Survey of Musculoskeletal Disorders Prevention Tools/Methods: 10 Year Follow-up

Forms and Documents

Document Name	Status
Practicing Ergonomist Survey of Tools and Methods Form	New
Att. C. IRB approval Letter.pdf Supplementary Document	2016-09-21
Att. B - FRN 60 day.pdf Supplementary Document	2016-09-21
Attachment A Authorizing Legislation.docx Supplementary Document	2016-09-21
Part B supporting statement - CPE survey.doc Supporting Statement B	2016-09-21
Part A supporting statement CPE survey updated 092016_BDL.docx Supporting Statement A	2016-09-21

IC Document Collections

IC ID	Document Title	Status
223616	Practicing Ergonomist Survey of Tools and Methods Form	New

ICR Details

OMB Control No: 0920-1177	ICR Reference No: 201609-0920-013
Status: Historical Active	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 16AMV
Title: Survey of Musculoskeletal Disorders Prevention Tools/Methods: 10 Year Follow-up
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: 04/12/2017
	Date Received in OIRA: 09/27/2016
Terms of Clearance:

	Inventory as of this Action	Requested	Previously Approved
Expiration Date	04/30/2018	12 Months From Approved
Responses	938	0	0
Time Burden (Hours)	469	0	0
Cost Burden (Dollars)	0	0	0

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Abstract: NIOSH will administer a web-based survey of ergonomics professionals to gather information on the types of basic tools, direct and observational measurement techniques, and software used in the field of Ergonomics to assess workplace risk factors for musculoskeletal disorders. Results will be use to understand the prevalence of use of tools and methods by practitioners within the discipline.

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Authorizing Statute(s): PL: Pub.L. 91 - 596 20-122 Name of Law: Occupational Safety and Health Act of 1970
  

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:
	81 FR 36547	06/07/2016
30-day Notice:	Federal Register Citation:	Citation Date:
	81 FR 66026	09/26/2016
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
Practicing Ergonomist Survey of Tools and Methods	none	Egonomist Survey of Tools and Methods

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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	938	0	0	938	0	0
Annual Time Burden (Hours)	469	0	0	469	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 ICR.

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Annual Cost to Federal Government: $81,697

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]? No

Is this ICR related to the Dodd-Frank Wall Street Reform and Consumer Protection Act, [Pub. L. 111-203]? No

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: 09/27/2016

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