OMB.report

Federal forms, ICRs, and supporting documents

Information Collection Request

[NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Settings

ICR 202506-0920-001 · OMB 0920-1441 · Active

Forms and Documents
DocumentTypeStatusAvailability
Form Post Test Question 0920-26-0012 Form New Available
Form Demographics/ cons 0920-26-0012 Form New Available
Form Informed Consent 0920-26-0012 Form New Available
Form Motion Sickness pr 0920-26-0012 Form New Available
Form 0920-25CW Safety and Trust Robots Form Modified Available
Form 0920-25CW Record of Test Subject Participation Form Modified Available
Form 0920-25CW Robot Attribute Ratings Form Modified Available
Form 0920-25CW Post-Interaction Questionnaire Form Modified Available
Form 0920-25CW Comfort Level Questionnaire Form Modified Available
Form 0920-25CW Robot Experience Questionnaire Form Modified Available
Form 0920-1441 Demographic Survey_12JUN2025 Form Modified Repair queued
Form 0920-1441 Informed Consent Form_12JUN2025 Form Modified Available
Form 0920-25CW Participant Recruitment Form Modified Available
Form 0920-25CW Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form Modified Missing upstream
Informed Consent (amended) Form and Instruction Unchanged Available
Demographic Survey (Amended) Form and Instruction Unchanged Available
Form 0920-1441 Participant Recruitment Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Demographic Survey Form and Instruction Unchanged Available
Form 0920-1441 Robot Evaluation Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Post Condition Questionnaire:Interface Modality, Safety, and Trust Form and Instruction Unchanged Available
Form 0920-1441 Installation/Set-Up of Virtual Reality Controller Form and Instruction Unchanged Available
Form 0920-1441 Virtual Reality Sickness Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Virtual Reality Experience Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Robot Experience Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Informed Consent Form and Instruction Unchanged Available
Form 0920-1441 [NIOSH] Evaluation of robot to human communication designs Form and Instruction Unchanged Repair queued
Form 0920-1441 Post-Test Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Robot Trust Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 NASA Task Load Index Form and Instruction Unchanged Available
Form 0920-1441 Virtual Reality Sickness Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Construction_Demolition Robot Experience Questionnaire Form and Instruction Unchanged Available
Form 0920-1441 Informed Consent Form and Instruction Unchanged Available
Form 0920-1441 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction Unchanged Repair queued
Change Request form EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-06-02 Available
Change Request form EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-06-02 Repair queued
Change Request form EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-02-26 Available
Change Request form EO 14168.docx Justification for No Material/Nonsubstantive Change Uploaded 2025-02-26 Repair queued
SSA_NIOSH_Lab with VR Pkg_Final.docx Supplementary Document Uploaded 2024-10-24 Available
SSA_NIOSH_Lab with VR Pkg_Final.docx Supplementary Document Uploaded 2024-10-24 Repair queued
SSA_NIOSH_Lab with VR Pkg_Change_Track.docx Supplementary Document Uploaded 2024-10-24 Available
SSA_NIOSH_Lab with VR Pkg_Change_Track.docx Supplementary Document Uploaded 2024-10-24 Repair queued
SSA_NIOSH_Lab with VR Pkg_Change_Clean.docx Supplementary Document Uploaded 2024-10-24 Available
SSA_NIOSH_Lab with VR Pkg_Change_Clean.docx Supplementary Document Uploaded 2024-10-24 Missing upstream
NIOSH genIC_0920-1441_Request to Debit Hours.docx Supplementary Document Uploaded 2024-10-24 Available
NIOSH genIC_0920-1441_Request to Debit Hours.docx Supplementary Document Uploaded 2024-10-24 Repair queued
Change request justification 0920-1441.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-24 Available
Change request justification 0920-1441.docx Justification for No Material/Nonsubstantive Change Uploaded 2024-10-24 Repair queued
Attachment C - FRN_60-day 2024-08596.pdf Supplementary Document Uploaded 2024-07-19 Available
Attachment C - FRN_60-day 2024-08596.pdf Supplementary Document Uploaded 2024-07-19 Repair queued
Attachment B_MSHA Act 1977.pdf Supplementary Document Uploaded 2024-07-19 Available
Attachment B_MSHA Act 1977.pdf Supplementary Document Uploaded 2024-07-19 Repair queued
Attachment A - OSH Act 1970.pdf Supplementary Document Uploaded 2024-07-19 Available
Attachment A - OSH Act 1970.pdf Supplementary Document Uploaded 2024-07-19 Repair queued
2. SSB_NIOSH_Lab with VR Package_5.31.24.docx Supporting Statement B Uploaded 2024-07-19 Available
2. SSB_NIOSH_Lab with VR Package_5.31.24.docx Supporting Statement B Uploaded 2024-07-19 Missing upstream
1. SSA_NIOSH_Lab with VR Pkg_5.31.24_final jjb_NIOSH_response_final.docx Supporting Statement A Uploaded 2024-08-30 Available
1. SSA_NIOSH_Lab with VR Pkg_5.31.24_final jjb_NIOSH_response_final.docx Supporting Statement A Uploaded 2024-08-30 Repair queued
IC Document Collections
IC IDCollectionTypeStatusForm
278792 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting Form New0920-26-0012
278792 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting Form New0920-26-0012
278792 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting Form New0920-26-0012
278792 [NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting Form New0920-26-0012
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedSafety and Trust Robots
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedRecord of Test Subject Participation
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedRobot Attribute Ratings
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedPost-Interaction Questionnaire
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedComfort Level Questionnaire
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedRobot Experience Questionnaire
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedDemographic Survey_12JUN2025
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedInformed Consent Form_12JUN2025
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form ModifiedParticipant Recruitment
273728 Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting Form Modified
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedInformed Consent (amended)
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedDemographic Survey (Amended)
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedParticipant Recruitment Questionnaire
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedDemographic Survey
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedRobot Evaluation Questionnaire
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedPost Condition Questionnaire:Interface Modality, Safety, and Trust
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedInstallation/Set-Up of Virtual Reality Controller
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedVirtual Reality Sickness Questionnaire
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedVirtual Reality Experience Questionnaire
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedRobot Experience Questionnaire
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction UnchangedInformed Consent
273435 [NIOSH] Evaluation of robot to human communication designs Form and Instruction Unchanged
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction UnchangedPost-Test Questionnaire
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction UnchangedRobot Trust Questionnaire
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction UnchangedNASA Task Load Index
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction UnchangedVirtual Reality Sickness Questionnaire
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction UnchangedConstruction_Demolition Robot Experience Questionnaire
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction UnchangedInformed Consent
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction Unchanged
272964 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Other-Installation_Removal of Wearable Markers Unchanged
ICR Details
0920-1441 202506-0920-001
Active 202502-0920-005
HHS/CDC 0920-25-0019
[NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Settings
No material or nonsubstantive change to a currently approved collection   No
Regular
Approved with change 06/12/2025
Retrieve Notice of Action (NOA) 06/02/2025
  Inventory as of this Action Requested Previously Approved
09/30/2027 09/30/2027 09/30/2027
274,000 0 274,000
205,002 0 205,002
0 0 0
NIOSH has submitted a request for OMB approval of a New GENERIC ICR [0920-1441]. The goal of this GENERIC mechanism is to enable CDC/NIOSH to assess the effectiveness of a sub-set of automated direct reading methodologies, sensor technologies, and robotics technologies (hereafter referred to as “technologies”) that are used to protect worker safety and health. This Non-Substantive Change Request is submitted to align language used in a previously approved GenIC (0920-1441 - Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting) to align with recently issued EO. There is no change to approved burden hours.
PL: Pub.L. 91 - 173 501(a) Name of Law: Mine Safety and Health Act of 1977
   US Code: 29 USC 669 Name of Law: Occupational Safety and Health Act of 1970
  
