Assessing Safety and Health Hazards of Workers in Oil and Gas Extraction: A Survey

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Attachment N. Consent Form (Spanish)_v2.docx	Supplementary Document	Uploaded 2017-07-21	Available
Attachment F. Consent Form v2.docx	Supplementary Document	Uploaded 2017-07-21	Available
SSA v3 clean (002).docx	Supporting Statement A	Uploaded 2017-07-21	Available
SSB v3 clean (002).docx	Supporting Statement B	Uploaded 2017-07-21	Available
Att M. Worker Handout.docx	Supplementary Document	Uploaded 2017-04-28	Available
Att I. Worker Response Tracking Form.docx	Supplementary Document	Uploaded 2017-04-28	Repair queued
Attachment H. Letter to Workers v2.docx	Supplementary Document	Uploaded 2017-07-21	Available
Attachment G. Flyer v2.pdf	Supplementary Document	Uploaded 2017-07-21	Available
Att E. HSRB 15-WSD-01XP Approval.pdf	Supplementary Document	Uploaded 2017-04-28	Available
Att B. FRN 60-day 2016-18940.pdf	Supplementary Document	Uploaded 2017-04-28	Available
Att A. OSHA Act of 1970 (Sec. 20a1).PNG	Supplementary Document	Uploaded 2017-04-28	Available

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
226611	Att C_Oil and Gas Extraction Workers Survey - Module 4 (Hardcopy)	Other-WORD	New
226610	Att D_ Non Respondent Questionnaire	Other-WORD & WEB	New
226608	Att C_Oil and Gas Workers Safety and Health Survey 2,3,5 (Hardcopy)	Other-WORD	New
226607	Att C_Oil and Gas Extraction Workers Survey - Module 4 (WEB)	Other-WEB	New
226604	Att C_Oil and Gas Workers Safety and Health Survey-Module 2,3,5 (WEB)	Other-WEB	New
226601	Att K_Screening	Other-WORD	New

ICR Details

OMB Control No: 0920-1195	ICR Reference No: 201704-0920-010
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16AXC
Title: Assessing Safety and Health Hazards of Workers in Oil and Gas Extraction: A Survey
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: 07/25/2017
	Date Received in OIRA: 05/02/2017
Terms of Clearance: Approved consistent with the understanding that this study is intended primarily to generate hypotheses and acknowledges the limitations inherent in its convenience sampling design--which will be communicated in any presentations, publications, or reports.

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	07/31/2019	24 Months From Approved
Responses	813	0	0
Time Burden (Hours)	151	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: This is a new information collection request (ICR) from the National Institute for Occupational Safety and Health (NIOSH), Centers for Disease Control and Prevention (CDC). This ICR is to conduct a survey of U.S. land-based oil and gas extraction workers to provide current occupational safety and health data, which are not available elsewhere. Survey results will help to determine factors that contribute to injury and illness in this workforce. Second, it will help to identify the perceived safety and health needs and concerns of oil and gas extraction workers, a largely non-unionized workforce.

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Authorizing Statute(s): PL: Pub.L. 9 - 596 20(a)(1) Name of Law: Safety and Health Act
  

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:
	81 FR 52870	08/10/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	82 FR 16836	04/06/2017
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
Att C_Oil and Gas Workers Safety and Health Survey 2,3,5 (Hardcopy)
Att C_Oil and Gas Workers Safety and Health Survey-Module 2,3,5 (WEB)
Att D_ Non Respondent Questionnaire
Att C_Oil and Gas Extraction Workers Survey - Module 4 (Hardcopy)
Att C_Oil and Gas Extraction Workers Survey - Module 4 (WEB)
Att K_Screening

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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	813	0	0	813	0	0
Annual Time Burden (Hours)	151	0	0	151	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 information collection.

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Annual Cost to Federal Government: $174,584

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: 05/02/2017

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