Information Collection Request
[NIOSH] Noise Exposures and Hearing Loss in the Oil and Gas Extraction Industry
ICR 202502-0920-009 · OMB 0920-1416 · Active
Forms and Documents
| Document | Type | Status | Availability |
|---|---|---|---|
 Form 0920-22DI Audiometry Testing |
Form and Instruction | Unchanged | Available |
| Form 0920-22DI Audiometry Testing |
Form and Instruction | Unchanged | Missing upstream |
| Form 0920-22DI Informed Consent |
Form and Instruction | Unchanged | Available |
| Form 0920-22DI Informed Consent |
Form and Instruction | Unchanged | Repair queued |
| Form 0920-22DI Noise and Hearing Questionnaire |
Form and Instruction | Modified | Available |
| Form 0920-22DI Noise and Hearing Questionnaire |
Form and Instruction | Modified | Missing upstream |
 Change Request form EO 14168_BK.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-02-26 | Repair queued |
| Change Request form EO 14168_BK.docx |
Justification for No Material/Nonsubstantive Change | Uploaded 2025-02-26 | Repair queued |
 Attachment B_60_day FRN.pdf |
Supplementary Document | Uploaded 2023-08-30 | Available |
| Attachment B_60_day FRN.pdf |
Supplementary Document | Uploaded 2023-08-30 | Repair queued |
| NIOSH IRB Conditional Approval Report.docx |
Supplementary Document | Uploaded 2023-08-23 | Available |
| NIOSH IRB Conditional Approval Report.docx |
Supplementary Document | Uploaded 2023-08-23 | Repair queued |
| Attachment J_Audiometric exam results notification letter.docx |
Supplementary Document | Uploaded 2023-08-23 | Available |
| Attachment J_Audiometric exam results notification letter.docx |
Supplementary Document | Uploaded 2023-08-23 | Repair queued |
| Attachment I_Exposure results notification letter.docx |
Supplementary Document | Uploaded 2023-08-23 | Available |
| Attachment I_Exposure results notification letter.docx |
Supplementary Document | Uploaded 2023-08-23 | Missing upstream |
| Attachment H_Sample forms.docx |
Supplementary Document | Uploaded 2023-08-23 | Available |
| Attachment H_Sample forms.docx |
Supplementary Document | Uploaded 2023-08-23 | Repair queued |
| Attachment E_Fact sheet.docx |
Supplementary Document | Uploaded 2023-08-23 | Repair queued |
| Attachment E_Fact sheet.docx |
Supplementary Document | Uploaded 2023-08-23 | Repair queued |
| Attachment D_Introductory recruitment letter.docx |
Supplementary Document | Uploaded 2023-08-23 | Available |
| Attachment D_Introductory recruitment letter.docx |
Supplementary Document | Uploaded 2023-08-23 | Missing upstream |
| Attachment A - Authorizing Legislation.docx |
Supplementary Document | Uploaded 2023-08-23 | Available |
| Attachment A - Authorizing Legislation.docx |
Supplementary Document | Uploaded 2023-08-23 | Repair queued |
| Supporting Statement B_04-12-23.docx |
Supporting Statement B | Uploaded 2023-08-23 | Available |
| Supporting Statement B_04-12-23.docx |
Supporting Statement B | Uploaded 2023-08-23 | Repair queued |
| Supporting Statement A_04-12-23.docx |
Supporting Statement A | Uploaded 2023-08-30 | Available |
| Supporting Statement A_04-12-23.docx |
Supporting Statement A | Uploaded 2023-08-30 | Missing upstream |
IC Document Collections
| IC ID | Collection | Type | Status | Form |
|---|---|---|---|---|
| 261727 |  Audiometry Testing |
Form and Instruction | Unchanged | |
| 261727 | Audiometry Testing |
Form and Instruction | Unchanged | |
| 261725 | Informed Consent |
Form and Instruction | Unchanged | |
| 261725 | Informed Consent |
Form and Instruction | Unchanged | |
| 261723 | Noise and Hearing Questionnaire |
Form and Instruction | Modified | |
| 261723 | Noise and Hearing Questionnaire |
Form and Instruction | Modified |
ICR Details
| Status | Active |
|---|---|
| Agency/Subagency | HHS/CDC |
| OMB Control No | 0920-1416 |
| Type of Information Collection | No material or nonsubstantive change to a currently approved collection |
| Previous ICR Reference No | 202308-0920-005 |
| Agency Tracking No | 0920-25-0022 |
| Date Submitted to OIRA | 2025-03-28 |
| Requested Expiration Date | 1969-12-31 |