Occupational Driver Safety at Intersections

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920 Att K_Actual Test (CIV) - Exp 2	Form	New	Repair queued
Form 0920 Att L_Advance Driver Assistance System (CIV) - Exp 2	Form	New	Repair queued
Form 0920 Att I_Sharpened Romberg Postural Stability Test (CIV) - Exp 2	Form	New	Repair queued
Form 0920 Att F_Informed Consent (CIV) - Exp 2	Form and Instruction	New	Repair queued
Form 0920 Att H_Pre/Post Drive Simulator Sickness Assessment (CIV) - Exp 2	Form	New	Repair queued
Form 0920 Att G_Motioon Sickness Screen Form (CIV) - Exp 2	Form	New	Repair queued
Form 0920- Att E _Participant Data Collection Form (CIV) - Exp 2	Form	New	Repair queued
Form 0920 Att K_Actual Test (FF) - Exp 2	Form	New	Repair queued
Form 0920 Att L_Advance Driver Assistance System (FF) - Exp 2	Form	New	Repair queued
Form 0920 Att I_Sharpened Romberg Postural Stability Test (FF) - Exp 2	Form	New	Repair queued
Form 0920 Att H_Pre/Post Drive Simulator Sickness Assessment (FF) - Exp 2	Form	New	Repair queued
Form 0920 Att G_Motioon Sickness Screen Form (FF) - Exp 2	Form	New	Repair queued
Form 0920 Att F_Informed Consent (FF) - Exp 2	Form and Instruction	New	Repair queued
Form 0920- Att E _Participant Data Collection Form (FF) - Exp 2	Form	New	Repair queued
Form 0920 Att L_Advance Driver Assistance System (LEO) - Exp 2	Form	New	Repair queued
Form 0920 Att K_Actual Test (LEO) - Exp 2	Form	New	Repair queued
Form 0920 Att I_Sharpened Romberg Postural Stability Test (LEO) -Exp 2	Form	New	Available
Form 0920 Att H_Pre/Post Drive Simulator Sickness Assessment (LEO) - Exp 2	Form	New	Repair queued
Form 0920 Att G_Motioon Sickness Screen Form (CIV) - Exp 1	Form	New	Repair queued
Form 0920 Att G_Motioon Sickness Screen Form (FF) - Exp 1	Form	New	Repair queued
Form 0920 Att F_Informed Consent (CIV) - Exp 2	Form and Instruction	New	Repair queued
Form 0920 Att F_Informed Consent (FF) - Exp 1	Form and Instruction	New	Repair queued
Form 0920- Att E _Participant Data Collection Form (CIV) - Exp 1	Form	New	Repair queued
Form 0920- Att E _Participant Data Collection Form (FF) - Exp 1	Form	New	Repair queued
Form 0920 Att G_Motioon Sickness Screen Form (LEO) - Exp 2	Form	New	Repair queued
Form 0920 Att F_Informed Consent (LEO) - Exp 2	Form and Instruction	New	Repair queued
Form 0920- Att E _Participant Data Collection Form (LEO) - Exp 2	Form	New	Repair queued
Form 0920 Att K_Actual Test (CIV) - Exp 1	Form	New	Missing upstream
Form 0920 Att I_Sharpened Romberg Postural Stability Test (CIV) - Exp 1	Form	New	Repair queued
Form 0920 Att H_Pre/Post Drive Simulator Sickness Assessment (CIV) - Exp 1	Form	New	Repair queued
Form 0920 Att K_Actual Test (FF) - Exp 1	Form	New	Repair queued
Form 0920 Att I_Sharpened Romberg Postural Stability Test (FF) - Exp 1	Form	New	Repair queued
Form 0920 Att H_Pre/Post Drive Simulator Sickness Assessment (FF) - Exp 1	Form	New	Repair queued
Form 0920 Att K_Actual Test (LEO) - Exp 1	Form	New	Repair queued
Form 0920 Att I_Sharpened Romberg Postural Stability Test (LEO) -Exp 1	Form	New	Missing upstream
Form 0920 Att H_Pre/Post Drive Simulator Sickness Assessment (LEO) - Exp 1	Form	New	Repair queued
Form 0920 Att G_Motioon Sickness Screen Form (LEO) - Exp 1	Form	New	Repair queued
Form 0920 Att F_Informed Consent (LEO) - Exp 1	Form and Instruction	New	Repair queued
Form 0920- Att E _Participant Data Collection Form (LEO) - Exp 1	Form	New	Repair queued
Attachment C 17-DSR-03XP 071319 HSRB Approval Letter and protocol.pdf	Supplementary Document	Uploaded 2020-07-20	Repair queued
SSB Intersection Safety ICR.docx	Supporting Statement B	Uploaded 2020-07-20	Repair queued
Attachment A OSH Act of 1970 (1).pdf	Supplementary Document	Uploaded 2020-07-20	Repair queued
SSA Intersection Safety ICR.docx	Supporting Statement A	Uploaded 2020-07-20	Missing upstream

