Gulf Oil Spill Worker Rostering Survey

Forms and Documents

Document Name	Status
Form No number Web-based Initial Survey Form	New
Form No number Paper-based Initial Survey Form	Modified
Change Justification NIOSH Gulf Oil Spill Initial Survey (2).docx Justification for No Material/Nonsubstantive Change	2010-05-28

IC Document Collections

IC ID	Document Title	Status
193089	Web-based Initial Survey Form	New
192873	Paper-based Initial Survey Form	Modified

ICR Details

OMB Control No: 0920-0851	ICR Reference No: 201005-0920-007
Status: Historical Active	Previous ICR Reference No: 201005-0920-002
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Gulf Oil Spill Worker Rostering Survey
Type of Information Collection: No material or nonsubstantive change to a currently approved collection	Common Form ICR:  No
Type of Review Request: Emergency	Approval Requested By: 05/13/2010
OIRA Conclusion Action: Approved without change	Conclusion Date: 06/01/2010
	Date Received in OIRA: 05/28/2010
Terms of Clearance: Previous terms of clearance apply: Approved with the understanding that (1) the emergency clearance will not cover the anticipated health symptom monitoring study and (2) CDC will submit a regular package for any post-event study using the data obtained through this emergency clearance.

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	08/31/2010	08/31/2010	08/31/2010
Responses	10,000	0	6,500
Time Burden (Hours)	833	0	1,625
Cost Burden (Dollars)	0	0	0

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Abstract: On April 21, 2010, the Deep Water Horizon oil drilling rig (owned by British Petroleum (BP)) caught fire and sank leading to oil spilling from the sea floor. Thousands of workers are responding to the clean-up activities. The National Institute for Occupational Safety and Health (NIOSH) has been asked to support the Unified Command to establish a systematic rostering of workers participating in Gulf spill response clean-up efforts, including volunteers, by obtaining this information at the time of training, or for those already trained, by working with safety and on-site supervisory officials.

Emergency Justfication: The National Institute for Occupational Safety and Health (NIOSH)requests an emergency clearance in order to support the Unified Command to establish a systematic rostering of workers participating in Gulf spill response clean-up efforts.

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Authorizing Statute(s): US Code: 29 USC 20 Name of Law: Occupational Safety and Health Act
  

Citations for New Statutory Requirements: None

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Associated Rulemaking Information
RIN:	Stage of Rulemaking:	Federal Register Citation:	Date:
	Not associated with rulemaking

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Federal Register Notices & Comments

Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 2

IC Title	Form No.	Form Name
Paper-based Initial Survey	No number	Paper-based Survey
Web-based Initial Survey	No number	Web-based Survey

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ICR Summary of Burden

	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	10,000	6,500	0	3,500	0	0
Annual Time Burden (Hours)	833	1,625	0	-792	0	0
Annual Cost Burden (Dollars)	0	0	0	0	0	0

Burden increases because of Program Change due to Agency Discretion: Yes

Burden Increase Due to: Miscellaneous Actions

Burden decreases because of Program Change due to Agency Discretion: Yes

Burden Reduction Due to: Using Information Technology

Short Statement: This is a change request to an emergency clearance which adds a web-based version of the survey, adds respondents, but reduces the burden hours due to revised time per response.

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Annual Cost to Federal Government: $11,844

Does this IC contain surveys, censuses, or employ statistical methods? No

Is the Supporting Statement intended to be a Privacy Impact Assessment required by the E-Government Act of 2002? No

Is this ICR related to the Affordable Care Act [Pub. L. 111-148 & 111-152]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? Uncollected

Is this ICR related to the American Recovery and Reinvestment Act of 2009 (ARRA)? No

Is this ICR related to the Pandemic Response? Uncollected

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Common Form ICR:  No

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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:

(a) It is necessary for the proper performance of agency functions;

(b) It avoids unnecessary duplication;

(c) It reduces burden on small entities;

(d) It uses plain, coherent, and unambiguous language that is understandable to respondents;

(e) Its implementation will be consistent and compatible with current reporting and recordkeeping practices;

(f) It indicates the retention periods for recordkeeping requirements;

(g) It informs respondents of the information called for under 5 CFR 1320.8 (b)(3) about:

(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;

(h) It was developed by an office that has planned and allocated resources for the efficient and effective management and use of the information to be collected.

(i) It uses effective and efficient statistical survey methodology (if applicable); and

(j) It makes appropriate use of information technology.

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.

Certification Date: 05/28/2010

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