Childhood Injury and Adult Occupational Injury Survey

Forms and Documents

Document Name	Status
Form QID Childhood Injury and Adult Occupational Injury Survey Form and Instruction	Modified
Presurvey Letter - 2012.pdf Supplementary Document	2012-07-23
0235 - Presurvey Letter - 2012.docx Supplementary Document	2012-06-05
0235-niosh-12-SSA - Reinstatment - July 20, 2012.docx Supporting Statement A	2012-07-23
Worker Safety Brochure - 2010-137.pdf Supplementary Document	2012-05-18
NASDA - 004 Revised - June 2009.doc Supplementary Document	2012-05-18
0535 - Agricultural Safety - 2009 Injuries to Youth - Apr 5 2012.pdf Supplementary Document	2012-05-18
0235 - Injuries to Hispanic Operators - 2008.pdf Supplementary Document	2012-05-18
0235 - Youth Injuries on Minority Farms - 2008.pdf Supplementary Document	2012-05-18
0235 - Farm and Ranch Safety Survey - 2006.pdf Supplementary Document	2012-05-18
0235 - NIOSH Bibliography of Publications - Oct 2011.doc Supplementary Document	2012-05-18
PIA - NASS UNIX MA Oct. 2011.doc Supplementary Document	2012-05-18
0235-niosh-12-SSB Reinstatement - July 20, 2012.doc Supporting Statement B	2012-07-23

IC Document Collections

IC ID	Document Title	Status
36789	Childhood Injury and Adult Occupational Injury Survey Form and Instruction	Modified
184429	Non Response Statement Other-Non Response Statement	Modified

ICR Details

OMB Control No: 0535-0235	ICR Reference No: 201205-0535-001
Status: Historical Active	Previous ICR Reference No: 200803-0535-002
Agency/Subagency: USDA/NASS	Agency Tracking No:
Title: Childhood Injury and Adult Occupational Injury Survey
Type of Information Collection: Reinstatement with change of a previously approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 07/23/2012
	Date Received in OIRA: 06/11/2012
Terms of Clearance: This information collection request is approved conditional on the receipt of a nonresponse bias analysis for the 2012 and 2014 Childhood Injury and Adult Occupational Injury Surveys prior to the submission of the next request for clearance on this docket. The nonresponse bias analysis should be consistent with OMB statistical standards and guidance, using the OMB response rate calculation method.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2015	36 Months From Approved	02/29/2012
Responses	66,668	0	150,500
Time Burden (Hours)	9,333	0	12,111
Cost Burden (Dollars)	0	0	0

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Abstract: Measure incidence of nonfatal injuries occurring to children on farms and agricultural injury to adults.

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Authorizing Statute(s): US Code: 7 USC Sec. 2276 Name of Law: Confidentiality of Information
   US Code: 18 USC Sec. 1905 Name of Law: Disclosure of Confidential Information Generally
   PL: Pub.L. 91 - 596 29 USC 669 Sec 20 Name of Law: Occupational Safety and Health Act
   US Code: 7 USC Sec. 2204 Name of Law: General Duties of Secretary
   PL: Pub.L. 91 - 173 501 Name of Law: Federal Mine Safety and Health Act
   PL: Pub.L. 107 - 347 503(a) Name of Law: CIPSEA
  

Citations for New Statutory Requirements: None

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

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Federal Register Notices & Comments
60-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 17405	03/26/2012
30-day Notice:	Federal Register Citation:	Citation Date:
	77 FR 34004	06/08/2012
Did the Agency receive public comments on this ICR? Yes

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Childhood Injury and Adult Occupational Injury Survey	QID	Childhhood Injury and Adult Occupational Injury Questionnnaire
Non Response Statement

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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	66,668	150,500	0	16,501	-100,333	0
Annual Time Burden (Hours)	9,333	12,111	0	-2,778	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: The reduction in number of responses is due primarily to an adjustment to the way in which the data was reported in the previous approval. Also the annual survey will only be conducted twice during the three year approval period, since we will skip 2013 while NASS conducts the Census of Agriculture that year.

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Annual Cost to Federal Government: $700,000

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? Yes

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]? No

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

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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: 06/11/2012

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