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
243025	Att K_Actual Test (CIV) - Exp 2	Form	New
243024	Att J_Practice Roadmmap - Driving Practice in Stimulator (CIV) - Exp 2	Instruction	New
243023	Att L_Advance Driver Assistance System (CIV) - Exp 2	Form	New
243022	Att I_Sharpened Romberg Postural Stability Test (CIV) - Exp 2	Form	New
243021	Att F_Informed Consent (CIV) - Exp 2	Form and Instruction	New
243020	Att H_Pre/Post Drive Simulator Sickness Assessment (CIV) - Exp 2	Form	New
243019	Att G_Motioon Sickness Screen Form (CIV) - Exp 2	Form	New
243018	Att E _Participant Data Collection Form (CIV) - Exp 2	Form	New
243017	Att D - Email Confirmation of Participation (CIV) - Exp 2	Other-Email	New
243015	Att K_Actual Test (FF) - Exp 2	Form	New
243014	Att J_Practice Roadmmap - Driving Practice in Stimulator (FF) - Exp 2	Instruction	New
243013	Att L_Advance Driver Assistance System (FF) - Exp 2	Form	New
243012	Att I_Sharpened Romberg Postural Stability Test (FF) - Exp 2	Form	New
243011	Att H_Pre/Post Drive Simulator Sickness Assessment (FF) - Exp 2	Form	New
243010	Att G_Motioon Sickness Screen Form (FF) - Exp 2	Form	New
243009	Att F_Informed Consent (FF) - Exp 2	Form and Instruction	New
243008	Att E _Participant Data Collection Form (FF) - Exp 2	Form	New
243007	Att L_Advance Driver Assistance System (LEO) - Exp 2	Form	New
243003	Att D - Email Confirmation of Participation (FF) - Exp 2	Other-Email	New
243002	Att K_Actual Test (LEO) - Exp 2	Form	New
243001	Att J_Practice Roadmmap - Driving Practice in Stimulator (LEO) - Exp 2	Instruction	New
243000	Att I_Sharpened Romberg Postural Stability Test (LEO) -Exp 2	Form	New
242999	Att H_Pre/Post Drive Simulator Sickness Assessment (LEO) - Exp 2	Form	New
242998	Att G_Motioon Sickness Screen Form (CIV) - Exp 1	Form	New
242997	Att G_Motioon Sickness Screen Form (FF) - Exp 1	Form	New
242996	Att F_Informed Consent (CIV) - Exp 2	Form and Instruction	New
242995	Att F_Informed Consent (FF) - Exp 1	Form and Instruction	New
242994	Att E _Participant Data Collection Form (CIV) - Exp 1	Form	New
242993	Att E _Participant Data Collection Form (FF) - Exp 1	Form	New
242992	Att D - Email Confirmation of Participation (CIV) - Exp 1	Other-Email	New
242991	Att D - Email Confirmation of Participation (FF) - Exp 1	Other-Email	New
242990	Att G_Motioon Sickness Screen Form (LEO) - Exp 2	Form	New
242989	Att F_Informed Consent (LEO) - Exp 2	Form and Instruction	New
242988	Att E _Participant Data Collection Form (LEO) - Exp 2	Form	New
242987	Att D - Email Confirmation of Participation (LEO) - Exp 2	Other-Email	New
242874	Att K_Actual Test (CIV) - Exp 1	Form	New
242844	Att J_Practice Roadmmap - Driving Practice in Stimulator (CIV) - Exp 1	Instruction	New
242843	Att I_Sharpened Romberg Postural Stability Test (CIV) - Exp 1	Form	New
242842	Att H_Pre/Post Drive Simulator Sickness Assessment (CIV) - Exp 1	Form	New
242841	Att K_Actual Test (FF) - Exp 1	Form	New
242840	Att J_Practice Roadmmap - Driving Practice in Stimulator (FF) - Exp 1	Instruction	New
242839	Att I_Sharpened Romberg Postural Stability Test (FF) - Exp 1	Form	New
242838	Att H_Pre/Post Drive Simulator Sickness Assessment (FF) - Exp 1	Form	New
242837	Att K_Actual Test (LEO) - Exp 1	Form	New
242836	Att J_Practice Roadmmap - Driving Practice in Stimulator (LEO) - Exp 1	Instruction	New
242835	Att I_Sharpened Romberg Postural Stability Test (LEO) -Exp 1	Form	New
242834	Att H_Pre/Post Drive Simulator Sickness Assessment (LEO) - Exp 1	Form	New
242830	Att G_Motioon Sickness Screen Form (LEO) - Exp 1	Form	New
242829	Att F_Informed Consent (LEO) - Exp 1	Form and Instruction	New
242736	Att E _Participant Data Collection Form (LEO) - Exp 1	Form	New
242735	Att D - Email Confirmation of Participation (LEO) - Exp 1	Other-Email	New

