[NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators

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

Documents and Forms

Document Name Document Type
Form 0920-1441 [NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators Form and Instruction
Wearable Markers_Study 1.docx Other-Installation_Removal of Wearab
Wearable Markers_Study 2.docx Other-Installation_Removal of Wearab
0920-1441 Informed Consent Attachment G_Informed Consent Form.docx Form and Instruction
0920-1441 Construction_Demolition Robot Experience Questionnaire Attachment B_ConstructionDemolition Robot Experience Questionnaire.docx Form and Instruction
0920-1441 Virtual Reality Sickness Questionnaire Attachment C_Virtual Reality Sickness Questionnaire.docx Form and Instruction
0920-1441 NASA Task Load Index Attachment D_NASA Task Load Index.docx Form and Instruction
0920-1441 Robot Trust Questionnaire Attachment E_Human-Robot Trust Questionnaire.docx Form and Instruction
0920-1441 Post-Test Questionnaire Attachment F_Post-Test Questionnaire.docx Form and Instruction
2. NIOSH DSR genIC_Sampling Plan_VR Demolition Robots.docx NIOSH Sampling Plan IC Document
Attachment A_Recruitment Flyer.docx Recruitment Flyer IC Document
Attachment H_Record of Test Subject Participation.docx Record of Participation IC Document
Attachment I_23-NIOSH-11 041524 approval CamargoH.pdf Research Determination IC Document
Attachment J_OSH Act 1970_Authorizing Legislation.pdf Authorizing Legislation IC Document
1. NIOSH DSR genIC Request_VR Demolition Robots.docx 0920-1441 GenIC Request Template IC Document

Information Collection (IC) Details

IC Title:	[NIOSH] Identification of Hazards and Risk Factors for Demolition Robot Operators	Agency IC Tracking Number:	0920-1441-25BX

IC Status: New

Obligation to Respond: Voluntary

CFR Citation:

Information Collection Instruments:

Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Electronic Capability
Form and Instruction	0920-1441	Informed Consent	Attachment G_Informed Consent Form.docx	N/A	No	Fillable Fileable
Form and Instruction	0920-1441	Construction_Demolition Robot Experience Questionnaire	Attachment B_ConstructionDemolition Robot Experience Questionnaire.docx	N/A	No	Fillable Fileable
Form and Instruction	0920-1441	Virtual Reality Sickness Questionnaire	Attachment C_Virtual Reality Sickness Questionnaire.docx	N/A	No	Fillable Fileable
Other-Installation_Removal of Wearable Markers			Wearable Markers_Study 1.docx	N/A	No	Fillable Fileable
Other-Installation_Removal of Wearable Markers			Wearable Markers_Study 2.docx	N/A	No	Fillable Fileable
Form and Instruction	0920-1441	NASA Task Load Index	Attachment D_NASA Task Load Index.docx	N/A	No	Fillable Fileable
Form and Instruction	0920-1441	Robot Trust Questionnaire	Attachment E_Human-Robot Trust Questionnaire.docx	N/A	No	Fillable Fileable
Form and Instruction	0920-1441	Post-Test Questionnaire	Attachment F_Post-Test Questionnaire.docx	N/A	No	Fillable Fileable

Line of Business: Health

Subfunction: Consumer Health and Safety

Privacy Act System of Records
Title:	FR Citation:

Number of Respondents: 1,052	Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

	Approved	Program Change Due to Agency Discretion
Annual Number of Responses for this IC	2,104	2,104
Annual IC Time Burden (Hours)	250	250
Annual IC Cost Burden (Dollars)	0	0

Documents for IC

Title	Document	Date Uploaded
NIOSH Sampling Plan	2. NIOSH DSR genIC_Sampling Plan_VR Demolition Robots.docx	12/12/2024
Recruitment Flyer	Attachment A_Recruitment Flyer.docx	12/12/2024
Record of Participation	Attachment H_Record of Test Subject Participation.docx	12/12/2024
Research Determination	Attachment I_23-NIOSH-11 041524 approval CamargoH.pdf	12/12/2024
Authorizing Legislation	Attachment J_OSH Act 1970_Authorizing Legislation.pdf	12/12/2024
0920-1441 GenIC Request Template	1. NIOSH DSR genIC Request_VR Demolition Robots.docx	12/12/2024

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.