Information Collection

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

IC 271878 under ICR 202507-0920-005 · 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⚠️ Notice: This information collection may be referencing outdated material.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

Documents and forms in this information collection
Document Name	Document Type
[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 [NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction
Focus Group Conversation Guide for Mine Managers and HS Professionals [NIOSH] Developing a Framework to Identify and Address Job Hazards Unique to Women Mine Workers	Form and Instruction
Demo [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_030525.docx	Form and Instruction
Demo Attachment D -- demographic and work history survey_030525.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 2.21.25_revised.docx SSA	IC Document
WIM SSA 2.21.25_revised.docx SSA	IC Document
WIM SSB 2.21.25_revised.docx SSB	IC Document
WIM SSB 2.21.25_revised.docx SSB	IC Document
Change Request form EO 14168_WIM.docx Change Request Justification	IC Document
Change Request form EO 14168_WIM.docx Change Request Justification	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:

0920-25-0042

IC Status: Unchanged

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	Yes	Yes	Fillable Fileable
Form and Instruction	n/a	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 %

table that charts list of burden
	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

table that charts IC Documents
Title	Document	Date Uploaded
Authorizing Legislation		10/29/2024
Recruitment Materials		10/29/2024
Research Determination		10/29/2024
Informed Consent for Women Mine Workers		10/29/2024
Informed Consent for Mine Managers and HS Professionals		10/29/2024
GenIC Request Template		10/31/2024
SSA		07/03/2025
SSB		07/03/2025
Change Request Justification		07/03/2025

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

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