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II.
Table of Contents
I. Title Page 1
II. Table of Contents. 2
III.
Narrative Statement
3
IV. Study Background and Rationale
5
V.
Applicant Background 6
VI. Study Work Plan... 8
A.
Study Objectives.. 8
B.
Project Results/Benefits Expected
8
C.
Study Approach.... 9
1.
Project Accomplishment...............
9
2.
Facilities 17
3.
Non-federal Funding Sources and Facilities...
20
4.
Chronological Schedule of Project Accomplishments........... 21
5.
Staff, Supporting Agencies, Consultants, and Contractors.................. 24
6.
Data Collection, Analysis, and Evaluation
27
Environmental
Data.......... 27
Epidemiological
Data...... 28
Respiratory
Health Data.................. 28
D.
General Program/Project Information
29
1.
Data to be Collected.. 29
2.
Effect or Relationship of Program to Other Organization Work......... 31
3.
Federal, State, Interstate, and Local Programs to be Coordinated
With Project..................
31
E.
Itemized Budget...... 32
F.
Human Subjects Protocol.... 34
G.
Quality Assurance Requirements................
40
H.
Biographical Sketch of the Project Manager - H. William
Barkman, M.D........... 40
Appendices
A.
Environmental Monitoring Assessment Quality Assurance Project Plan
B.
Respiratory Health and Cancer Incidence and Mortality Rates Quality
Assurance Project
Plan
1.
Letter of Information for Respiratory Health Questionnaire
2.
Instructions for Completing Respiratory Health Questionnaire
3.
Adult Consent Form for Respiratory Health Questionnaire
4.
Parental Permission Form/Child's Assent Form
5.
Adult Respiratory Health Questionnaire
6.
Children's Respiratory Health Questionnaire
7.
Consent Form for Participants in Study's Respiratory Health Medical Evaluation
8.
Initial and Periodic Respiratory Health Evaluation Questionnaires
9.
Physical Examination Form
10. Kansas Cancer
Registry Validation Form
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