Examining Safety and Health among Aviation Industry Workers in Alaska: A Survey

Forms and Documents

Document Name	Status
Form 0920-21AN Non-respondent Questionnaire Form and Instruction	New
Form 0920-21AN CSA_Survey Form and Instruction	New
Form 0920-21AN RBCD_Survey Form and Instruction	New
Form 0920-21AN Maintenance Technician_ Survey Form and Instruction	New
Form 0920-21AN Pilot Survey Form and Instruction	New
Form 0920-21AN Operator Survey Form and Instruction	New
Supporting Statement B.docx Supporting Statement B	2021-03-25
Supporting Statement A .docx Supporting Statement A	2021-03-25
Privacy Act Checklist.docx Supplementary Document	2021-03-25
Attachment 9.pdf Supplementary Document	2021-03-25
Attachment 8a.pdf Supplementary Document	2021-03-25
Attachment 7a.docx Supplementary Document	2021-03-25
Attachment 6b.docx Supplementary Document	2021-03-25
Attachment 6a.docx Supplementary Document	2021-03-25
Attachment 5b.docx Supplementary Document	2021-03-25
Attachment 5a.docx Supplementary Document	2021-03-25
Attachment 4.docx Supplementary Document	2021-03-25
Attachment 1.docx Supplementary Document	2021-03-25

IC Document Collections

IC ID	Document Title	Status
246444	Non-respondent Questionnaire Form and Instruction	New
246443	CSA_Survey Form and Instruction	New
246442	RBCD_Survey Form and Instruction	New
246441	Maintenance Technician_ Survey Form and Instruction	New
246440	Pilot Survey Form and Instruction	New
246439	Operator Survey Form and Instruction	New

ICR Details

OMB Control No:	ICR Reference No: 202103-0920-009
Status: Received in OIRA	Previous ICR Reference No:
Agency/Subagency: HHS/CDC	Agency Tracking No: 0920-21AN
Title: Examining Safety and Health among Aviation Industry Workers in Alaska: A Survey
Type of Information Collection: New collection (Request for a new OMB Control Number)	Common Form ICR:  Yes
Type of Review Request: Regular	Date Submitted to OIRA: 03/26/2021

	Requested	Previously Approved
Expiration Date	12 Months From Approved
Responses	6,271	0
Time Burden (Hours)	1,547	0
Cost Burden (Dollars)	0	0

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Abstract: The primary goal of this study is to collect information on injuries and illnesses among workers in the aviation industry in Alaska. Second, to provide information to identify risk factors for adverse illness and injury outcomes. Third, the survey will provide information to the Alaska aviation industry stakeholders to assist in identifying intervention strategies to mitigate identified and perceived safety and health needs and concerns, and provide information to the research community to allow generation of hypotheses and prioritize future research in health and safety topics in this workforce.

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Authorizing Statute(s): US Code: 29 USC 669 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:
	85 FR 82478	12/18/2020
30-day Notice:	Federal Register Citation:	Citation Date:
	86 FR 14918	03/19/2021
Did the Agency receive public comments on this ICR? No

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Number of Information Collection (IC) in this ICR: 6

IC Title	Form No.	Form Name
CSA_Survey	0920-21AN	CSA_Survey
Maintenance Technician_ Survey	0920-21AN	Maintenance Technician_ Survey
Non-respondent Questionnaire	0920-21AN	Non-respondent Questionnaire
Operator Survey	0920-21AN	Operator Survey
Pilot Survey	0920-21AN	Pilot Survey
RBCD_Survey	0920-21AN	RBCD_Survey

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ICR Summary of Burden

	Total Request	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	6,271	0	0	6,271	0	0
Annual Time Burden (Hours)	1,547	0	0	1,547	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: The new collection aims to collect information on injuries and illness among workers in the aviation industry in Alaska. The request is for one-year of approval and 1,547 burden hours.

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Annual Cost to Federal Government: $105,877

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

Does this ICR request any personally identifiable information (see OMB Circular No. A-130 for an explanation of this term)? Please consult with your agency's privacy program when making this determination.     No

Does this ICR include a form that requires a Privacy Act Statement (see 5 U.S.C. §552a(e)(3))? Please consult with your agency's privacy program when making this determination.     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? No

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Common Form ICR:  Yes

Description/Changes for Common Form Usage: 

Approved RCFs using this ICR

Agency/Sub Agency	RCF ID	RCF Title	RCF Status	IC Title

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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: 03/26/2021

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