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

Forms and Documents

Document Name	Status
Form 1 Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey Form and Instruction	New
SuppStat_B revised 090910.doc Supporting Statement B	2009-09-29
Appendix G.pdf Supplementary Document	2009-09-29
Appendix F_090910.doc Supplementary Document	2009-09-29
Appendix E.pdf Supplementary Document	2009-09-29
Appendix C.pdf Supplementary Document	2009-09-29
SuppStat_A revised 090910.doc Supporting Statement A	2009-09-29

IC Document Collections

IC ID	Document Title	Status
191021	Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey Form and Instruction	New

ICR Details

OMB Control No: 0920-0834	ICR Reference No: 200910-0920-005
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No:
Title: Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  No
Type of Review Request: Regular
OIRA Conclusion Action: Approved without change	Conclusion Date: 12/08/2009
	Date Received in OIRA: 10/16/2009
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	12/31/2012	36 Months From Approved
Responses	175	0	0
Time Burden (Hours)	58	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: 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. This project is a collaborative effort between the Division of Safety Research (DSR) in the NIOSH and the Office of Emergency Medical Services in the National Highway Traffic Safety Administration (NHTSA). The Consumer Product Safety Commission (CPSC) will also contribute to this project as they are responsible for coordinating the collection of all NEISS-Work data and for overseeing the collection of all telephone interview data. Based on previous examination of the data, we estimate that we will capture approximately 350 unweighted EMS cases per year in the NEISS-Work data. We estimate that we will complete 175 telephone interviews per year based on current response rate to NEISS telephone interviews and a positive response to the questionnaire pilot testing. We anticipate collecting four years of data, allowing us to produce weighted, national estimates describing injuries and illnesses to EMS workers. Using the routine NEISS-Work data, an analysis of all identified EMS workers will be performed to determine if there are any differences between the telephone interview respondent and non-respondent groups.

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Authorizing Statute(s): PL: Pub.L. 91 - 596 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
60-day Notice:	Federal Register Citation:	Citation Date:
	73 FR 66246	11/07/2008
30-day Notice:	Federal Register Citation:	Citation Date:
	74 FR 48750	09/24/2009
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 1

IC Title	Form No.	Form Name
Occupational injuries and illnesses among emergency medical services (EMS) workers: A NEISS-Work telephone interview survey	1	EMS Worker Injury and Illness Questionnaire

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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	175	0	0	175	0	0
Annual Time Burden (Hours)	58	0	0	58	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: No

Burden Reduction Due to:

Short Statement: This is a new data collection.

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Annual Cost to Federal Government: $75,000

Does this IC contain surveys, censuses, or employ statistical methods? Yes Part B of Supporting Statement

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]? Uncollected

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: 10/16/2009

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