PAPERWORK
REDUCTION
ACT
SUBMISSION
Please
read
the
instructions
before
completing
this
form.
For
additional
forms
or
assistance
in
completing
this
form,
contact
your
agency's
Paperwork
Clearance
Officer.
Send
two
copies
of
this
form,
the
collection
instrument
to
be
reviewed,
the
Supporting
Statement
and
any
additional
documentation
to:
Office
of
Information
and
Regulatory
Affairs,
Office
of
Management
and
Budget,
Docket
Library,
Room
10102,
725
17th
Street
NW
Washington,
DC
20503.

1.
Agency/
Subagency
originating
request
U.
S.
Environmental
Protection
Agency
2.
OMB
control
number
b.
X
None
a__
__
__
__
­
__
__
__
__
_
2_
0
6_
0__

3.
Type
of
information
collection
(
check
one)
a.
X
New
collection
b.
G
Revision
of
a
currently
approved
collection
c.
G
Extension
of
a
currently
approved
collection
d.
G
Reinstatement,
without
change,
of
a
previously
approved
collection
for
which
approval
has
expired
e.
G
Reinstatement,
with
change,
of
a
previously
approved
collection
for
which
approval
has
expired
f.
G
Existing
collection
in
use
without
an
OMB
control
number
4.
Type
of
review
requested
(
check
one)
a.
X
Regular
b.
G
Emergency
­
Approval
requested
by:
/
/
c.
G
Delegated
5.
Small
entities
Will
this
information
collection
have
a
significant
economic
impact
on
a
substantial
number
of
small
entities?
G
Yes
X
No
For
b­
f,
note
item
A2
of
Supporting
Statement
Instructions
6.
Requested
expiration
date
a.
X
Three
years
from
approval
date
b.
G
Other
Specify:
/
/___

7.
Title
:
National
Survey
on
Environmental
Management
of
Asthma
8.
Agency
form
number(
s)
(
If
applicable)
1996.01
9.
Keywords
Asthma,
Environmental
Asthma,
Asthma
Triggers,
Environmental
Management
Measures,
Households
10.
Abstract
:
Executive
Order
13045
of
1997
created
the
Task
Force
on
Environmental
Health
Risks
and
Safety
Risks
in
Children,
which
identified
childhood
asthma
as
a
priority.
In
response,
the
Environmental
Protection
Agency
(
EPA)'
s
Indoor
Environments
Division
(
IED)
has
studied
how
environmental
factors,
such
as
dust
mites,
cockroaches,
mold,
animal
dander,
and
environmental
tobacco
smoke
(
ETS),
may
trigger
asthma.
IED
works
to
integrate
management
of
environmental
factors
with
the
medical
treatment
of
asthma,
particularly
among
children
and
low­
income
populations.
To
evaluate
its
effectiveness,
EPA
proposes
to
collect
survey
data
from
U.
S.
households.
The
survey
will
determine
the
number
of
asthmatics
who
have
improved
the
quality
of
their
indoor
environment
to
manage
asthma,
and
learn
of
any
barriers
to
action.
EPA
will
compare
findings
to
the
Agency's
Government
Performance
and
Results
Act
of
1993
(
GPRA)
goal
that
2.5
million
people
with
asthma
will
reduce
their
exposure
to
indoor
asthma
triggers
by
2005.
In
Phase
I
of
the
survey,
EPA
will
contact
up
to
87,652
households
randomly.
EPA
expects
60%,
or
52,591
individuals,
will
participate
in
the
screening
survey.
Of
these,
EPA
expects
10%,
or
5,259
individuals,
to
have
asthma
or
live
with
an
asthmatic.
Adult
asthmatics
and
parents
of
asthmatic
children
will
be
invited
to
participate
in
a
more
in­
depth
survey.
Of
the
5,259
individuals
identified
in
Phase
I,
EPA
estimates
74%,
or
3,892,
will
participate
in
Phase
II.
No
individual
will
be
surveyed
twice
while
this
ICR
is
in
effect.
Ultimately,
EPA
expects
completed
responses
from
3,308
individuals.
This
sample
size
will
permit
a
statistically
valid
assessment
of
EPA's
progress
toward
its
GPRA
goal
and
evaluate
its
outreach
efforts.
Additionally,
EPA
will
over­
sample
in
communities
with
low­
income
households
to
ensure
sufficient
information
from
this
population
to
draw
valid
conclusions.
This
information
will
guide
EPA's
asthma
program
and
its
future
outreach
initiatives.

