[p. 22]
Section III -- INJURIES
Injuries are a major health problem. In order to develop new ways to help prevent both accidental and intentional injuries, we need to know more about them. In this next set of questions, I will ask about injuries that happened in the past 3 months; Note here that we are only interested in injuries that required medical advice or treatment.
DURING THE PAST THREE MONTHS, that is since {91 days before today date},{were/was} {you/anyone in the family} injured seriously enough that {you/they} got medical advice or treatment?
FINJ3M
(1) Yes (FIJ.020)
(2) No (FIJ.300)
(7) Refused (FIJ.300)
(9) DK (FIJ.300)
(2) No (FIJ.300)
(7) Refused (FIJ.300)
(9) DK (FIJ.300)
FIJ.020
Who was this? (Anyone else?)
PINJ3MR
[ ]
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[ ]
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[ ]
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[ ]
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[ ]
[ ]
How many different times in the past three months {were/was} {you/subject's name} injured seriously enough to seek medical advice?
IJNO3M
Times Injured (01-94): ____________
[If FIJ.030 equals 1, ask:]
When did {subject's name} injury happen?
When did {subject's name} injury happen?
IJDATE_M MONTH: _________________
IJDATE_D DAY: ____________________
IJDATE_Y YEAR: ___________________
IJDATE_D DAY: ____________________
IJDATE_Y YEAR: ___________________
[If FIJ.030 greater than 1, ask:]
Now I'm going to ask a few question about {subject's name} most recent injury. When did that injury happen?
Now I'm going to ask a few question about {subject's name} most recent injury. When did that injury happen?
IJDATE_M MONTH: ________________________
IJDATE_D DAY: ____________________________
IJDATE_Y YEAR: ___________________________
IJDATE_D DAY: ____________________________
IJDATE_Y YEAR: ___________________________
[If FIJ.030 equals 2 or more, ask:]
We just talked about {subject's name} injury on {recent injury date}. When did {subject's name} injury BEFORE THAT happen?
We just talked about {subject's name} injury on {recent injury date}. When did {subject's name} injury BEFORE THAT happen?
IJDATE_M MONTH: _________________________
IJDATE_D DAY: _____________________________
IJDATE_Y YEAR: ____________________________
IJDATE_D DAY: _____________________________
IJDATE_Y YEAR: ____________________________
[p. 23]
[FIJ.050 to FIJ.295 are asked for each injury episode]
FIJ.050
At the time of the injury, what part(s) of {subject's name} body was hurt? What kind of injury was it? Anything else?
BODY PART
BODY PART
IJBODY1 __________
IJBODY2 __________
IJBODY3 __________
IJBODY4 __________
IJBODY2 __________
IJBODY3 __________
IJBODY4 __________
KIND OF INURY
IJKIND1___________
IJKIND2___________
IJKIND3___________
IJKIND4___________
IJKIND2___________
IJKIND3___________
IJKIND4___________
How did {subject's name} injury(s) happen? Please describe fully the circumstances or events leading to the injury(s), and any object, substance, or other person involved.
FR: ENTER THE VERBATIM RESPONSE, PROBING FOR AS MUCH DETAIL AS POSSIBLE, INCLUDING SPECIFICALLY WHAT THE INJURED PERSON WAS DOING AT THE TIME AND ALL CIRCUMSTANCES SURROUNDING THE EVENT. RECORD ALL VOLUNTEERED INFORMATION.
FR: ENTER THE VERBATIM RESPONSE, PROBING FOR AS MUCH DETAIL AS POSSIBLE, INCLUDING SPECIFICALLY WHAT THE INJURED PERSON WAS DOING AT THE TIME AND ALL CIRCUMSTANCES SURROUNDING THE EVENT. RECORD ALL VOLUNTEERED INFORMATION.
IJHOW1 __________________
IJHOW2 __________________
IJHOW3 __________________
IJHOW4 __________________
IJHOW2 __________________
IJHOW3 __________________
IJHOW4 __________________
FIJ.080
FR: ENTER THE FIRST APPROPRIATE BOX WHICH DESCRIBES THE CAUSE OF THE PERSON'S INJURY FROM THE LIST BELOW.
