OMB.report

Federal forms, ICRs, and supporting documents

OMB control number

[NIOSH] Noise Exposures and Hearing Loss in the Oil and Gas Extraction Industry

OMB 0920-1416 ยท HHS/CDC.

OMB 0920-1416

The proposed data collection will provide an initial step toward achieving a prioritized activity goals identified by the National Occupational Research Agenda (NORA) for workers in the Oil and Gas sector, specifically addressing goals related to hearing loss. NORA is a partnership program designed to stimulate innovative research and improve workplace practices. Unveiled in 1996, NORA has become a research framework for NIOSH and the nation. Diverse parties (industry, academia, government, insurance, etc.) collaborate to identify the most critical issues in workplace safety and health.

The latest form for [NIOSH] Noise Exposures and Hearing Loss in the Oil and Gas Extraction Industry expires 2026-10-31 and is listed under ICR 202502-0920-009.

Latest Forms, Documents, and Supporting Material

Latest forms, documents, and information collections
DocumentType
Form 0920-22DI Attachment G_Audiometry testing data captureForm and Instruction
Form 0920-22DI Audiometry TestingForm and Instruction
Form 0920-22DI ConsentForm and Instruction
Form 0920-22DI Informed ConsentForm and Instruction
Form 0920-25-0022 Attachment C_Noise_and_Hearing_Questionnaire_amended Feb 2025Form
Form 0920-22DI Attachment C_Noise_and_Hearing_QuestionnaireForm and Instruction
Form 0920-22DI Noise and Hearing QuestionnaireForm and Instruction
Change Request form EO 14168_BK.docxJustification for No Material/Nonsubstantive Change
Change Request form EO 14168_BK.docx Justification for No Material/Nonsubstantive Change
Attachment B_60_day FRN.pdfSupplementary Document
Attachment B_60_day FRN.pdf Supplementary Document
NIOSH IRB Conditional Approval Report.docxSupplementary Document
NIOSH IRB Conditional Approval Report.docx Supplementary Document
Attachment J_Audiometric exam results notification letter.docxSupplementary Document
Attachment J_Audiometric exam results notification letter.docx Supplementary Document
Attachment I_Exposure results notification letter.docxSupplementary Document
Attachment I_Exposure results notification letter.docx Supplementary Document
Attachment H_Sample forms.docxSupplementary Document
Attachment H_Sample forms.docx Supplementary Document
Attachment E_Fact sheet.docxSupplementary Document
Attachment E_Fact sheet.docx Supplementary Document
Attachment D_Introductory recruitment letter.docxSupplementary Document
Attachment D_Introductory recruitment letter.docx Supplementary Document
Attachment A - Authorizing Legislation.docxSupplementary Document
Attachment A - Authorizing Legislation.docx Supplementary Document
Supporting Statement B_04-12-23.docxSupporting Statement B
Supporting Statement B_04-12-23.docxSupporting Statement B
Supporting Statement A_04-12-23.docxSupporting Statement A
Supporting Statement A_04-12-23.docxSupporting Statement A
Audiometry Testing Form and Instruction
Audiometry Testing Form and Instruction
Informed Consent Form and Instruction
Informed Consent Form and Instruction
Noise and Hearing Questionnaire Form
Noise and Hearing Questionnaire Form and Instruction
Noise and Hearing Questionnaire Form and Instruction

All Historical Document Collections

Historical document collections
ReferenceFilingReceivedConcludedAction
202502-0920-009 No material or nonsubstantive change to a currently approved collection 2025-03-28
202308-0920-005 New collection (Request for a new OMB Control Number) 2023-08-30 Approved without change

OMB Details

Noise and Hearing Questionnaire

Federal Enterprise Architecture: Workforce Management - Worker Safety

Information collection instruments
FormNameElectronic accessType
Form 0920-25-0022Attachment C_Noise_and_Hearing_Questionnaire_amended Feb 2025Fillable FileableForm
Form 0920-22DIAttachment C_Noise_and_Hearing_QuestionnaireFillable FileableForm and instruction

Review document collections for all forms, instructions, and supporting documents - including paper/printable forms.