Information Collection Request

National Survey of U.S. Long-Haul Truck Driver Injury and Health

ICR 201006-0920-004 · OMB 0920-0865 · Historical Active

Forms and Documents

Forms and supporting documents for this ICR
DocumentTypeStatusAvailability
Main interview Form New Available
Non-respondent interview Form New Available
Eligibility Screening Form New Available
Focus Group - Cognitive Interview Report FINAL 12-05-08-1.pdf Supplementary Document Uploaded 2010-09-20 Available
Pretest Report 10-06-09-1.doc Supplementary Document Uploaded 2010-09-20 Available
parking survey-3.pdf Supplementary Document Uploaded 2010-09-20 Available
Part A Sieber Survey of Long Haul Truck Drivers revised 8-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Part B Sieber Survey of Long Haul Truck Drivers revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment E2 Oral Consent Script For All Participants revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment E3 Printed Material Available For Participants revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment F1 Recruitment Procedure To Be Used At Truck Stop revised 09-01-2010.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment F4 Non-Respondent Interview revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment F3 Eligibility Screening Interview revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment F5 Main Survey Interview revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment F6 Show Cards for Main Survey Interview revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment F7 Previous Data Collection Instruments Used revised 08-30-2010-3.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment G1 Text for Pre-Survey Publicity revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Attachment G2 Publicity Flyer To Be Posted At Truck Stop revised 08-30-2010-2.doc Supplementary Document Uploaded 2010-09-20 Available
Part B Sieber Survey of Long Haul Truck Drivers revised 08-30-2010-2.doc Supporting Statement B Uploaded 2010-09-20 Available
Attachment H Sample Size and Sample Plan.doc Supplementary Document Uploaded 2010-05-24 Available
Attachment F7 Previous Data Collection Instruments Used.doc Supplementary Document Uploaded 2010-05-24 Available
Attachment F2 Flowchart .doc Supplementary Document Uploaded 2010-05-24 Available
Attachment G3 Recruitment Procedure To Be Used At Truck Stop.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment G2 Publicity Flyer To Be Posted At Truck Stop.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment G1 Text for Pre-Survey Publicity.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment F6 Show Cards for Main Survey Interview.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment F1 Recruitment Procedure.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment E3 Printed Material Available For Participants.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment E2 Oral Consent Script For All Participants.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment E1 NIOSH HSRB Approval.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment D Stakeholder Letters of Support.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment C - NIOSH Surveillance Strategic Goal 3.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment B 60-Day FRN.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment B4 List of Webinar Attendees.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment B3 List of Public Meeting Attendees.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment B2 - Notice of Public Meeting.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment B1 Summary of Public Comment and CDC Response.doc Supplementary Document Uploaded 2010-04-28 Available
Attachment A - Occupational Safety and Health Act .doc Supplementary Document Uploaded 2010-04-28 Available
Part A Sieber Survey of Long Haul Truck Drivers revised 8-30-2010-2.doc Supporting Statement A Uploaded 2010-09-20 Available

IC Document Collections

Information collection document groups
IC IDCollectionTypeStatusForm
193332 Main interview Form New
193331 Non-respondent interview Form New
193330 Eligibility Screening Form New

ICR Details

Reginfo record details
table that charts list comparision
  Inventory as of this Action Requested Previously Approved
09/30/2011 12 Months From Approved
6,517 0 0
2,102 0 0
0 0 0





Reginfo record details
3
table that charts list of burden
IC Title Form No. Form Name
Eligibility Screening none Eligibility screening interview
Non-respondent interview none Non-respondent interview
Main interview none Main interview questionnaire

table that charts list of burden
  Total Approved Previously Approved Change Due to New Statute Change Due to Agency Discretion Change Due to Adjustment in Estimate Change Due to Potential Violation of the PRA
Annual Number of Responses 6,517 0 0 6,517 0 0
Annual Time Burden (Hours) 2,102 0 0 2,102 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0


Reginfo record details
  No