None
Not associated with rulemaking
  89 FR 30372 04/23/2024
89 FR 58734 07/19/2024
No
4
IC Title Form No. Form Name
Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in LabSimulator-based Setting 0920-25CW, 0920-25CW, 0920-1441, 0920-1441, 0920-25CW, 0920-25CW, 0920-25CW, 0920-25CW, 0920-25CW Participant Recruitment ,   Informed Consent Form_12JUN2025 ,   Demographic Survey_12JUN2025 ,   Robot Experience Questionnaire ,   Comfort Level Questionnaire ,   Post-Interaction Questionnaire ,   Robot Attribute Ratings ,   Record of Test Subject Participation ,   Safety and Trust Robots
[NIOSH] Direct Reading Methodologies, Sensors, and Robotics Technology Assessment in Lab/Simulator-based Setting Post Test Questionnaire, Motion Sickness prescreening Questionnaire , Demographics/ construction and robot experience , Informed Consent 0920-26-0012 ,   0920-26-0012 ,   0920-26-0012 ,   0920-26-0012
[NIOSH] Evaluation of robot to human communication designs 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441, n/a, n/a Informed Consent ,   Robot Experience Questionnaire ,   Virtual Reality Experience Questionnaire ,   Virtual Reality Sickness Questionnaire ,   Installation/Set-Up of Virtual Reality Controller ,   Post Condition Questionnaire:Interface Modality, Safety, and Trust ,   Robot Evaluation Questionnaire ,   Demographic Survey ,   Participant Recruitment Questionnaire ,   Demographic Survey (Amended) ,   Informed Consent (amended)
[NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441, 0920-1441 Informed Consent ,   Construction_Demolition Robot Experience Questionnaire ,   Virtual Reality Sickness Questionnaire ,   NASA Task Load Index ,   Robot Trust Questionnaire ,   Post-Test Questionnaire
  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 274,000 274,000 0 0 0 0
Annual Time Burden (Hours) 205,002 205,002 0 0 0 0
Annual Cost Burden (Dollars) 0 0 0 0 0 0
No
No
New Generic Collection
$574,091
Yes Part B of Supporting Statement
    Yes
    No
No
No
No
No
Jeffrey Zirger 404 639-7118 [email protected]
  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.
06/02/2025