Attachment E3 Printed Material Available for Participants revised 8-30-2010

Attachment E3: Printed Material Available For Participants

NATIONAL INSTITUTE FOR OCCUPATIONAL SAFETY AND HEALTH (NIOSH)

CENTERS FOR DISEASE CONTROL

U.S. PUBLIC HEALTH SERVICE

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

AGREEMENT TO PARTICIPATE IN A RESEARCH STUDY

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You have been asked to participate in a NIOSH research study. We explain here the nature of your participation, describe your rights, and specify how NIOSH will treat your records.

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I. DESCRIPTION

1. Title:

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

2. Sponsor and/or Project Director:

The National Institute for Occupational Safety and Health (NIOSH), Karl Sieber (Project Officer)

3. Purpose of Research:

The purpose of this study is to learn more the about the hazards faced by long-haul truck drivers. This survey is being conducted by Westat, on behalf of the National Institute for Occupational Safety and Health, otherwise known as NIOSH. NIOSH improves worker safety and health through research and education. NIOSH does NOT enforce any laws.

We will ask about your work, your health, and your work-related injuries. The interview will last about 45 minutes, plus about 5 minutes to take some body measurements

Benefits of Research:

You will not receive any direct benefit from being in this survey. However, your honest answers may increase our knowledge of the health and safety issues facing long-haul truck drivers.

II. CONDITIONS OF THE STUDY

1. Procedures that we will use:

For most questions, an interviewer will read you each survey question. Then, the interviewer will ask you to answer the question. At the end of the interview you will be asked to fill out an activity diary for the last 48 hours, following which your height, weight, and neck size will be measured.

The interview will last about 50minutes.

You may find that some of the questions personal or sensitive. You may choose not to answer any question, for any reason. If you do not want to answer a question, just say so, and the interviewer will move on to the next one. You may also stop the interview at any time.

2. Risks Associated with Participation:

There is very little risk to you if you take part in this survey. We will not collect your name or any other data that can identify you. All data we collect will be private and protected to the extent permitted by law.

3. Injury or harm from this project is unlikely. But if it results, medical care is not provided, other than emergency treatment. If you are injured through negligence of a NIOSH employee you may be able to obtain compensation under Federal Law. If you want to file a claim against the Federal government your contact point is: Public Health Service Claims Office: (301) 443-1904. If you are injured or harmed through the negligence of a NIOSH contractor, your claim would be against the contractor, not the federal government. If an injury or harm should occur to you as the result of your participation, you also should contact: Karl Sieber, Project Officer, 513-841-4231 or Cheryl F. Estill, Chair NIOSH HSRB, 513-533-8591.

4. If you have questions about this research, contact Karl Sieber, Project Officer, at 513- 841-4231. If you have questions about your rights as a member of this study, please contact Cheryl F. Estill, Chair NIOSH Human Subjects Review Board at 513-533-8591, Monday-Friday, 8:30 to 5:00 Eastern Time.

5. You may take part in this survey or not. The choice is yours. If you say ‘no’, you will not lose any benefits that you normally have the right to receive. If you choose to take part, you do not have to answer every question or you may quit at any time. When we are done with the entire interview, you will receive either a $25 gift card to use at any stop in this truck stop chain or a cash card as reimbursement for your participation. Field study results are likely to be available in 2011 and will be made available by contacting the Project Officer, through publication in scientific journals and notices in trade publications, and through the Internet.

III. USE OF INFORMATION

This study is being done by The National Institute for Occupational Safety and Health (NIOSH). NIOSH is part of the Centers for Disease Control and Prevention (CDC), a government agency in the Department of Health and Human Services. We collect this information in order to learn about various kinds of work hazards that may influence the health of the American worker.

NIOSH is allowed to collect and keep information about you, including your results from this study, because of three laws passed by Congress. These laws are:

1. The Public Health Service Act (42 U.S.C 241)

2. The Occupational Safety and Health Act (29 U.S.C. 669)

3. The Federal Mine Safety and Health Act of 1977 (30 U.S.C. 951)

This survey is anonymous, meaning that we will not ask you for any identification. All of the answers you give to the questions will be stored in a locked file cabinet, accessible only to project staff. This handout is not connected to the answers you give to the questions we are testing.