Emergency Self-Escape for Coal Miners

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
HTA Focus Group Sessions	Form	New	Available
Initial Focus Group Sessions	Form	New	Available
CTA Interviews	Form	New	Available
Initial Interviews	Form	New	Available
Informed Consent	Form	New	Available
Recruitment Script	Form	New	Available
Revision 20150817_SS A (clean).docx	Supporting Statement A	Uploaded 2015-08-17	Available
Attachment H- IRB.pdf	Supplementary Document	Uploaded 2015-03-05	Available
Attachment G- Obs Forms.docx	Supplementary Document	Uploaded 2015-03-05	Available
Revised 20150817_SS B (clean).docx	Supporting Statement B	Uploaded 2015-08-17	Available
Attachment B.pdf	Supplementary Document	Uploaded 2015-03-05	Available
Attachment A.doc	Supplementary Document	Uploaded 2015-03-05	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
215553	HTA Focus Group Sessions	Form	New
215552	Initial Focus Group Sessions	Form	New
215551	CTA Interviews	Form	New
215550	Initial Interviews	Form	New
215549	Informed Consent	Form	New
215548	Recruitment Script	Form	New

ICR Details

OMB Control No: 0920-1081	ICR Reference No: 201503-0920-004
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15GD
Title: Emergency Self-Escape for Coal Miners
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: 08/18/2015
	Date Received in OIRA: 04/02/2015
Terms of Clearance: This pilot study is intended to be the first of a series of projects conducted by NIOSH in the area of mine self-escape emergency response and training. This project will conduct a case study on two mines to establish some of the factors necessary for consideration when evaluating the cognitive and physical activities involved in miner self-escape. This study does not sample from a series of mines representative of the United States mining industry and is thus not designed to produce outcomes that will directly result in the development of best practices guidance.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2017	24 Months From Approved
Responses	234	0	0
Time Burden (Hours)	207	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The National Institute for Occupational Safety and Health (NIOSH) seeks to identify and specify the physical and mental tasks required for underground coal miners to successfully escape a mine emergency under various mine disaster scenarios.

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Authorizing Statute(s): PL: Pub.L. 95 - 164 501 Name of Law: Federal Mine Safety & Health Act of 1977
  

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:
	79 FR 73586	12/11/2014
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 16398	03/27/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

table that charts list of burden

IC Title	Form No.	Form Name
Recruitment Script	none	Recruitment script
Informed Consent	none	Informed Consent
Initial Interviews	none	Initial Interviews
CTA Interviews	none	CTA Interviews
Initial Focus Group Sessions	none	Initial Focus Group Sessions
HTA Focus Group Sessions	none	HTA Focus group

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ICR Summary of Burden

table that charts list 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	234	0	0	234	0	0
Annual Time Burden (Hours)	207	0	0	207	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 data collection request.

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Annual Cost to Federal Government: $178,970

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]? 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: 04/02/2015

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