Enhancing Mine Workers Abilities to Identify Hazards at Sand, Stone, and Gravel Mines

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-15XT Open Ended Questions (Mine Employee, Safety Professionals, Student)	Form and Instruction	New	Available
Form 0920-15XT Mine Specific Risk Tolerance Measure (Mine Employee, Safety Professional , Student)	Form and Instruction	New	Available
Form 0920-15XT Risk Propensity Scale (Mine Employee, Safety Professional, Student)	Form and Instruction	New	Available
Form 0920-15XT Risk Assessment Measure (Mine Workers, Safety Professional, Student)	Form and Instruction	New	Repair queued
Form 0920-15XT Demographic Questionnaire (Mine Employee, Safety Professional, Student)	Form and Instruction	New	Available
Prescreening Questionnaire (Mine Emppoyee, Safety Professional, Student)	Form and Instruction	New	Available
SSB_HazRec_Part B_2_20_16.docx	Supporting Statement B	Uploaded 2016-03-10	Available
SSA_Haz Rec_OMB_bme 05JUL2016.docx	Supporting Statement A	Uploaded 2016-07-05	Available
Att I Informed Consent 3 3 16.docx	Supplementary Document	Uploaded 2016-03-10	Available
Att A Authorizing Legislation.docx	Supplementary Document	Uploaded 2016-03-09	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
220560	Open Ended Questions (Mine Employee, Safety Professionals, Student)	Form and Instruction	New
220559	Mine Specific Risk Tolerance Measure (Mine Employee, Safety Professional , Student)	Form and Instruction	New
220558	Risk Propensity Scale (Mine Employee, Safety Professional, Student)	Form and Instruction	New
220557	Risk Assessment Measure (Mine Workers, Safety Professional, Student)	Form and Instruction	New
220556	Experimental Task (Mine Employee, Safety Professional, Student)	Instruction	New
220555	Demographic Questionnaire (Mine Employee, Safety Professional, Student)	Form and Instruction	New
220547	Prescreening Questionnaire (Mine Emppoyee, Safety Professional, Student)	Form and Instruction	New

ICR Details

OMB Control No: 0920-1121	ICR Reference No: 201603-0920-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 15XT
Title: Enhancing Mine Workers Abilities to Identify Hazards at Sand, Stone, and Gravel Mines
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: 07/05/2016
	Date Received in OIRA: 03/11/2016
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2018	24 Months From Approved
Responses	229	0	0
Time Burden (Hours)	77	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: Hazard recognition is a necessary skill for all mine workers; therefore, a better understanding of the hazard recognition process within the mining environment is a critical need that this research will fulfill for the industry. The objective of the project is to characterize SSG mine workers' ability to recognize worksite hazards, to understand how this ability relates to perceived and measured risk as well as to other factors internal and external to the SSG mine worker.

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Authorizing Statute(s): Statute at Large: 91 Stat. 173 Name of Statute: Federal Mine Safety and 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:
	80 FR 18844	04/08/2015
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 12732	03/10/2016
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 7

table that charts list of burden

IC Title	Form No.	Form Name
Mine Specific Risk Tolerance Measure (Mine Employee, Safety Professional , Student)	0920-15XT	Att G Mine Specific
Risk Propensity Scale (Mine Employee, Safety Professional, Student)	0920-15XT	Att F Risk Propensity
Open Ended Questions (Mine Employee, Safety Professionals, Student)	0920-15XT	Att H QualitativeOpenended Questions
Demographic Questionnaire (Mine Employee, Safety Professional, Student)	0920-15XT	Att C Demographic Questionaire
Prescreening Questionnaire (Mine Emppoyee, Safety Professional, Student)	NA	Pre-Screening Questionnaire 05JUL2016
Experimental Task (Mine Employee, Safety Professional, Student)
Risk Assessment Measure (Mine Workers, Safety Professional, Student)	0920-15XT	Att E Risk Assessment

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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	229	0	0	229	0	0
Annual Time Burden (Hours)	77	0	0	77	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 ICR.

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Annual Cost to Federal Government: $257,775

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: 03/11/2016

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