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

Forms and Documents

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

IC Document Collections

IC ID	Document Title	Status
193332	Main interview Form	New
193331	Non-respondent interview Form	New
193330	Eligibility Screening Form	New

ICR Details

OMB Control No: 0920-0865	ICR Reference No: 201006-0920-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: National Survey of U.S. Long-Haul Truck Driver Injury and Health
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 09/23/2010
	Date Received in OIRA: 06/21/2010
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	09/30/2011	12 Months From Approved
Responses	6,517	0	0
Time Burden (Hours)	2,102	0	0
Cost Burden (Dollars)	0	0	0

---

Abstract: Truck drivers experience high rates of illness and occupational injury, but little is known about the prevalence of specific health conditions or factors that place them at risk. Operational characteristics predispose truck drivers to fatigue, and may contribute to stress and chronic disease. Long work hours may increase exposure to risks associated with vibration, chemicals, dust, noise and vehicle emissions. This survey will allow NIOSH to explore inter-relationships among dimensions of occupational injury, health status, risk factors, fatigue, and putative environmental exposures.

---

Authorizing Statute(s): PL: Pub.L. 29 - 671 20 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

---

Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

---

Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 55559	10/28/2009
30-day Notice:	Federal Register Citation:	Citation Date:
	75 FR 33622	06/14/2010
Did the Agency receive public comments on this ICR? Yes

---

Number of Information Collection (IC) in this ICR: 3

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

---

ICR Summary 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

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement: This is a new ICR.

---

Annual Cost to Federal Government: $1,113,268

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

---

Common Form ICR:  No

---

On behalf of this Federal agency, I certify that the collection of information encompassed by this request complies with 5 CFR 1320.9 and the related provisions of 5 CFR 1320.8(b)(3).

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 language 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) about:

(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.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

If you are unable to certify compliance with any of these provisions, identify the item by leaving the box unchecked and explain the reason in the Supporting Statement.

Certification Date: 06/21/2010

---