OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey

ICR 201208-0920-004 · OMB 0920-0834 · Historical Active

Forms and Documents
DocumentTypeStatusAvailability
Form 0920-0834 Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey Form and Instruction Modified Available
EMS_ICR_Section_B revised 090910_120430.doc Supporting Statement B Uploaded 2012-08-02 Available
Attachment G.doc Supplementary Document Uploaded 2012-08-02 Available
Attachment F_090910.docx Supplementary Document Uploaded 2012-08-02 Available
Attachment E.doc Supplementary Document Uploaded 2012-08-02 Available
Attachment C.doc Supplementary Document Uploaded 2012-08-02 Repair queued
Attachment H.docx Supplementary Document Uploaded 2012-08-02 Available
EMS_ICR_Section_A revised 120713.doc Supporting Statement A Uploaded 2012-08-02 Available
IC Document Collections
IC IDCollectionTypeStatusForm
191021 Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey Form and Instruction Modified
ICR Details
0920-0834 201208-0920-004
Historical Active 200910-0920-005
HHS/CDC
Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey
Revision of a currently approved collection   No
Regular
Approved without change 10/01/2012
Retrieve Notice of Action (NOA) 08/09/2012
  Inventory as of this Action Requested Previously Approved
10/31/2014 24 Months From Approved 12/31/2012
150 0 175
50 0 58
0 0 0
The purpose of this project is to conduct research to provide a detailed description of non-fatal occupational injuries and illnesses incurred by emergency medical services (EMS) workers. This project will use two related data sources. The first source is data abstracted from medical records of EMS workers treated in a nationally stratified sample of emergency departments (ED). These data are routinely collected by the occupational supplement to the National Electronic Injury Surveillance System (NEISS-Work). The second data source, for which the National Institute for Occupational Safety and Health (NIOSH) is seeking OMB approval, involves data collected from telephone interview surveys of injured EMS workers identified within NEISS-Work.
PL: Pub.L. 91 - 596 20 Name of Law: Occupational Safety and Health Act
  
None
Not associated with rulemaking
  77 FR 30014 05/21/2012
77 FR 47074 08/07/2012
Yes
  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 150 175 0 0 -25 0
Annual Time Burden (Hours) 50 58 0 0 -8 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
For this revision request, the data collected to-date were used to produce an updated estimate of the number of completed interviews to be obtained each year. The data collected thus far indicate we will collect approximately 150 interviews annually. This is a reduction from the previous estimate of 175 that was extrapolated based on routine NEISS-Work surveillance data from earlier years. This reduction resulted in a decrease in the respondent burden hours from 58 to 50.
$75,000
Yes Part B of Supporting Statement
Yes
No
No
No
Uncollected
Catina Conner 4046394775
  No
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:
 
 
 
 
 
 
 
    (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;
 
 
 
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.
08/09/2012