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[p.188]

Section N - OCCUPATIONAL HEALTH

Section N1 - WORK HISTORY

In this part of the survey I will ask about your work experience, certain medical conditions and other health-related matters.

1a. First, I'll ask about the king of work you have done the longest, not counting work around the house. Thinking of all the jobs or businesses you have ever had, what kind of work did you do the longest? Include work done while in the Armed Forces.

b. When you were doing this kind of work, what were your most important activities or duties?

2a. How long did you do this kind of work?

b. How old were you when you started doing this kind of work?

3a. In what kind of business or industry did you do this kind of work the longest? For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

g. In the industry where you worked the longest as a (entry in 1a) were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

Check item 1
Refer to HIS-1, C1.

4a. During the past 12 months, that is, since (12 month date) a year ago, did you work at any time at a job or business, not counting work around the house? (Include unpaid work in the family business or farm.)

b. How long has it been since you last worked at a job or business?
If less than 1 year (4c); If 1 year or more (8)

c. For whom did you work at your last job or business? Enter name of company, business, organization or other employer

d. What kind of business or industry is this? For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

e. What kind of work were you doing? For example, electrical engineer, stock clerk, typist, farmer.

f. What were your most important activities or duties? For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete.

Complete from entries in 4c-f. If not clear ask:
g. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

[p. 189]

Section N1 - WORK HISTORY - Continued

5. How long did you work as a (occupation in 4a) for (employer in 4c)?

Check item 2
Refer to 4e and 1a.

6a. Considering all of your employers, for how many years altogether did you do this KIND of work?

b. How old were you when you started doing this kind of work?

7a. In what kind of business or industry did you do this kind of work the longest? For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

b. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

Hand Card N1, read list if telephone interview.

Card N1

8a. Which of these statements describe the reason or reasons you stopped working (entry in 4b) ago?
Mark all that apply.

Check item 3
Refer to 8a.

8b. Was a worker's compensation claim filed for your illness, injury, disability, or other health problem?

c. Have you received any money or other benefits from worker's compensation since you stopped working (entry in 4b) ago?

d. Was a claim filed for any other income or benefits because your health problem was job-related?

Check item 4
Refer to question 4. Mark first appropriate box.

[p.190]

Section N1 - WORK HISTORY - Continued

Check item 5A
Refer to HIS-1, pages 44 and 45.

Hand calendar
9a. Earlier I was told you had a job during the 2 weeks [outlines on that calendar/beginning Monday (date) and ending Sunday [(date)]. For whom did you work? Enter name of company, business, organization, or other employer.

b. What kind of business or industry is this? For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

If "Active duty" in 9a, mark "AF" box without asking.
c. What kind of work was -- doing? For example, electrical engineer, stock clerk, typist, farmer.

d. What were your most important activities or duties at that job?
For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete

Complete from entries in 9a-d. If not clear ask:
e. Were you -
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

Check Item 5B
Refer to questions 9a and c or to HIS-1 pages 44--45.
Transcribe from questions 9a and c or from 6b/c and e on HIS-1.

Hand calendar
9f. (You told me that during the 2 weeks (outlined on that calendar/beginning Monday (date) and ending Sunday (date)) you were employed as a (occupation in Check Item 5B) for (employer in Check Item 5B.)) How long have you worked as a (occupation in Check Item 5B) for (employer in Check Item 5B)?

____
Number

1[] Weeks
2[] Months
3[] Years

Check Item 6
Refer to Check item 5B and question 1a:

9g. Considering all of your employers, for how many years altogether did you do this kind of work?

h. How old were you when you started doing this kind of work?

i. In what kind of business or industry did you do this kind of work the longest? For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

j. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

[p.191]

Section N1 -- Work History -- Continued

Check Item 7
Refer to Check Item 5B.

These next questions are about your job as a (occupation in Check Item 7) for (employer in Check item 7).
10a. Did your job require you to do repeated strenuous physical activities such as lifting, pushing or pulling heavy objects?

1[] Yes
2[] No (11)

b. During a typical work day, how many minutes or hours altogether did you spend doing strenuous physical activities?

