[Federal Register Volume 69, Number 23 (Wednesday, February 4, 2004)]
[Notices]
[Pages 5372-5374]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 04-2213]


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NATIONAL SCIENCE FOUNDATION


Notice of Intent To Seek Approval To Renew an Information 
Collection

AGENCY: National Science Foundation.

ACTION: Notice and request for comments.

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SUMMARY: The National Science Foundation (NSF) is announcing plans to 
request clearance of this collection. In accordance with the 
requirement of section 3506(c)(2)(A) of the Paperwork Reduction Act of 
1995 (Pub. L. 104-13), we are providing opportunity for public comment 
on this action. After obtaining and considering public comment, NSF 
will prepare the submission requesting that OMB approve clearance of 
this collection for no longer than 3 years.

DATES: Written comments on this notice must be received by April 5, 
2004, to be assured of consideration. Comments received after that date 
will be considered to the extent practicable.

FOR FURTHER INFORMATION CONTACT: Contact Suzanne H. Plimpton, Reports 
Clearance Officer, National Science Foundation, 4201 Wilson Boulevard, 
Suite 295, Arlington, Virginia 22230; telephone (703) 292-7556; or send 
e-mail to [email protected]. You also may obtain a copy of the data 
collection instrument and instructions from Ms. Plimpton.

SUPPLEMENTARY INFORMATION:
    Title of Collection: Medical Clearance Process for Deployment to 
Antarctica.
    OMB Number: 3145-0177.
    Expiration Date of Approval: May 31, 2004.

[[Page 5373]]

    Type of Request: Intent to seek approval to renew an information 
collection for three years.

Abstract

A. Proposed Project

    All individuals who anticipate deploying to Antarctica and to 
certain regions of the Arctic under auspices of the United States 
Antarctica Program are required to take and pass a rigorous physical 
examination prior to deploying. The physical examination includes a 
medical history, medical examination, a dental examination and for 
those persons planning to winter over in Antarctica a psychological 
examination is also required. The requirement for this determination of 
physical status is found in 42 U.S.C. 1870 (Authority) and 62 FR 31522, 
June 10, 1997 (Source), unless otherwise noted. This part sets forth 
the procedures for medical screening to determine whether candidates 
for participation in the United States Antarctic [(Page 216)] Program 
(USAP) are physically qualified and psychologically adapted for 
assignment or travel to Antarctica. Medical screening examinations are 
necessary to determine the presence of any physical or psychological 
conditions that would threaten the health or safety of the candidate or 
other USAP participants or that could not be effectively treated by the 
limited medical care capabilities in Antarctica.
    Presidential Memorandum No. 6646 (February 5, 1982) (available from 
the National Science Foundation, Office of Polar Programs, room 755, 
4201 Wilson Blvd., Arlington, VA 22230) sets forth the National Science 
Foundation's overall management responsibilities for the entire United 
States national program in Antarctica.

