[Federal Register Volume 64, Number 235 (Wednesday, December 8, 1999)]
[Notices]
[Pages 68692-68693]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 99-31744]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control And Prevention
[60Day-00-09]


Proposed Data Collections Submitted for Public Comment and 
Recommendations

    In compliance with the requirement of Section 3506 (c)(2)(A) of the 
Paperwork reduction Act of 1995, the Centers for Disease Control and 
Prevention is providing opportunity for public comment on proposed data 
collection projects. To request more information on the proposed 
projects or to obtain a copy of the data collection plans and 
instruments, call the CDC Reports Clearance Officer on (404) 639-7090.
    Comments are invited on: (a) Whether the proposed collection of 
information is necessary for the proper performance of the functions of 
the agency, including whether the information shall have practical 
utility; (b) the accuracy of the agency's estimate of the burden of the 
proposed collection of information; (c) ways to enhance the quality, 
utility, and clarity of the information to be collected; and (d) ways 
to minimize the burden of the collection of information on respondents, 
including through the use of automated collection techniques for other 
forms of information technology. Send comments to Seleda Perryman, CDC 
Assistant Reports Clearance Officer, 1600 Clifton Road, MS-D24, 
Atlanta, GA 30333. Written comments should be received within 60 days 
of this notice.

1. Proposed Projects

    National Surveillance System for Hospital Health Care Workers 
(NaSH)--Reinstatement--National Center for Infectious Diseases (NCID)--
has developed a surveillance system called the National Surveillance 
System for Hospital Health Care Workers (NaSH) that focuses on 
surveillance of exposures and infections among hospital-based health 
care workers (HCWs). NaSH (OMB 0920-0417) includes standardized 
methodology for various occupational health issues. It is a 
collaborative effort of the Hospital Infections Program, National 
Center for Infectious Diseases (NCID); the Hepatitis Branch, Division 
of Viral and Rickettsial Diseases, NCID; the Division of Tuberculosis 
(TB) Elimination, National Center for HIV, STD, and TB Prevention; the 
National Immunization Program (NIP), and the National Institute for 
Occupational Safety and Health (NIOSH).
    NaSH consists of modules for collection of data about various 
occupational issues. Baseline information about each HCW such as 
demographics, immune-status for vaccine-preventable diseases, and TB 
status is collected when the HCW is enrolled in the system. Results of 
routine tuberculin skin test (TST) are collected and entered in the 
system every time a TST is placed and read; follow-up information is 
collected for HCWs with a positive TST. When an HCW is exposed to 
blood/bloodborne pathogen, to a vaccine-preventable disease (VPD), or 
to an infectious TB patient/HCW, epidemiologic data are collected about 
the exposure. For HCWs exposed to a bloodborne pathogen (i.e., HIV, 
HCV, or HBC) and for susceptible HCWs exposed to VPDs, additional data 
are collected during follow-up visits. Once a year, hospitals complete 
a survey to provide denominator data and every 2-5 years, the hospitals 
perform a survey to assess the level of underreporting of needlesticks 
(HCW Survey). Optionally, hospitals may collect information about HCW 
noninfectious occupational injuries such as acute musculoskeletal 
injuries. Data are entered into the software and transmitted on 
diskette to CDC. No HCW identifiers are sent to CDC. This system is 
protected by the Assurance of Confidentiality (308d).
    Data collected in NaSH will assist hospitals, HCWs, health care 
organizations, and public health agencies. This system will allow CDC 
to monitor national trends, to identify newly emerging hazards for 
HCWs, to assess the risk of occupational infection, and to evaluate 
preventive measures, including engineering controls, work practices, 
protective equipment, and postexposure prophylaxis to prevent 
occupationally acquired infections. Hospitals that volunteer to 
participate in this system benefit by receiving technical support and 
standardized methodologies, including software, for conducting 
surveillance activities on occupational health.
    This system was developed and piloted in large teaching hospitals 
(RFP-200-94-0834(P) and RFP-200-96-0524(P)). The first pilot included 
four hospitals and the second, five. After the refinement pilot in an 
additional 13 hospitals (PA-786 and interagency agreements), 
participation in NaSH became voluntary. The system is being made 
available to all acute-care hospitals in the United States wishing to 
participate voluntarily in the project. We anticipate no more than 100 
hospitals participating by the end of fiscal 2000 and potentially 150 
by fiscal 2002. To participate in NaSH, hospitals are required to 
provide information on all exposures to infectious agents, baseline 
information on the exposed HCWs, as well as the underreporting and 
hospital surveys.
    A new component of NaSH will be a web-based surveillance for 
occupational exposures to blood that can be used by any health care 
facility and will meet OSHA requirements and needs mandated by national 
and state legislation. Referred to as ``NaSH Lite'', this module is an 
abbreviated version of the bloodborne pathogen exposure module. Data 
collected through NaSH Lite will help create a national database for 
benchmarking and for tracking trends in sharps-injuries as well as help 
health care facilities to record and prevent exposures. This module 
will be developed with OSHA input and in conjunction with state health 
departments. In addition, data collected through NaSH Lite will assist 
health care facilities to select, implement, and evaluate strategies 
(including safety devices) to prevent percutaneous exposures.

[[Page 68693]]



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                                                      No. of          No. of       Avg. burden/
                      Form                          respondents     responses/     response  (in     Total (in
                                                    (hospitals)     Respondent         hrs.)           hrs.)
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Baseline Information............................             150           1,000           20/60          50,000
TST.............................................
TST Result......................................              50           1,000           10/60           8,333
Positive TST....................................              50             100           10/60             833
Exposure to Blood...............................
Exposure........................................             150             125           25/60           7,813
Exposure (NaSH Lite/abbreviated/form)...........           1,000              10           10/60              66
Exposure to VPD.................................
Summary.........................................             150               3           20/60             150
HCW.............................................             150              10           20/60             500
Exposure to TB..................................             150               3           30/60             225
Noninfectious Injury............................              60           1,000           10/60          10,000
HCW Survey......................................              75             500           10/60           6,250
Hospital Survey.................................             150               1               2             300
                                                                                 -------------------------------
    TOTAL.......................................  ..............  ..............  ..............          86,720
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    Dated: December 1, 1999.

    A different number of hospitals will be completing each of the 
separate forms listed above. The number of respondents is the number of 
hospitals. The number of responses per respondent varies with the form.
    The maximum total burden hours may reach 86,720. (The total 
estimated maximum cost to respondents may be $1,300,800 [$15 an hour 
for hospital personnel who will collect/input the data].)
    Since all of the data collection activities except the HCW survey, 
outlined in the modules are currently routinely done by infection 
control practitioners and employee health, personnel health, and/or 
occupational medicine personnel in hospitals with existing well 
established surveillance programs, the only additional burden for some 
hospitals participating in the NaSH system is the time needed for data 
entry and transmission of data to CDC. Thus, the real burden hours and 
burden cost could be significantly less. The only activity that may not 
be routinely performed by the hospitals is the survey to assess 
underreporting of needlesticks (HCW survey).
Nancy Cheal,
Acting Associate Director for Policy Planning and Evaluation, Centers 
for Disease Control and Prevention.
[FR Doc. 99-31744 Filed 12-7-99; 8:45 am]
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