{
BEACH
INTERVIEW
DATE}?

C7.
On
what
day
did
your
headache
start?

C7a.
Do
you
still
have
a
headache
?

C7b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
headache?

C8.
On
what
day
did
your
sore
throat
start?

C8a.
Do
you
still
have
a
sore
throat
?

C8b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
sore
throat
?

C9.
On
what
day
did
your
bad
cough
start?
Page
37
C9a.
Do
you
still
have
a
bad
cough
?

C9b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
bad
cough?

C9c.
Was
this
bad
cough
related
to
allergies?

C10.
On
what
day
did
your
cold
start?

C10a.
Do
you
still
have
a
cold?

C10b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
cold?

C10c.
Was
this
cold
related
to
allergies?

C11.
On
what
day
did
your
runny
or
stuffy
nose
start?

C11a.
Do
you
still
have
a
runny
or
stuffy
nose?

C11b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
runny
or
stuffy
nose?

C11c.
Was
this
runny
or
stuffy
nose
related
to
allergies?

C12.
On
what
day
did
your
earache,
ear
infection
or
runny
ears
start?

C12a.
Do
you
still
have
a
earache,
ear
infection
or
runny
ears?

C12b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
earache,
ear
infection
or
runny
ears?

C12c.
Was
this
earache,
ear
infection
or
runny
ears
related
to
allergies?

C13.
On
what
day
did
your
watery
eyes
start?

C13a.
Do
you
still
have
watery
eyes?

C13b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
watery
eyes?

C13c.
Was
this
watery
eyes
related
to
allergies?

C14.
On
what
day
did
your
eye
infection
start?
Page
38
C14a.
Do
you
still
have
eye
infection?

C14b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
eye
infection?

C15.
On
what
day
did
your
cut
first
get
infected?

C15a.
Do
you
still
have
an
infected
cut?

C15b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
an
infected
cut?

C15c.
Where
were
you
cut?
Mark
all
that
apply
Drop
down
list
C16.
On
what
day
did
your
rash,
itchy
skin,
or
skin
infection
start?

C16a.
Do
you
still
have
a
rash,
itchy
skin,
or
skin
infection?

C16b.
(
For
persons
that
still
have
symptom)
For
how
many
days
did
you
have
a
rash,
itchy
skin,
or
skin
infection?

C16c.
Where
did
you
have
a
rash,
itchy
skin,
or
skin
infection?
Mark
all
that
apply
Drop
down
list
C17.
On
which
parts
of
the
body
were
you
sunburned?
Mark
all
that
apply
Drop
down
list
SECTION
D
Ask
only
once
for
each
person
reporting
symptoms
D1.
When
your
condition
began,
were
you
working
for
pay
either
inside
or
outside
the
home?
Please
include
jobs
for
which
you
were
self­
employed.

D2.
During
your
illness,
did
you
miss
any
time
from
work,
for
example
because
you
called
in
sick
or
took
time
off
to
see
a
doctor?

D3.
How
many
days?
Page
39
D4.
Did
this
illness
prevent
you
from
performing
daily
activities
such
as
school,
recreation,
or
vacation
activities,
or
work
around
the
home?

D5.
How
many
days?

D6.
Did
this
illness
cause
other
household
members
to
lose
time
at
work?

D7.
How
many
days?

D8a.
Did
you
consult
a
healthcare
provider
over
the
phone
about
this
illness/
condition?

D8b.
Did
you
visit
a
healthcare
provider?

D8c.
How
many
times?

D8d.
What
illness
did
the
healthcare
provider
say
you
had?

D8e.
Did
you
visit
an
emergency
room?

D8f
How
many
times?

D8g.
Were
you
admitted
to
a
hospital?

D8h.
How
many
days
were
you
hospitalized?

D8i.
Were
you
given
intravenous
fluids?

D9a.
Did
you
receive
a
prescription
for
an
antibiotic
or
other
drug
for
this
illness/
condition?

D9b.
About
how
much
of
your
own
or
your
household's
money
was
spent
altogether
for
these
prescription
medicines?
Amount
to
nearest
dollar.

D10a.
Did
you
use
any
over­
the­
counter
medications,
including
things
like
special
drinks,
only
because
of
this
illness/
condition
D10b.
About
how
much
of
your
own
or
your
household's
money
was
spent
altogether
for
these
over­
the­
counter
medications?
Amount
to
nearest
dollar.
Page
40
SECTION
E
E1.
Before
today,
were
you
aware
that
people
could
become
ill
by
swimming
at
the
beach?

E2.
After
today,
will
you
change
the
way
you
use
the
water
at
the
beach?

SECTION
Q
These
are
questions
from
beach
interview
to
ensure
data
collection
for
important
exposures.
Ask
for
all
households.

Q1.
Did
you
or
anyone
in
your
household
wade,
swim,
or
play
in
the
water
on
{
BEACH
INTERVIEW
DATE}?

Q1a.
1.
Did
you
immerse
your
body,
not
necessarily
your
head
in
the
water
{
BEACH
INTERVIEW
DATE}?

Q1a.
2.
Did
you
put
your
face
in
the
water
or
submerge
head
in
the
water
on
{
BEACH
INTERVIEW
DATE}?