11a. Did this job require you to do repeated bending, twisting or reaching?

b. During a typical work day, how many minutes or hours altogether did you spend bending, twisting or reaching?

12a. Did this job require you to bend or twist your hands or wrists many times an hour?

b. During a typical workday, how many minutes or hours altogether did you spend bending or twisting your hands or wrists?

13a. On this job, did you work with hand-held or hand-operated vibrating tools or machinery?

b. During a typical work day, how many minutes or hours altogether did you spend working with hand-held or hand-operated vibrating machinery?

14. I am going to read a list of substances that some people get on their skin at work. Tell me if you got any of these things on your hands or arms at your job as a (occupation in Check Item 7) for (employer in Check Item 7) during the past 12 months --

a. Did you get solvents or degreasers on your hands or arms?

b. Petroleum products other than solvents? For example, grease, oil, or fuel?

c. Soaps, detergents, or cleaning and disinfecting solutions used in performing your job?

d. Cutting oils, machine coolants, or metal working fluids?

e. Paints, varnishes, lacquers, or other coatings?

f. Glues, pastes, or other adhesives?

g. Acids or alkalies?

h. Pesticides, insecticides, herbicides, fungicides, or fumigants?

i. Foods or food products handled as part of your job duties?

j. Plants, trees, or shrubs handled as part of your job duties?

k. Did you get any other chemicals or substances on your hands or arms that could irritate the skin?

[p.192]

Section N2 -- Back Pain

These next questions are about back pain.

1a. At any time during the past 12 months, that is, since (12 month date) a year ago, did you have back pain every day for a week or more?

Check Item 8
Refer to sex and age.

b. Did you have this back pain only at the tiem of your monthly periods?

2a. (The remaining questions are about back pain other than menstrual pain.)
During the past 12 months, on about how many days altogether did you have back pain?

b. During the past 12 months, how many full days did you miss from work because of back pain?

3a. When you had this back pain, what part of your back bothered you the most -- the upper back, the middle back or the lower back?

b. During the past 12 months, did the back pain ever spread to your:

4a. Did any of the back pain you had in the past 12 months result from a single accident or injury? Some examples are slipping, falling, twisting, lifting something, or being in a car accident.

b. When did the accident or injury happen?

c. Were you at work at your job or business when the accident or injury happened?

d. Was this at your job as a (occupation in Check Item 7) for (employer in Check Item 7)?

e. For whom did you work when the accident or injury happened?
Enter name of company, business, organization, or other employer.

f. What kind of business or industry is this?
For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

g. What kind of work did you do at that job?
For example, electrical engineer, stock clerk, typist, farmer.

h. What were the most important activities or duties at that job?
For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete.

Complete from entries in 4e--h. If not clear, ask:
i. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

[p. 193]

Section N2 -- Back Pain -- Continued

5a. Was any of the back pain you had in the past 12 months brought on by repeated activities such as lifting, pushing, pulling, bending, twisting, or reaching?

b. Where did you perform the activities that brought on your back pain?
Mark only one box.

6a. Was this at your job as a (occupation in Check Item 7) for (employer in Check Item 7)?

b. For whom did you work?
Enter name of company, business, organization, or other employer.

c. What kind of business or industry is this?
For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

d. What kind of work did you do at that job?
For example, electrical engineer, stock clerk, typist, farmer.

e. What were your most important activities or duties at that job?
For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete.

Complete from entries in 6b--e. If not clear, ask:
f. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

If "Yes" in 5a, go to 8.
7. What caused your back pain? ________

8a. Has your back bothered you today?

b. How many days, weeks or months ago did you last have back pain?

c. For how many consecutive days, weeks or months (did your back bother you that time/has your back been bothering you)?

[p. 194]

Section N2 -- Back Pain -- Continued

9a. In what year did you first have an episode of back pain that lasted for a week or more?

b. Counting (year in 9a), in how many different years have you had episodes of back pain lasting for a week or more?

Hand Card N2, read list if telephone interview

Card N2

c. What was the longest period of time that you had back pain every day?

10a. Have you ever stopped working at a job or changed jobs because of back pain?

b. Have you ever made a major change in your work activities because of back pain?

[p.195]

Section N3 -- Hand Discomfort

Now I will ask some questions about your hands and wrists.

