Mine Worker Recruitment Script/Consent

Attachment H

Mine Worker Recruitment Script

Form Approved
OMB No. 0920-xxxx
Exp. Date xx/xx/20xx

First, thank you very much for your time. We conduct research for the National Institute for Occupational Safety and Health (NIOSH) Office of Mine Safety and Health Research (OMSHR). We collect information to learn about various kinds of work hazards that may affect the health and safety of the mine worker. In the current study we are recruiting mine workers to participate in a study that is assessing ways that workers can reduce exposure to respirable dust and improve other health/safety behaviors as a result of increased organizational support.

As you know, respiratory diseases, such as silicosis, occur among mine workers who undergo prolonged exposure to dust. Helmet-CAM technology assists workers in seeing areas of higher dust exposure, allows you to try and mitigate problems that cause exposure, and quickly see if the behavior change made a difference in your exposure level. Several mine sites are using this technology as a learning tool. In this study, we are looking for workers who are willing to wear the Helmet-CAM for up to two hours over a period of several weeks while completing work tasks as usual. After wearing the Helmet-CAM, we will go over the video footage and maximum dust exposure levels with you. During this time we can answer questions about the data and also ask you what you think has the biggest impact on your dust exposure and what you would like to change. Please note, the footage on the Helmet-CAM will not be shared with any other individuals except and is only being used to provide information about dust-control corrective behaviors.

If you choose to participate in this study, you will be asked to provide information at three different time points over a six week period. These three time points include the following:

• A pre- survey, wearing the Helmet-CAM, and completing an interview. This will take no more than two hours.

• An interview that includes wearing the Helmet-CAM. This will take no more than one hour.

• A post- survey and interview that includes a final wearing of the Helmet-CAM. This will take no more than one hour and 15 minutes.

The questions that will be asked pose minimal risk to you, if you participate. You may choose not to answer any question. You will not be asked to write your name on any of the materials you complete. Information collected from you will be kept confidential and no individual data will be reported.

You will not receive compensation or reimbursement for your time but will be participating during normal work hours. Surveys and interviews will occur onsite behind closed doors to help maintain your confidentiality. Your participation is entirely voluntary and you have the right to discontinue your participation without penalty.

Throughout the research study you may learn methods to reduce your exposure to respirable dust. Long term, this study may reduce the number of workers who are diagnosed with silicosis by offering insights into ways the mining environment and personal behaviors can be modified to reduce sources of respirable dust exposure.

Only NIOSH staff who are involved in collecting or preparing the information for analysis will have access to your answers. Questions are not of a sensitive nature and you may chose not to answer any or all of them. If you have any comments about the study procedures or your rights as a participant, you should contact Emily Haas, Principal Investigator, 412.386.4627. Do you have any questions?

Public reporting burden of this collection of information is estimated to average 5 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden to CDC/ATSDR Information Collection Review Office, 1600 Clifton Road NE, MS D-74, Atlanta, Georgia 30333; ATTN: PRA (0920-xxxx).