[NIOSH] Artificial Stone Countertops: Exposures, Controls, Surveillance, & Translation

Forms and Documents

Forms and supporting documents for this ICR

Document	Type	Status	Availability
Form 0920-22SF Workplace Survey	Form and Instruction	New	Available
Form 0920-22SF Workplace Survey	Form and Instruction	New	Repair queued
Att.4—Info Sheet.pdf	Supplementary Document	Uploaded 2023-02-14	Repair queued
Att.1—Authorizing Legislation.docx	Supplementary Document	Uploaded 2023-02-14	Repair queued
Countertop_ICR_SupportingStatement_B .docx	Supporting Statement B	Uploaded 2023-02-14	Repair queued
Countertop_ICR_SupportingStatement_A.docx	Supporting Statement A	Uploaded 2023-02-14	Repair queued

IC Document Collections

Information collection document groups

IC ID	Collection	Type	Status	Form
258548	Workplace Survey	Form and Instruction	New	Workplace Survey
258548	Workplace Survey	Form and Instruction	New

ICR Details

OMB Control No: 0920-1407	ICR Reference No: 202302-0920-012
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-22FS
Title: [NIOSH] Artificial Stone Countertops: Exposures, Controls, Surveillance, & Translation
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular
OIRA Conclusion Action: Approved with change	Conclusion Date: 06/23/2023
Retrieve Notice of Action (NOA)	Date Received in OIRA: 05/03/2023
Terms of Clearance:

table that charts list comparision

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	06/30/2026	36 Months From Approved
Responses	8,600	0	0
Time Burden (Hours)	2,150	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: The Centers for Disease Control and Prevention (CDC), National Institute for Occupational Safety and Health (NIOSH) seek approval from the Office of Management and Budget (OMB) to conduct a study involving countertop fabrication facilities using artificial stone products. The purpose of the proposed collection is to conduct a survey with artificial stone countertop fabrication facilities to better understand (1) work practices and controls related to respirable crystalline silica, (2) barriers or facilitators to implementation of medical and exposure monitoring requirements, (3) identify areas for potential intervention, and (4) identify countertop fabrication facilities willing to participate in future NIOSH exposure and health research.

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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:
	87 FR 33488	06/02/2022
30-day Notice:	Federal Register Citation:	Citation Date:
	88 FR 12361	02/27/2023
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

table that charts list of burden

IC Title	Form No.	Form Name
Workplace Survey	0920-22SF	Workplace Survey

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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	8,600	0	0	8,600	0	0
Annual Time Burden (Hours)	2,150	0	0	2,150	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 data/information collection. The annual burden is estimated to be 2,150 hours.

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Annual Cost to Federal Government: $270,427

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

table that charts list of RCF

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: 05/03/2023

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