1. Are you left handed, right handed or able to use both hands equally well?

2. Which hand do you use most at work?

3. During the past 12 months, that is, since (12 month date) a year ago, have you had discomfort in your hands, wrists or fingers? Discomfort can mean pain, burning, stiffness, numbness, or tingling.

4. Was this discomfort due entirely to an injury, such as a cut, sprain or broken bone?

5a. During the past 12 months, on about how many days altogether did you have discomfort in your hands, wrists or fingers?

b. During the past 12 months, did you have the discomfort every day for a week or more?

Check Item 9
Refer to 5a and 5b: Mark first appropriate box

6. In which hand did you have this discomfort?

7. Was your discomfort worse when you were trying to sleep or did it awaken you from sleep?

8. In the past 12 months, did your hands or fingers often feel clumsy, that is, did you often have difficulty picking up or holding things?

9a. Has your hand(s) bothered you today?

b. How many days, weeks or months ago did you last have this discomfort?

c. For how many consecutive days, weeks, or months did your hand(s) bother you that time/has your hand(s) been bothering you?

10a. In what year did you first notice this hand discomfort?

b. Counting (year in 10a), in how many different years has your hand(s) bothered you?

11a. During the past 12 months, were you away from work for more than one week for any reason?

b. When you were away from work for more than one week, did your hand discomfort increase, decrease, or stay the same?

12. During the past 12 months, did you miss at least a full day from work because of your hand discomfort?

[p.196]

Section N3 -- Hand Discomfort -- Continued

13a. Have you ever stopped working at a job or changed jobs because of your hand discomfort?

b. Have you ever made a major change in your work activities because of your hand discomfort?

14a. How long has it been since you last saw or talked to a medical doctor, chiropractor, physical therapist or other medical person about your hand discomfort?

b. What did the medical person call your hand discomfort? ____

15. Even if you have mentioned it before, please tell me if you have ever had any of the following conditions --

[p.197]

Section N4 -- Work Injuries

Now I will ask about on-the-job injuries in the past 12 months.
Hand Card N3

Card N3

By "on-the-job injury" we mean an injury at work that resulted in at least one of the following:
an injury that required you to get medical attention or treatment, other than first aid for minor injuries; or to be unable to do some of your work activities; or to lose consciousness; or to transfer to another job.

1. During the past 12 months, that is, since (12 month date) a year ago, have you had any on-the-job injuries?

2. How many times have you been injured on the job during the past 12 months?

3. On what date did your [(most recent) injury/injury before that] happen?
Enter each date in a separate column.

Complete question 4-21 as appropriate for the first injury before completing them for the next, etc.

4. At the time of your injury on (date in 3) were you working as a (occupation in Check Item 7) for (employer in Check Item 7)?

5a. For whom did you work when the injury happened?
Enter name of company, business, organization, or other employer.

b. What kind of business or industry is this?
For example, TV and radio manufacturing, retail shoe store, State labor Department, farm.

c. What kind of work did you do at that job?
For example, electrical engineer, stock clerk, typist, farm.

d. What were your most important activities or duties at that job?
For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete.

Complete from entries in 5a--d. If not clear, ask:
e. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

6. At the time of this injury, what part of your body was hurt? What kind of injury was it? Anything else?

7. Did you lose consciousness as a result of the injury?

8. What were you doing at the time of the injury? ____

9. How did the injury happen? ____

Go to 10 for this injury

[p.198]

Section N4 -- Work Injuries -- Continued

10. Was the activity you were doing at the time of the injury a new or unfamiliar job task?
Injury 1.

11. Was the activity you were doing at the time of the injury part of your usual job tasks?

12. Did you see or talk to a medical doctor, nurse, chiropractor, physician's assistant, nurse practitioner or other medical person as a result of this injury?

13. Where did you first see or talk to a medical person about this injury?

Check Item 10
Refer to question 6.

14a. Were you wearing eye protection equipment over your eyes at the time of the injury?

b. What type of eye protection equipment were you wearing?