ICR Details

OMB Control No:	ICR Reference No: 202007-0920-006
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-20IP
Title: Occupational Driver Safety at Intersections
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular	Date Submitted to OIRA: 08/06/2020

table that charts list comparision

	Requested	Previously Approved
Expiration Date	36 Months From Approved
Responses	561	0
Time Burden (Hours)	341	0
Cost Burden (Dollars)	0	0

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Abstract: The objective of this project is to establish a science-based database on effects of occupation, vehicle type, vehicle approach speed, signal light logic, and emergency response status on emergency vehicle driver decision-making at intersections. This 3-year data collection will gather experimental information in the CDC/NIOSH Motor Vehicle Safety Research Lab on the effects of occupation, vehicle type, signal light logic, and emergency response status on emergency vehicle driver decision-making at intersections. This data collection is important for advancing the safety of approximately 900,000 law enforcement officers and 1,134,400 career and volunteer firefighters.

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Authorizing Statute(s): PL: Pub.L. 91 - 596 2193 Name of Law: OSH Act 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:
	85 FR 10689	02/25/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 43846	07/20/2020
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 51

table that charts list of burden

IC Title	Form No.	Form Name
Att G_Motioon Sickness Screen Form (CIV) - Exp 1	0920	Motion Sickness Screen Form
Att H_Pre/Post Drive Simulator Sickness Assessment (LEO) - Exp 2	0920	Pre and Post Drive Simulator Sickness Assessment
Att I_Sharpened Romberg Postural Stability Test (LEO) -Exp 2	0920	Sharpened Romberg Postural Stability Test
Att J_Practice Roadmmap - Driving Practice in Stimulator (LEO) - Exp 2
Att K_Actual Test (LEO) - Exp 2	0920	Actual Test Roadmap
Att D - Email Confirmation of Participation (FF) - Exp 2
Att D - Email Confirmation of Participation (LEO) - Exp 2
Att E _Participant Data Collection Form (LEO) - Exp 2	0920-	PARTICIPANT DATA COLLECTION FORM
Att F_Informed Consent (LEO) - Exp 2	0920	Informed Consent
Att G_Motioon Sickness Screen Form (LEO) - Exp 2	0920	Motion Sickness Screen Form
Att D - Email Confirmation of Participation (FF) - Exp 1
Att E _Participant Data Collection Form (CIV) - Exp 1	0920-	PARTICIPANT DATA COLLECTION FORM
Att D - Email Confirmation of Participation (CIV) - Exp 1
Att F_Informed Consent (FF) - Exp 1	0920	Informed Consent
Att F_Informed Consent (CIV) - Exp 2	0920	Informed Consent
Att G_Motioon Sickness Screen Form (FF) - Exp 1	0920	Motion Sickness Screen Form
Att E _Participant Data Collection Form (FF) - Exp 1	0920-	PARTICIPANT DATA COLLECTION FORM
Att F_Informed Consent (FF) - Exp 2	0920	Informed Consent
Att G_Motioon Sickness Screen Form (FF) - Exp 2	0920	Motion Sickness Screen Form
Att H_Pre/Post Drive Simulator Sickness Assessment (FF) - Exp 2	0920	Pre and Post Drive Simulator Sickness Assessment
Att E _Participant Data Collection Form (FF) - Exp 2	0920-	PARTICIPANT DATA COLLECTION FORM
Att I_Sharpened Romberg Postural Stability Test (CIV) - Exp 2	0920	Sharpened Romberg Postural Stability Test
