Assessing the Safety Culture of Underground Coal Mining Survey

Attachment C1 –

Survey Oral Consent Script

First off, we want to thank you very much for your time. Today we are conducting a research study and we would like to have you all fill out a questionnaire. This study is being done by The National Institute for Occupational Safety and Health (NIOSH). NIOSH is part of the Centers for Disease Control (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. We are looking at safety in coal mining and trying to understand what it is like and make recommendations for how it can be improved. The first part of this study will involve filling out a questionnaire. This should take about 20 minutes. Please do not write your name on this questionnaire as it is completely anonymous and you will not be linked to your responses. Information collected from you will be kept secure and no individual data will be reported from this study. Results will only be reported by groups representing at least 8 or more individual responses.

The questions on this survey pose minimal risk to you, if you participate. You may choose not to answer any question. This study involves minimal risk. Questions are not of a sensitive nature and you may chose not to answer any or all of them. If you have any comment about the tests/procedures, you should contact Katherine A. Margolis, Principal Investigator, 412.386.4627. There are also no individual benefits to participation. Your participation is entirely voluntary and you have the right to discontinue your participation without penalty. If you stay and complete the survey this is an indication that you consent to participating in this portion of the study.