15a. Did you miss more than half of the day from work on the day of the injury?

b. Other than the day of the injury, how many full days of scheduled work did you miss as a result of the injury?

c. (Not counting the (number in 15b) full days), Did you miss any (other) scheduled time from work other than the day of the injury?

d. (Again, not counting the (number in 15b) full days), How many days did you miss more than half the day from work as a result of the injury?

16a. Were you temporarily transferred to another job because of the injury?

b. Were you temporarily assigned lighter work or excused from certain duties at work other than the day of the injury?

17a. Did you report this injury to your employer?

b. Was a worker's compensation claim filed as a result of this injury?

18a. Did you change employers as a result of the injury?

b. Was your salary lower, higher or the same after your change of employers?

c. Were you as satisfied, less satisfied or more satisfied with your new employer as with your employer prior to the injury?

[p.199]

Section N4 -- Work Injuries -- Continued

19a. Did you change the kind of work you do as a result of the injury?
Injury 1

Mark box or ask:

b. Was your salary lower, higher or the same after your job change?

c. Were you as satisfied, less satisfied or more satisfied with your new job as with your job prior to the injury?

Check Item 11
Refer to 18a and 19a.

20. Did you make a permanent change in your work activities because of this injury?

21. Did you permanently change your off-the-job activities because of this injury?

Check Item 12
Refer to question 2, section N4.

[p. 200]

Section N5 -- Skin Conditions

Now I will ask about skin conditions.

1a. During the past 12 months, that is, since (12 month date) a year ago have you had dermatitis, eczema, or any other red, inflamed skin rash?

b. During the past 12 months, on about how many days altogether did you have a skin condition? Include days when you used treatment for the condition

2. What parts of your body were affected by this skin condition?
Mark all that apply.

3. During the past 12 months, did you miss at least a full day from work because of your skin condition?

4a. Did any skin condition you had in the past 12 months result from chemicals or other substances which got on your skin?

b. What chemicals or other substances were these? ____

c. Did you get these substances on your skin during the past 12 months?

d. Were you at work at your job or business when you got these substances on your skin?

5a. Was this at your job as a (occupation in Check Item 7) for (employer in Check Item 7)?

b. For whom did you work when you got these substances on your skin?
Enter name of company, business, organization, or other employer.

c. What kind of business or industry is this?
For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

d. What kind of work did you do at that job?
For example, electrical engineer, stock clerk, typist, farmer.

e. What were your most important activities or duties at that job?
For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete.

f. Were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

6a. During the past 12 months, did you use any prescription medications or other treatments prescribed by a doctor for your skin condition?

b. Did you use any over-the-counter or non-prescription medications or treatments for your skin condition?

[p.201]

Section N5 -- Skin Conditions -- Continued

7a. How long has it been since you last saw or talked to a dermatologist or skin specialist about your skin condition?

b. How long has it been since you last saw or talked to any other type of medical person about your skin condition?

8a. During the past 12 months, have you stopped working at a job or changed jobs because of your skin condition?

b. During the past 12 months, did you make a major change in your work activities because of your skin condition?

Check Item 13
Refer to question 4d.

9. During the past 12 months, did you report your skin condition to your employer as a work-related illness or injury?

10. During the past 12 months, was a worker's compensation claim filed for your skin condition?

[p.202]

Section N6 -- Eye, Nose, Throat Irritation

Check Item 14
Refer to HIS-1, C1.

These questions are about eye, nose and throat irritation.
Hand calendar
1a. During the past 2 weeks (outlined on that calendar/beginning Monday (date) and ending Sunday (date)), have you had any episodes of itchy, irritated or watery eyes?

b. On how many days during the past 2 weeks did you have itchy, irritated or watery eyes?

c. Were these symptoms due to a cold or flu, hay fever, other allergies, or something else?

2a. Did you have these symptoms while you were at work?

b. When you were away from work, did these symptoms increase, decrease, or stay the same?

3. During the past 2 weeks when you had these symptoms, did you also have a fever?

4a. Do you wear contact lenses?

b. What type of contact lenses do you wear?
Mark all that apply.

5a. During the past 2 weeks, have you had any episodes of stuffy, blocked, itchy or runny nose?

b. On how many days during the past 2 weeks did you have stuffy, blocked, itchy or runny nose?

c. Were these symptoms due to a cold or flu, hay fever, other allergies, or something else?

