Skip to Content


Notice of Intent To Seek Approval To Renew an Information Collection

Document Details

Information about this document as published in the Federal Register.

Published Document

This document has been published in the Federal Register. Use the PDF linked in the document sidebar for the official electronic format.

Start Preamble


National Science Foundation.


Notice and request for comments.


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.


Written comments on this notice must be received by December 20, 2010 to be assured of consideration. Comments received after that date will be considered to the extent practicable.

For Additional Information or Comments: 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 You also may obtain a copy of the data collection instrument and instructions from Ms. Plimpton.

End Preamble Start Supplemental Information


Title of Collection: Medical Clearance Process for Deployment to Antarctica.

OMB Number: 3145-0177.

Expiration Date of Approval: January 31, 2011.Start Printed Page 64358

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


A. Proposed Project: All individuals who anticipate deploying to Antarctica under the auspices of the United States Antarctic Program and to certain regions of the Arctic 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 a psychological examination for those persons planning to winter over in Antarctica. 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 participants or that could not be effectively treated by the limited medical care capabilities in Antarctica or in Greenland.

(b) 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. Section 107.(a) of Public Law 98-373 (July 31, 1984; amended as Public Law 101-609—November 16, 1990) (available from the National Science Foundation, Office of Polar Programs, Room 755, 4201 Wilson Blvd., Arlington, VA 22230) designates the National Science Foundation as the lead agency responsible for implementing Arctic research policy, and the Director of the National Science Foundation shall insure that the requirements of section 108 are fulfilled.

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 nine-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 and which location 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, has been discontinued. It was previously used to document changes in family and personal history for those healthy individuals who are under age 40 and had no adverse personal medical information to report for the preceding year.

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 gums 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, and obtaining an Employer Statement of Support. Individuals on a case-by-case basis may also be asked to submit additional medical documentation and a letter from the individual's physician(s) regarding the individual's medical condition and his or her 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:

  • The Medical Risks for NSF-Sponsored Personnel Traveling to Antarctica or Greenland
  • the NSF Privacy Notice
  • the NSF Medical Screening for Blood-Borne Pathogens/Consent for HIV Testing
  • the NSF Authorization for Treatment of Field-Team Member/Participant Under the Age of 18 Years. This form will 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.
  • the influenza vaccination requirement letter.

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, 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 Notifications—Important Notice for Participants in the United States Antarctic or Arctic Program. These forms provide information on the laws, of the nations through which program participants must transit en route to Antarctica or Greenland, 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, the method used to complete the forms 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 Start Printed Page 64359be 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, and for NSF to make and promulgate a decision.

Respondents: All individuals deploying to the Antarctic under the auspices of the United States Antarctic Program and certain Arctic areas 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; fewer if the individual has previously deployed and saved his or her prior year's data for future use.

Frequency of Responses: Physical qualifications are valid for 12 months. Individuals must complete the forms annually or not earlier than six months prior to their anticipated deployment date, if they are infrequent travelers. 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.

Start Signature

Dated: October 14, 2010.

Suzanne H. Plimpton,

Reports Clearance Officer, National Science Foundation.

End Signature End Supplemental Information

[FR Doc. 2010-26249 Filed 10-18-10; 8:45 am]