11.
Affected
public
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
P
Individuals
or
households
d.
Farms
b.
Business
or
other
for­
profit
e.
Federal
Government
c.
Not­
for­
profit
institutions
f.
State,
Local
or
Tribal
Government
12.
Obligation
to
respond
(
Mark
primary
with
"
P"
and
all
others
that
apply
with
"
X")
a.
P
Voluntary
b.
G
Required
to
obtain
or
retain
benefits
c.
G
Mandatory
13.
Annual
reporting
and
recordkeeping
hour
burden
a.
Number
of
respondents
52,591
b.
Total
annual
responses
52,591
1.
Percentage
of
these
responses
collected
electronically
0
%
c.
Total
hours
requested
726
d.
Current
OMB
inventory
0
e.
Difference
726
f.
Explanation
of
difference
1.
Program
Change
726
2.
Adjustment
0
14.
Annual
reporting
and
recordkeeping
cost
burden
(
in
thousands
of
dollars)
a.
Total
annualized
capital/
startup
costs
$
0
b.
Total
annual
costs
(
O&
M)
$
0
c.
Total
annualized
cost
requested
$
0
d.
Current
OMB
inventory
$
0
e.
Difference
$
0
f.
Explanation
of
difference
1.
Program
change
New
Collection
$
0
2.
Adjustment
$
0
15.
Purpose
of
information
collection
(
Mark
Primary
With
"
P"
and
all
others
that
apply
with
"
X")
a.
__
Application
for
benefits
e.
X_
Program
planning
or
management
b.
P_
Program
evaluation
f.
__
Research
c.
__
General
purpose
statistics
g.
__
Regulatory
or
compliance
d.
__
Audit
16.
Frequency
of
recordkeeping
or
reporting
(
check
all
that
apply)
a.
Q
Recordkeeping
b.
Q
Third
party
disclosure
c.
x
Reporting
1.
Q
On
occasion
2.
Q
Weekly
3.
Q
Monthly
4.
Q
Quarterly
5.
Q
Semi­
annually
6.
Q
Annually
7.
Q
Biannually
8.
X
Other
(
describe)
Once
17.
Statistical
methods
Does
this
information
collection
employ
statistical
methods?
X
Yes
Q
No
18.
Agency
contact
(
person
who
can
best
answer
questions
regarding
the
content
of
this
submission)
Name:
Dr.
Susan
Conrath
Phone:
202­
564­
9389
OMB
83­
I
10/
95
19.
Certification
for
Paperwork
Reduction
Act
Submissions
On
behalf
of
this
Federal
agency,
I
certify
that
the
collection
of
information
encompassed
by
this
request
complies
with
5
CFR
1320.9.

NOTE:
The
text
of
5
CFR
1320.9,
and
the
related
provisions
of
5
CFR
1320.8(
b)(
3),
appear
at
the
end
of
the
instructions.
The
certification
is
to
be
made
with
reference
to
those
regulatory
provisions
as
set
forth
in
the
instructions.

The
following
is
a
summary
of
the
topics,
regarding
the
proposed
collection
of
information,
that
the
certification
covers:

(
a)
It
is
necessary
for
the
proper
performance
of
agency
functions;

(
b)
It
avoids
unnecessary
duplication;

(
c)
It
reduces
burden
on
small
entities;

(
d)
It
uses
plain,
coherent,
and
unambiguous
terminology
that
is
understandable
to
respondents;

(
e)
Its
implementation
will
be
consistent
and
compatible
with
current
reporting
and
recordkeeping
practices;

(
f)
It
indicates
the
retention
periods
for
recordkeeping
requirements;

(
g)
It
informs
respondents
of
the
information
called
for
under
5
CFR
1320.8(
b)(
3):
(
i)
Why
the
information
is
being
collected;
(
ii)
Use
of
information;
(
iii)
Burden
estimate;
(
iv)
Nature
of
response
(
voluntary,
required
for
a
benefit,
or
mandatory);
(
v)
Nature
and
extent
of
confidentiality;
and
(
vi)
Need
to
display
currently
valid
OMB
control
number;

(
h)
It
was
developed
by
an
office
that
has
planned
and
allocated
resources
for
the
efficient
and
effective
management
and
use
of
the
information
to
be
collected
(
see
note
in
Item
19
of
the
instructions);

(
i)
It
uses
effective
and
efficient
statistical
survey
methodology;
and
(
j)
It
makes
appropriate
use
of
information
technology.

If
you
are
unable
to
certify
compliance
with
any
of
these
provisions,
identify
the
item
below
and
explain
the
reason
in
Item
18
of
the
Supporting
Statement.

Signature
of
Program
Official
Mary
T.
Smith,
Director
Indoor
Environments
Division
Office
of
Radiation
and
Indoor
Air
(
ORIA)
Date
Signature
of
Senior
Official
or
designee
Oscar
Morales,
Director
Collection
Strategies
Division
Office
of
Environmental
Information
(
OEI)
Date
OMB
83­
I
10/
95