6a. Did you have these symptoms while you were at work?

b. When you were away from work, did these symptoms increase, decrease, or stay the same?

7. During the past 2 weeks when you had these symptoms, did you also have a fever?

8a. During the past 2 weeks, have you had any episodes of sore or dry throat?

b. On how many days during the past 2 weeks did you have sore or dry throat?

c. Were these symptoms due to a cold or flu, hay fever, other allergies, or something else?

[p.203]

Section N6 -- Eye, Nose, Throat Irritation -- Continued

9a. Did you have these symptoms while you were at work?

b. When you were away from work, did these symptoms increase, decrease or stay the same?

10. During the past 2 weeks when you had these symptoms, did you also have a fever?

[p. 204]

Section N7 - Conditions

I am going to read a list of medical conditions. Tell me if you have had any of these conditions even if you have mentioned them before.

1. During the past 12 months, that is, since (12 month date) a year ago, have you had --

During the past 12 months have you had --

2. Do you now have --

Check Item 15
Refer to questions 1 and 2.

[p. 205]

Section N7 -- Conditions -- Continued

Condition 1

3. Were you ever told by a doctor or other medical person that your (condition) was related to any job you ever had?

4. Was a worker's compensation claim ever filed for your (condition)?

5. Did you ever report to your employer or to other company personnel that your (condition) was related to your job?

6. Did you ever tell a doctor or other medical person that your (condition) was related to any job you ever had?

Check Item 16
Refer to Check Item 7, page 45.

7a. During the past 12 months, were you told by your doctor or employer to stay home from work temporarily because of your (condition)?

b. During the past 12 months, did your employer transfer you to another job, either temporarily or permanently, because of your (condition)?

c. During the past 12 months, did your employer give you lighter work or excuse you from certain duties at work because of your (condition)?

SEEM TO BE MISSING A QUESTION HERE, FOR INVAR 2944, 2963, 2982, 3001, 3020, 3039, 3058, 3077, 3096, 3115, 3134, 3153, 3172

Check Item 17
Refer to 3, 4, 5, 6:

9a. What kind of work did you do that was related to your (condition)?
For example, electrical engineer, stock clerk, typist, farmer.

Occupation____

b. What were your most important activities or duties at that job?
For example, types, keeps account books, files, sells cars, operates printing press, finishes concrete.

Duties ____

c. In what kind of business or industry did you work the longest as a (entry in 9a)?
For example, TV and radio manufacturing, retail shoe store, State Labor Department, farm.

d. In the industry where you worked the longest as a (entry in 9a) were you --
An employee of private company, -business, or individual for wages, salary or commission? .... P
A member of the armed forces? .... AF
A federal government employee? .... F
A state government employee? .... S
A local government employee? .... L
Self-employed in own business, professional practice or farm?
Ask: Is the business incorporated?
Yes .... I
No .... SE
Working without pay in family business or farm? ....WP

[p. 206]

Section N8 -- Cigarette Smoking

These questions are about smoking cigarettes.
1. Have you smoked at least 100 cigarettes in your entire life?

2. About how old were you when you first started smoking cigarettes fairly regularly?

3. Do you smoke cigarettes now?

Mark box or ask:
4. About how long has it been since you last smoked cigarettes fairly regularly?

5. On the average, about how many cigarettes a day (do/did) you smoke?

6a. Do you live with anyone who smokes cigarettes?

b. Do they regularly smoke in the home?

Check Item 18
Refer to Check Item 5B on page 44.

7a. Is smoking allowed in your place of work other than in designated areas?

b. Do you find that cigarette smoke in the work place causes you no discomfort, some discomfort, moderate discomfort, or great discomfort?

Section N -- Occupational Health Addendum

If Yes in question 17b, page 54/55, ask:
1. Was the worker's compensation claim for your injury on (date in 3, page 52/53) awarded, denied, or is it still in process?

If Yes in question 10, page 59, ask:
2. Was the worker's compensation claim for your skin condition awarded, denied, or is it still in process?

If Yes in question 4, page 64/65, ask:
3. Was the worker's compensation claim for your (condition) awarded, denied, or is it still in process?