Evaluating the Effectiveness of Occupational Safety and Health Program Elements in theWholesale Retail Sector

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Att E-3_Comparison of US and Ohio NAICS codes.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att E-2_Letter of Support from OBWC.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att K_OSH Program Survey Sample Size Requirements.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att J_OSH Program Survey Sampling Strategy.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att I_IRB.pdf	Supplementary Document	Uploaded 2015-10-05	Available
Att F_Information Security Plan.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att E-1_OBWC- NIOSH Letter of Agreement.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att D-2_Prior OSH Program intervention studies.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att D-1_Relation of project to CDCs broader research.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att C_NIOSH Strategic Goals.docx	Supplementary Document	Uploaded 2015-10-05	Available
Att B_60-day.pdf	Supplementary Document	Uploaded 2015-10-05	Available
Att A_Authorizing Legislation.docx	Supplementary Document	Uploaded 2015-10-05	Available
Sup Sta B.092515..docx	Supporting Statement B	Uploaded 2015-09-28	Available
Section A.092515.docx	Supporting Statement A	Uploaded 2015-09-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
202833	Non-Respondent Follow-up Interview	Other-WORD	Modified
202832	Informed Consent to Participate in a Leading Indicbenchmarking Research Project	Other-WORD	Modified
202831	Occupational Safety and Health Program Evaluation Survey Year 1	Other-WORD	Modified

ICR Details

OMB Control No: 0920-0949	ICR Reference No: 201509-0920-004
Status: Historical Inactive	Previous ICR Reference No: 201206-0920-005
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-0949
Title: Evaluating the Effectiveness of Occupational Safety and Health Program Elements in theWholesale Retail Sector
Type of Information Collection: Extension without change of a currently approved collection	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Withdrawn	Conclusion Date: 02/03/2016
	Date Received in OIRA: 10/07/2015
Terms of Clearance: CDC informed OMB that due to problems with the Contractor (unable to recruit required number of participants), on January 5, 2016 the contract was de-scoped. Unexpended funds will be de-obligated and contract CLOSED by the end of February. CDC requests to withdraw this extension request and discontinued.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date		36 Months From Approved	02/29/2016
Responses	0	0	9,600
Time Burden (Hours)	0	0	1,681
Cost Burden (Dollars)	0	0	0

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Abstract: NIOSH proposes to continue a study to assess the effectiveness of occupational safety and health elements among wholesale/retail trade (WRT) employers. The proposed research involves a firm-level survey of a series of organizational metrics considered to be potential predictors of injury and illness workers' compensation claim rates and duration in a stratified sample of WRT firms in Ohio. There are expected to be up to 4,104 participant firms and surveys will be administered twice to the same firms in successive years (e.g. from January- December 2014 and again from January- December 2015). A nested study at 60 firms will ask multiple respondents at each firm to participate.

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Authorizing Statute(s): PL: Pub.L. 91 - 596 20-22 Name of Law: Occupational Safety and Health Act of 1970
  

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:
	80 FR 39781	07/10/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	80 FR 60149	10/05/2015
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 3

table that charts list of burden

IC Title	Form No.	Form Name
Occupational Safety and Health Program Evaluation Survey Year 1
Informed Consent to Participate in a Leading Indicbenchmarking Research Project
Non-Respondent Follow-up Interview

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Burden increases because of Program Change due to Agency Discretion: No

Burden Increase Due to:

Burden decreases because of Program Change due to Agency Discretion: No

Burden Reduction Due to:

Short Statement:

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Annual Cost to Federal Government: $152,454

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: 10/07/2015

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