Q1a.
3.
Did
you
get
water
in
your
mouth
on
{
BEACH
INTERVIEW
DATE}?

Q1a.
4.
Did
you
gag
or
cough
after
getting
water
in
your
mouth
on
{
BEACH
INTERVIEW
DATE}?

Q1a.
5.
Did
you
swallow
the
water
on
{
BEACH
INTERVIEW
DATE}?

This
completes
our
telephone
interview
and
your
participation.
I'd
like
to
verify
your
address
so
we
can
mail
a
check
for
$
25
to
{
BEACH
RESPONDENT}.
(
VERIFY
ADDRESS
ON
CALL
SHEET.)
You
will
receive
your
check
in
30
days
and
thank
you
for
your
participation
in
this
study.
You
can
find
information
about
the
results
of
this
study
by
calling
the
toll­
free
number
or
using
the
e­
mail
address
listed
in
the
brochure
that
we
gave
you.
Thank
you
for
taking
the
time
to
talk
with
me.
Goodbye.

IF
RESP
DOESN'T
HAVE
BROCHURE:

You
can
call
1­
888­
422­
3072,
from
8
am
to
4:
30
pm,
Monday
through
Friday,
Eastern
time;
mention
you
are
calling
about
the
NEEAR
study.
You
can
also
e­
mail
near_
water_
study@
epa.
gov.

This
completes
our
telephone
interview?
We
will
call
again
in
a
week
for
the
last
telephone
interview.
Will
you
still
be
at
this
telephone
number
next
week
when
we
call?
What
would
be
a
good
time
to
call?

Schedule
time:______________

Burden
Statement:
The
annual
public
reporting
and
recordkeeping
burden
for
this
collection
of
information
is
estimated
to
average
about
a
15
minutes
per
response.
Burden
means
the
total
time,
Page
41
effort,
or
financial
resources
expended
by
persons
to
generate,
maintain,
retain,
or
disclose
or
provide
information
to
or
for
a
Federal
agency.
This
includes
the
time
needed
to
review
instructions;
develop,
acquire,
install,
and
utilize
technology
and
systems
for
the
purposes
of
collecting,
validating,
and
verifying
information,
processing
and
maintaining
information,
and
disclosing
and
providing
information;
adjust
the
existing
ways
to
comply
with
any
previously
applicable
instructions
and
requirements;
train
personnel
to
be
able
to
respond
to
a
collection
of
information;
search
data
sources;
complete
and
review
the
collection
of
information;
and
transmit
or
otherwise
disclose
the
information.

Interview
&
Telephone
Follow­
ups:
Based
on
consultation
with
the
individuals
listed
in
Section
3(
c)
of
the
ICR,
and
our
experience
with
similar
types
of
information
collection,
we
estimate
that
each
family
will
spend
an
average
of
15
minutes
completing
the
home
telephone
interview.
The
telephone
interview
will
require
no
record
keeping.

Send
comments
on
the
Agency's
need
for
this
information,
the
accuracy
of
the
provided
burden
estimates,
and
any
suggested
methods
for
minimizing
respondent
burden,
including
through
the
use
of
automated
collection
techniques
to
the
Director,
Collection
Strategies
Division,
U.
S.
Environmental
Protection
Agency
(
2822T),
1200
Pennsylvania
Ave.,
NW,
Washington,
D.
C.
20460.
Include
the
OMB
Control
number
2080­
0068
in
any
correspondence.
Do
not
send
the
completed
survey
to
this
address.
Page
42
APPENDIX
E
References
Cabelli
VJ
"
Health
Effects
Criteria
for
Marine
Recreational
Waters"
EPA­
600/
1­
80­
031.
August
1983.

Calderon
RL,
Mood
EW
and
Dufour
AP.
"
Health
Effects
and
Nonpoint
Sources
of
Pollution",
Int.
J.
Environ.
Hlth
1:
21­
31,
1991.

Colford
JM,
Rees
JR,
Wade
TJ,
Khalakdina
A,
Hilton
JF,
Ergas
IJ,
Burns
S,
Benker
A,
Ma
C,
Bowen
C,
Mills
DC,
Vugia
DJ,
Juranek
DD,
and
Levy
DA.
"
Participant
Blinding
and
Gastrointestinal
Illness
in
a
Randomized,
Controlled
Trial
of
an
In­
Home
Drinking
Water
Intervention"
Emerging
Infectious
Diseases
8:
(
1)
2001.

Dufour
AP.
"
Health
Effects
Criteria
for
Fresh
Recreational
Waters"
EPA­
600/
1­
84­
004.
August
1984.

Payment
P,
Siemiatycki
J,
Richardson
L.
et
al.
A
Prospective
Epidemiological
Study
of
Gastrointestinal
Health
Effects
due
to
the
Consumption
of
Drinking
Water.
Intl
J
Environ.
Hlth
Res.
7:
5­
31,
1997.

Payment
P,
Richardson
L,
Siemiatycki
J,
et
al.
A
Randomized
Trial
to
Evaluate
the
Risk
of
Gastrointestinal
Disease
due
to
Consumption
of
Drinking
Water
Meeting
Current
Microbiological
Standards.
Amer.
J.
Pub.
Hlth
81:
703­
708
,
1991.