Information Collection

[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers

IC 271878 under ICR 202503-0920-028 · OMB 0920-1154.

⚠️ Notice: This information collection may be referencing outdated material. More recent filings for OMB 0920-1154 can be found here:

Documents and Forms

Document Name Document Type
[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers Form and Instruction
[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers Form and Instruction
Focus Group Conversation Guide for Women Mine Workers Attachment B -- focus group conversation guide for women mine workers_10.18.24.docx Form and Instruction
Focus Group Conversation Guide for Women Mine Workers Attachment B -- focus group conversation guide for women mine workers_10.18.24.docx Form and Instruction
Focus Group Conversation Guide for Mine Managers and HS Attachment C -- focus group conversation guide for mine managers and hs professionals_10.18.24.docx Form and Instruction
Focus Group Conversation Guide for Mine Managers and HS Attachment C -- focus group conversation guide for mine managers and hs professionals_10.18.24.docx Form and Instruction
Demo Attachment D -- demographic and work history survey_10.29.24_CLEAN.docx Form and Instruction
Demo Attachment D -- demographic and work history survey_10.29.24_CLEAN.docx Form and Instruction
Attachment A -- authorizing legislation.pdf Authorizing Legislation IC Document
Attachment A -- authorizing legislation.pdf Authorizing Legislation IC Document
Attachment E -- recruitment materials_10.18.24.docx Recruitment Materials IC Document
Attachment E -- recruitment materials_10.18.24.docx Recruitment Materials IC Document
Attachment F -- 7507 Exempt Research Approval_2024-08-13.pdf Research Determination IC Document
Attachment F -- 7507 Exempt Research Approval_2024-08-13.pdf Research Determination IC Document
Attachment G -- informed consent form for women mine workers.docx Informed Consent for Women Mine Workers IC Document
Attachment G -- informed consent form for women mine workers.docx Informed Consent for Women Mine Workers IC Document
Attachment H -- informed consent form for mine managers and hs professionals.docx Informed Consent for Mine Managers and HS Professionals IC Document
Attachment H -- informed consent form for mine managers and hs professionals.docx Informed Consent for Mine Managers and HS Professionals IC Document
GenICRequest_WIM Study_10.21.2024.docx GenIC Request Template IC Document
GenICRequest_WIM Study_10.21.2024.docx GenIC Request Template IC Document
WIM SSA 10.18.2024_CLEAN_final.docx SSA IC Document
WIM SSA 10.18.2024_CLEAN_final.docx SSA IC Document
WIM SSB 10.18.2024_CLEAN.docx SSB IC Document
WIM SSB 10.18.2024_CLEAN.docx SSB IC Document

Information Collection (IC) Details

View Information Collection (IC)

IC Title:	[NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Agency IC Tracking Number:	0920-1154-25AQ

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Focus Group Conversation Guide for Women Mine Workers	Attachment B -- focus group conversation guide for women mine workers_10.18.24.docx	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Focus Group Conversation Guide for Mine Managers and HS Professionals	Attachment C -- focus group conversation guide for mine managers and hs professionals_10.18.24.docx	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Demo	Attachment D -- demographic and work history survey_10.29.24_CLEAN.docx	Yes	Yes	Fillable Fileable

Federal Enterprise Architecture Business Reference Module

Line of Business: Workforce Management

Subfunction: Worker Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 260	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 10 %

	Requested	Previously Approved
Annual Number of Responses for this IC	260	260
Annual IC Time Burden (Hours)	217	217
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
Authorizing Legislation	Attachment A -- authorizing legislation.pdf	10/29/2024
Recruitment Materials	Attachment E -- recruitment materials_10.18.24.docx	10/29/2024
Research Determination	Attachment F -- 7507 Exempt Research Approval_2024-08-13.pdf	10/29/2024
Informed Consent for Women Mine Workers	Attachment G -- informed consent form for women mine workers.docx	10/29/2024
Informed Consent for Mine Managers and HS Professionals	Attachment H -- informed consent form for mine managers and hs professionals.docx	10/29/2024
GenIC Request Template	GenICRequest_WIM Study_10.21.2024.docx	10/31/2024
SSA	WIM SSA 10.18.2024_CLEAN_final.docx	10/31/2024
SSB	WIM SSB 10.18.2024_CLEAN.docx	10/31/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.