Work Organization Risks to Short-haul Truck Drivers’ Health & Safety

Forms and Documents

Document Name	Status
Form 092-20BY Hardcopy Survey Sections Form	New
Form 0920-20BY Non Respondent Questionnaire Form	New
Form 0920-20BY Participant Eligibility Screening Form Form	New
LSH_OnlineSurvey_ScreenShot3.png Supplementary Document	2021-07-26
LSH_OnlineSurvey_ScreenShot2.png Supplementary Document	2021-07-23
LSH_OnlineSurvey_ScreenShot1.png Supplementary Document	2021-07-23
IRB_Approval.pdf Supplementary Document	2021-07-23
AttachmentH_LSH_LetterToWorkers_UPDATED.docx Supplementary Document	2021-07-23
AttachmentF_LSH_ConsentForm_April 22 2021.docx Supplementary Document	2021-07-23
Comments_LSH_OMB_SSB_April 22 2021 rev 7.21.21.docx Supporting Statement B	2021-07-26
Comments_LSH_OMB_SSA_April 22 2021 rev 7.21.21.docx Supporting Statement A	2021-07-26

IC Document Collections

IC ID	Document Title	Status
248535	Hardcopy Survey Sections Form	New
248534	Non Respondent Questionnaire Form	New
248533	Participant Eligibility Screening Form Form	New

ICR Details

OMB Control No:	ICR Reference No: 202107-0920-008
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-20BY
Title: Work Organization Risks to Short-haul Truck Drivers’ Health & Safety
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 07/26/2021

	Requested	Previously Approved
Expiration Date	24 Months From Approved
Responses	600	0
Time Burden (Hours)	174	0
Cost Burden (Dollars)	0	0

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Abstract: The purpose of this effort is to collect data that will guide health and safety research and outreach in this underrepresented workforce. In particular, this information will: 1) provide a preliminary exploration of potential work organization risk factors (e.g., workplace policies, practices, and procedures) that may affect the health and safety of L/SH truck drivers, 2) provide a snapshot of perceived safety and health needs and concerns of L/SH truck drivers, 3) assist in generating hypotheses for future research on health and safety topics in this workforce, and 4) provide information to the L/SH industry and the research community about driver concerns and preliminary research priorities.

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Authorizing Statute(s): None

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:
	84 FR 64076	11/20/2019
30-day Notice:	Federal Register Citation:	Citation Date:
	85 FR 30961	05/21/2020
Did the Agency receive public comments on this ICR? No

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

IC Title	Form No.	Form Name
Hardcopy Survey Sections	092-20BY	AttachmentK_LSH_RespondentScreeningForm
Non Respondent Questionnaire	0920-20BY	AttachmentD_LSH_Non-RespondentSurvey
Participant Eligibility Screening Form	0920-20BY	Comments_AttachmentC_LSHSurvey_April 22 2021

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ICR Summary 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	600	0	0	600	0	0
Annual Time Burden (Hours)	174	0	0	174	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: A total annual estimated response burden of 173.75 (174) hours for this information collection. This burden will be incurred over a 2 year period.

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Annual Cost to Federal Government: $96,871

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:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 07/26/2021

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