B. Use of the Information

    1. Form NSF-1420, National Science Foundation
     Polar Physical Examination
    (Antarctica/Arctic/Official Visitors) Medical History, will be used 
by the individual to record the individual's family and personal 
medical histories. It is a five-page form that includes the 
individual's and the individual's emergency point-of-contact's name, 
address, and telephone numbers. It contains the individual's email 
address, employment affiliation and dates and locations of current and 
previous polar deployments. It also includes a signed certification of 
the accuracy of the information and understandings of refusal to 
provide the information or providing false information. The agency's 
contractor's reviewing physician and medical staff complete the 
sections of the form that indicated when the documents were received 
and whether or not the person qualified for polar deployment, in which 
season qualified to deploy and where disqualified the reasons.
    2. Form NSF-1421, Polar Physical Examination
     Antarctica/Arctic, will be used by the 
individual's physician to document specific medical examination results 
and the overall status of the individual's health. It is a two-page 
form which also provides for the signatures of both the patient and the 
examining physician, as well as contact information about the examining 
physician. Finally, it contains the name, address and telephone number 
of the agency's contractor that collects and retains the information.
    3. Form NSF-1422, National Science Foundation Polar Physical 
Examination
    (Antarctica/Arctic/Official Visitors) Medical History Interval 
Screening, will only be used by individuals who are under the age of 40 
and who successfully took and passed a polar examination the previous 
season or not more than 24 months prior to current deployment date. It 
allows the otherwise healthy individual to update his or her medical 
data without having to take a physical examination every year as 
opposed to those over 40 years of age who must be examined annually.
    4. Form NSF-1423, Polar Dental Examination-Antarctica/Arctic/
Official Visitors, will be used by the examining dentist to document 
the status of the individual's teeth and to document when the 
individual was examined. It will also be used by the contractor's 
reviewing dentist to document whether or not the individual is dentally 
cleared to deploy to the polar regions.
    5. Medical Waivers: Any individual who is determined to be not 
physically qualified for polar deployment may request an administrative 
waiver of the medical screening criteria. This information includes 
signing a Request for Waiver that is notarized or otherwise legally 
acceptable in accordance with penalty of perjury statutes, obtaining an 
Employer Statement of Support. Individuals on a case-by-case basis may 
also be required to submit additional medical documentation and a 
letter from the individual's physician(s) regarding the individual's 
medical suitability for Antarctic deployment.
    6. Other information requested: In addition to the numbered forms 
and other information mentioned above, the USAP medical screening 
package includes the following:
--Medical Risks for NSF-Sponsored Personnel Traveling to Antarctica--
multi-copy form
--the NSF Privacy Notice
--the NSF Medical Screening for Blood-borne Pathogens/Consent for HIV 
Testing--(multi-copy)
--the NSF Authorization for Treatment of Field-Team Member/Participant 
Under the Age of 18 Years--(multi-copy). This should only be sent to 
the individuals who are under 18 years of age.
--the Dear Doctor and Dear Dentist letters, which provide specific 
laboratory and x-ray requirements, as well as other instructions.
    7. There are two other, non-medical forms included in the mailing:
--the Personal Information Form-NSF Form Number 1424 includes a Privacy 
Act Notice. This form is used to collect information on current address 
and contact numbers, date and place of birth, nationality, citizenship, 
social security number, passport number, emergency point of contact 
information, travel dates, clothing sizes so that we may properly 
outfit those individuals who deploy, work-site information and prior 
deployment history.
--the Participant Notification--Important Notice for Participants in 
the United States Antarctic Program. This form provides information on 
the laws, of the nations through which program participants must 
transmit in route to Antarctica, regarding the transport, possession 
and use of illegal substances and the possibility of criminal 
prosecution if caught, tried and convicted.
    Estimate of Burden: Public reporting burden for this collection of 
information varies according to the overall health of the individual, 
the amount of research required to complete the forms, the time it 
takes to make an appointment, take the examination and schedule and 
complete any follow-up medical, dental or psychological requirements 
and the completeness of the forms submitted. The estimated time is up 
to six weeks from the time the individual receives the forms until he 
or she is notified by the contractor of their final clearance status. 
An additional period of up to eight weeks may be required for the 
individual who was disqualified to be notified of the disqualification, 
to request and receive the waiver packet, to obtain employer support 
and complete the waiver request, to do any follow-up testing, to return 
the waiver request to the contractor plus any follow-up information, 
for the contractor to get the completed packet to the National Science 
Foundation, for

[[Page 5374]]

the NSF to make and promulgate a decision.
    Respondents: All individuals deploying to the Antarctic and certain 
Arctic areas under the auspices of the United States Antarctic Program 
must complete these forms. There are approximately 3,000 submissions 
per year, with a small percentage (c.3%) under the age of 40 who 
provide annual submissions but with less information.
    Estimated Number of Responses Per Form: Responses range from 2 to 
approximately 238 responses.
    Estimated Total Annual Burden on Respondents: 28,728 hours.
    Frequency of Responses: Individuals must complete the forms 
annually to be current within 12 months of their anticipated deployment 
dates. Depending on individual medical status some persons may require 
additional laboratory results to be current within two to six weeks of 
anticipated deployment.
    Comments: 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 on 
respondents, including through the use of automated collection 
techniques or other forms of information technology; and (d) ways to 
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.

    Dated: January 29, 2004.
Suzanne H. Plimpton,
Reports Clearance Officer, National Science Foundation.
[FR Doc. 04-2213 Filed 2-3-04; 8:45 am]
BILLING CODE 7555-01-M