[Federal Register Volume 87, Number 223 (Monday, November 21, 2022)]
[Notices]
[Pages 70828-70830]
From the Federal Register Online via the Government Publishing Office [www.gpo.gov]
[FR Doc No: 2022-25245]


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DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

[60Day-23-0950; Docket No. CDC-2022-0133]


Proposed Data Collection Submitted for Public Comment and 
Recommendations

AGENCY: Centers for Disease Control and Prevention (CDC), Department of 
Health and Human Services (HHS).

ACTION: Notice with comment period.

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SUMMARY: The Centers for Disease Control and Prevention (CDC), as part 
of its continuing efforts to reduce public burden and maximize the 
utility of government information, invites the general public and other 
federal agencies the opportunity to comment on a continuing information 
collection, as required by the Paperwork Reduction Act of 1995. This 
notice invites comment on a proposed revision of the information 
collection project titled National Health and Nutrition Examination 
Survey (NHANES). NHANES produces descriptive statistics, which measure 
the health and nutrition status of the general population.

DATES: CDC must receive written comments on or before January 20, 2023.

ADDRESSES: You may submit comments, identified by Docket No. CDC-2022-
0133 by either of the following methods:
     Federal eRulemaking Portal: www.regulations.gov. Follow 
the instructions for submitting comments.
     Mail: Jeffrey M. Zirger, Information Collection Review 
Office, Centers for Disease Control and Prevention, 1600 Clifton Road 
NE, MS H21-8, Atlanta, Georgia 30329.
    Instructions: All submissions received must include the agency name 
and Docket Number. CDC will post, without change, all relevant comments 
to www.regulations.gov.
    Please note: Submit all Federal comments through the Federal 
eRulemaking portal (www.regulations.gov) or by U.S. mail to the address 
listed above.

FOR FURTHER INFORMATION CONTACT: To request more information on the 
proposed project or to obtain a copy of the information collection plan 
and instruments, contact Jeffrey M. Zirger, Information Collection 
Review Office, Centers for Disease Control and Prevention, 1600 Clifton 
Road NE, MS H21-8, Atlanta, Georgia 30329; Telephone: 404-639-7570; 
Email: [email protected].

SUPPLEMENTARY INFORMATION: Under the Paperwork Reduction Act of 1995 
(PRA) (44 U.S.C. 3501-3520), federal agencies must obtain approval from 
the Office of Management and Budget (OMB) for each collection of 
information they conduct or sponsor. In addition, the PRA also requires 
federal agencies to provide a 60-day notice in the Federal Register 
concerning each proposed collection of information, including each new 
proposed collection, each proposed extension of existing collection of 
information, and each reinstatement of previously approved information 
collection before submitting the collection to the OMB for approval. To 
comply with this requirement, we are publishing this notice of a 
proposed data collection as described below.
    The OMB is particularly interested in comments that will help:
    1. 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;
    2. 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;
    3. Enhance the quality, utility, and clarity of the information to 
be collected;
    4. 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 
submissions of responses; and
    5. Assess information collection costs.

Proposed Project

    The National Health and Nutrition Examination Survey (NHANES), (OMB 
Control No. 0920-0950, Exp. 04/30/2023)--Revision--National Center for 
Health Statistics (NCHS), Centers for Disease Control and Prevention 
(CDC).

Background and Brief Description

    Section 306 of the Public Health Service (PHS) Act (42 U.S.C. 
242k), as amended, authorizes that the Secretary of Health and Human 
Services (DHHS), acting through NCHS, shall collect statistics on the 
extent and nature of illness and disability; environmental, social and 
other health hazards; and determinants of health of the population of 
the United States.
    The National Health and Nutrition Examination Survey (NHANES) has 
been conducted periodically between 1970 and 1994, and continuously 
since 1999 by the National Center for Health Statistics (NCHS), CDC.
    NHANES produces descriptive statistics, which measure the health 
and nutrition status of the general population. With physical 
examinations, laboratory tests, and interviews, NHANES studies the 
relationship between diet, nutrition and health in a representative 
sample of the United States. NHANES monitors the prevalence of chronic 
conditions and risk factors and is used to produce national reference 
data on height, weight, and nutrient levels in the blood. Results from 
more recent NHANES can be compared to findings reported from previous 
surveys to monitor changes in the health of the U.S. population over 
time.
    In this Revision, the program is not considering any substantial 
changes to NHANES content or procedures. The proposed changes being 
requested