Att L_Advance Driver Assistance System (CIV) - Exp 2	0920	Pre and Post Drive Simulator Sickness Assessment
Att I_Sharpened Romberg Postural Stability Test (FF) - Exp 2	0920	Sharpened Romberg Postural Stability Test
Att L_Advance Driver Assistance System (FF) - Exp 2	0920	Pre and Post Drive Simulator Sickness Assessment
Att J_Practice Roadmmap - Driving Practice in Stimulator (FF) - Exp 2
Att K_Actual Test (FF) - Exp 2	0920	Actual Test Roadmap
Att D - Email Confirmation of Participation (CIV) - Exp 2
Att E _Participant Data Collection Form (CIV) - Exp 2	0920-	PARTICIPANT DATA COLLECTION FORM
Att G_Motioon Sickness Screen Form (CIV) - Exp 2	0920	Motion Sickness Screen Form
Att H_Pre/Post Drive Simulator Sickness Assessment (CIV) - Exp 2	0920	Pre and Post Drive Simulator Sickness Assessment
Att F_Informed Consent (CIV) - Exp 2	0920	Informed Consent
Att J_Practice Roadmmap - Driving Practice in Stimulator (CIV) - Exp 2
Att K_Actual Test (CIV) - Exp 2	0920	Actual Test Roadmap
Att L_Advance Driver Assistance System (LEO) - Exp 2	0920	Pre and Post Drive Simulator Sickness Assessment
Att K_Actual Test (CIV) - Exp 1	0920	Actual Test Roadmap
Att F_Informed Consent (LEO) - Exp 1	0920	Informed Consent
Att G_Motioon Sickness Screen Form (LEO) - Exp 1	0920	Motion Sickness Screen Form
Att H_Pre/Post Drive Simulator Sickness Assessment (LEO) - Exp 1	0920	Pre and Post Drive Simulator Sickness Assessment
Att I_Sharpened Romberg Postural Stability Test (LEO) -Exp 1	0920	Sharpened Romberg Postural Stability Test
Att J_Practice Roadmmap - Driving Practice in Stimulator (LEO) - Exp 1
Att K_Actual Test (LEO) - Exp 1	0920	Actual Test Roadmap
Att H_Pre/Post Drive Simulator Sickness Assessment (FF) - Exp 1	0920	Pre and Post Drive Simulator Sickness Assessment
Att I_Sharpened Romberg Postural Stability Test (FF) - Exp 1	0920	Sharpened Romberg Postural Stability Test
Att J_Practice Roadmmap - Driving Practice in Stimulator (FF) - Exp 1
Att K_Actual Test (FF) - Exp 1	0920	Actual Test Roadmap
Att H_Pre/Post Drive Simulator Sickness Assessment (CIV) - Exp 1	0920	Pre and Post Drive Simulator Sickness Assessment
Att I_Sharpened Romberg Postural Stability Test (CIV) - Exp 1	0920	Sharpened Romberg Postural Stability Test
Att J_Practice Roadmmap - Driving Practice in Stimulator (CIV) - Exp 1
Att D - Email Confirmation of Participation (LEO) - Exp 1
Att E _Participant Data Collection Form (LEO) - Exp 1	0920-	PARTICIPANT DATA COLLECTION FORM

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ICR Summary of Burden

table that charts list of burden

	Total Request	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	561	0	0	110	451	0
Annual Time Burden (Hours)	341	0	0	95	246	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: Yes

Burden Reduction Due to: Miscellaneous Actions

Short Statement: This a NEW information collection request.

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Annual Cost to Federal Government: $243,988

Does this IC contain surveys, censuses, or employ statistical methods? No

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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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: 08/06/2020

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