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pep

[p.13]


FIJ.300

The next questions are about POISONING, which includes coming into contact with harmful substances, and overdose or wrong use of any drug or medication. Do not include any illnesses such as poison ivy or food poisoning.

FR: HAND CALENDAR CARD.

DURING THE PAST THREE MONTHS, that is since {91 days before today's date}, did {you/anyone in the family} have a poisoning that caused someone to seek medical advice or treatment, including calls to a poison control center?
FPOIS3M
(1) Yes (FIJ.310)
(2) No (FAU.010)
(7) Refused (FAU.010)
(9) DK (FAU.010)

FIJ.310

Who was this? (Anyone else?)
PPOIS3MR
[ ]
[ ]
[ ]
[ ]
[ ]
[ ]


FIJ.320

How many different times in the PAST THREE MONTHS {were/was}{you/subject's name} poisoned?

(01-94) 1-94 times
(95) 95+ times
(97) Refused
(99) DK


FIJ.330

[If FIJ.320 equals 1, ask:]
When did {subject's name} poisoning happen?
POIDTEM MONTH: ____________________________
POIDTED DAY: ____________________________
POIDTEY YEAR: ____________________________
[If FIJ.320 is greater than 1, ask:]
Now I'm going to ask a few question about {subject's name} most recent poisoning. When did that happen?
POIDTEMMONTH:____________________________
POIDTEDDAY:____________________________
POIDTEYYEAR:____________________________
[If FIJ.320 is greater than or equal to 2, ask:]
We just talked about {subject's name} poisoning on {recent poisoning date}. When did {subject's name} poisoning BEFORE THAT happen?
POIDTEMMONTH:____________________________
POIDTEDDAY:____________________________
POIDTEYYEAR:____________________________

[p.14]

[FIJ.340 to FIJ.410 are repeated for each poisoning episode.]

FIJ.340

Did {you/subject's name} poisoning result from:
POITPR2
(1) a drug or medical substance used mistakenly or in overdose (FIJ.360)
(2) a harmful or toxic solid or liquid substance (FIJ.360)
(3) inhaling gases or vapors (FIJ.360)
(4) eating a poisonous plant or other substance mistaken for food (FIJ.360)
(5) a venomous animal or plant (FIJ.360)
(6) something else (FIJ.350)
(7) Refused (FIJ.360)
(9) DK (FIJ.360

FIJ.350

FR: ENTER THE VERBATIM RESPONSE.
PSPEC_1______________________________________
PSPEC_2______________________________________
PSPEC_3______________________________________
PSPEC_4______________________________________


FIJ.360

Did you or did someone else call a poison control center for advice in treating {subject's name} poisoning?
POICC
(1) Yes
(2) No
(7) Refused
(9) DK


FIJ.370

{Were/Was} {you/subject's name} hospitalized for at least one night as a result of this poisoning?
PHOSP
(1) Yes (FIJ.380)
(2) No (FIJ.390)
(7) Refused (FIJ.390)
(9) DK (FIJ.390)


FIJ.380

How many nights {were/was} {you/subject's name} in the hospital?

FR: IF "STILL IN HOSPITAL," ASK HOW MANY NIGHTS UP TO TODAY.
PHNO
(01-94) 1-94 nights
(95) 95+ nights
(97) Refused
(99) DK


Check item FIJCCI2:
If AGE greater than 13 then go to FIJ.400; Else
If AGE greater than 4 and less than 14 then go to FIJ.410; Else
If AGE less than 5 then return to FIJ.330 for the next poisoning event or the next person.
If there are no more persons and no more poisoning events, go to FAU.010.

[p.15]


FIJ.400

As a result of this poisoning, how much work did {you/subject's name} miss?

FR: HAND CARD F7.
Card F7
Not employed at the time of the injury/poisoning
None
Less than 1 day
1 to 5 days
6 or more days
PWKLS
(0) None
(1) Less than 1 day
(2) One to five days
(3) Six or more days
(6) Not employed at the time of poisoning
(7) Refused
(9) DK


FIJ.410

As a result of this poisoning, how many days of school did {you/subject's name} miss?

FR: HAND CARD F8.
Card F8
Not in school at the time of the injury/poisoning
None
Less than 1 day
1 to 5 days
6 or more days
PSCLS
(0) None
(1) Less than 1 day
(2) One to five days
(3) Six or more days
(6) Not in school at the time of poisoning
(7) Refused
(9) DK
(Goto next section--Health Care Access and Utilization)