[[Page 70829]]

include modifications previously approved via non-substantive change 
requests in addition to a request for three years of approval. As in 
previous years, the base sample will remain at approximately 5,000 
interviewed and examined individuals annually. It is possible that the 
survey may have to adapt its plans in response to the novel Coronavirus 
Disease (COVID-19) or related concerns.
    NCHS collects personally identifiable information (PII). 
Participant level data items will include basic demographic 
information, name, address, Social Security number, Medicare number and 
participant health information to allow for linkages to other data 
sources such as the National Death Index and data from the Centers for 
Medicare and Medicaid Services (CMS).
    A variety of agencies sponsors data collection components on 
NHANES. To keep burden down and respond to changing public health 
research needs, NCHS cycles in and out various components. The 2021-22 
NHANES physical examination includes the following components: 
anthropometry (all ages), liver elastography (ages 12 and older), 
standing balance (ages 20-69), 24-hour dietary recall via phone (all 
ages), blood pressure measurement (ages eight and older), and dual X-
ray absorptiometry (DXA) (ages 8-69, total body scan). While at the 
examination center, additional interview questions are asked of 
participants and a second 24-hour dietary recall (all ages) is 
scheduled to be conducted by phone 3-10 days later.
    The 2021-22 survey is similar to what was fielded in 2019-20. 
NHANES may conduct developmental projects, with a focus on planning for 
NHANES 2024 and beyond. These may include activities such as tests of 
new equipment, crossover studies between current and proposed methods, 
test of different study modes, settings or technology, outreach 
materials, incentive strategies, sample storage and processing or 
sample designs. The biospecimens collected for laboratory tests include 
urine and blood. Serum, plasma and urine specimens are stored for 
future testing, including genetic research, if the participant 
consents. Consent to store DNA is continuing in NHANES.
    Beginning in 2021, NHANES added the following laboratory tests: 
Acetylcholinesterase Enzyme Activity in whole blood; an Environmental 
Toxicant in Washed Red Blood Cells (Hemoglobin Adducts); Environmental 
Toxicants in serum (seven terpenes); Environmental Toxicants in urine 
(seven volatile organic compound (VOC) metabolites); Infectious Disease 
Markers in serum (Enterovirus 68 (EV-D68) and Human Papilloma Virus 
(HPV) in serum); Nutritional Biomarkers in plasma (Four trans-fatty 
acids (TFA)); and two Nutritional Biomarkers in serum.
    Additionally, at the start of the 2021 survey year, the following 
Laboratory Tests were modified: Steroid hormones in serum (eleven 
steroid hormones). Cycling out of NHANES is the Blood Pressure 
Methodology Study and laboratory tests of Adducts of Hemoglobin 
(Acrylamide, Glycidamide) and Urine flow rate.
    Most sections of the NHANES interviews provide self-reported 
information to be used in combination with specific examination or 
laboratory content, as independent prevalence estimates, or as 
covariates in statistical analysis (e.g., socio-demographic 
characteristics). Some examples include alcohol, drug, and tobacco use, 
sexual behavior, prescription and aspirin use, and indicators of oral, 
bone, reproductive, and mental health. Several interview components 
support the nutrition-monitoring objective of NHANES, including 
questions about food security and nutrition program participation, 
dietary supplement use, and weight history/self-image related behavior.
    NHANES will continue multi-mode screening and electronic consent 
procedures. Our yearly goal for interview, exam and post exam 
components is 5,600 participants. To achieve this goal, we may need to 
screen up to 8,300 individuals annually. Burden for individuals will 
vary based on their level of participation. For example, infants and 
children tend to have shorter interviews and exams than adults. This is 
because young people may have fewer health conditions or medications to 
report so their interviews take less time or because certain exams are 
only conducted on individuals 18 and older. In addition, adults often 
serve as proxy respondents for young people in their families.
    Participation in NHANES is voluntary and confidential. CDC requests 
OMB approval for a three-year extension, with 65,630 annualized burden 
hours. There is no cost to respondents other than their time to 
participate.

                                        Estimated Annualized Burden Hours
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                                                                     Number of    Average burden
      Type of respondent            Form name        Number of     responses per   per response    Total burden
                                                    respondents     respondent      (in hours)      (in hours)
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Individuals...................  Screener........           8,300               1           10/60           1,383
in households.................
Individuals in households.....  Household                  5,600               1               1           5,600
                                 Interview.
Individuals in households.....  MEC Interview &            5,600               1             2.5          14,000
                                 Examination.
Individuals in households.....  Telephone                  5,600               1             1.3           7,280
                                 Dietary Recall
                                 & Dietary
                                 Supplements.
Individuals in households.....  Flexible                   5,600               1           20/60           1,867
                                 Consumer
                                 Behavior Survey
                                 Phone Follow-Up.
Individuals in households.....  Developmental              3,500               1               3          10,500
                                 Projects &
                                 Special Studies.
Individuals in households.....  24-hour wearable           1,000               1              25          25,000
                                 device projects.
                                                 ---------------------------------------------------------------
    Total.....................  ................  ..............  ..............  ..............          65,630
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[[Page 70830]]

Jeffrey M. Zirger,
Lead, Information Collection Review Office, Office of Scientific 
Integrity, Office of Science, Centers for Disease Control and 
Prevention.
[FR Doc. 2022-25245 Filed 11-18-22; 8:45 am]
BILLING CODE 4163-18-P