CAUS
(1) Vehicle as transportation, including Motor Vehicle /bicycle /motorcycle /pedestrian /train / boat /airplane(FIJ.090)
(2) Gun/being shot (FIJ.190)
(3) Fire/burn/scald related (FIJ.150)
(4) Near drowning/water in lungs (FIJ.160)
(5) Fall (FIJ.170)
(6) Other (FIJ.200)
(7) Refused (FIJ.200)
(9) DK (FIJ.200)
(2) Gun/being shot (FIJ.190)
(3) Fire/burn/scald related (FIJ.150)
(4) Near drowning/water in lungs (FIJ.160)
(5) Fall (FIJ.170)
(6) Other (FIJ.200)
(7) Refused (FIJ.200)
(9) DK (FIJ.200)
FR: THE NEXT SET OF QUESTIONS ARE ASKED TO VERIFY DETAILS OF THE CIRCUMSTANCES SURROUNDING THE INJURY(S). IF YOU ALREADY KNOW THE ANSWER BECAUSE OF THE VERBATIM RESPONSE FOR HOW THE INJURY(S) OCCURRED, VERIFY THE ANSWER WITH THE RESPONDENT. OTHERWISE, ASK THE QUESTION
FIJ.090
{Were/Was} {you/subject's name} injured as the driver of a vehicle, a passenger in a vehicle, a bicycle rider, or as a pedestrian?
MVWHO
(1) Driver of a vehicle (FIJ.100)
(2) Passenger of a vehicle (FIJ.100)
(3) Bicycle rider (FIJ.130)
(4) Pedestrian (FIJ.140)
(7) Refused (FIJ.200)
(9) DK (FIJ.200)
(2) Passenger of a vehicle (FIJ.100)
(3) Bicycle rider (FIJ.130)
(4) Pedestrian (FIJ.140)
(7) Refused (FIJ.200)
(9) DK (FIJ.200)
[p. 24]
What type of vehicle {were/was} {you/subject's name} in?
MVTYP
(01) Passenger car (FIJ.120)
(02) Light truck (including pickups,vans and utility vehicles) (FIJ.120)
(03) Bus (FIJ.200)
(04) Large truck (FIJ.120)
(05) Motorcycles (including mopeds, minibikes) (FIJ.130)
(06) All terrain vehicle or ski/snow-mobile (FIJ.130)
(07) Farm equipment (tractor) (FIJ.200)
(08) Airplane (FIJ.200)
(09) Boat (FIJ.200)
(10) Train (FIJ.200)
(11) Other (FIJ.200)
(97) Refused (FIJ.200)
(99) DK (FIJ.200)
(02) Light truck (including pickups,vans and utility vehicles) (FIJ.120)
(03) Bus (FIJ.200)
(04) Large truck (FIJ.120)
(05) Motorcycles (including mopeds, minibikes) (FIJ.130)
(06) All terrain vehicle or ski/snow-mobile (FIJ.130)
(07) Farm equipment (tractor) (FIJ.200)
(08) Airplane (FIJ.200)
(09) Boat (FIJ.200)
(10) Train (FIJ.200)
(11) Other (FIJ.200)
(97) Refused (FIJ.200)
(99) DK (FIJ.200)
[If AGE is greater than or equal to 5, ask:]
{Were/Was} {you/subject's name} wearing a safety belt at the time of the accident?
[Else, ask:]
{Were/Was} {you/subject's name} buckled in a car safety seat at the time of the accident?
{Were/Was} {you/subject's name} wearing a safety belt at the time of the accident?
[Else, ask:]
{Were/Was} {you/subject's name} buckled in a car safety seat at the time of the accident?
SBELT
(1) Yes
(2) No
(7) Refused
(9) DK
(Go to FIJ.200)
(2) No
(7) Refused
(9) DK
(Go to FIJ.200)
{Were/Was} {you/subject's name} wearing a helmet at the time of the accident?
HELMT
(1) Yes
(2) No
(7) Refused
(9) DK
(Go to FIJ.200)
(2) No
(7) Refused
(9) DK
(Go to FIJ.200)
What type of vehicle {were/was} {you/subject's name} struck by?
MVHIT
(01) Passenger car
(02) Light truck (including pickups,vans and utility vehicles)
(03) Bus
(04) Large truck
(05) Motorcycles (including mopeds, minibikes)
(06) All terrain vehicle or ski/snow-mobile
(07) Farm equipment (tractor)
(08) Bicycle
(09) Train
(10) Boat (includes all on) water vehicles
(97) Refused (FIJ.200)
(99) DK
(Go to FIJ.200)
(02) Light truck (including pickups,vans and utility vehicles)
(03) Bus
(04) Large truck
(05) Motorcycles (including mopeds, minibikes)
(06) All terrain vehicle or ski/snow-mobile
(07) Farm equipment (tractor)
(08) Bicycle
(09) Train
(10) Boat (includes all on) water vehicles
(97) Refused (FIJ.200)
(99) DK
(Go to FIJ.200)
[p. 24]
What was it that burned/scalded {you/subject's name}?
FR: IF RESPONSE IS FIRE OR SMOKE ASK:
What caused the fire/smoke?
FR: IF RESPONSE IS FIRE OR SMOKE ASK:
What caused the fire/smoke?
BURN
(01) Cigarette, cigar, pipe
(02) Cooking unit
(03) Heater
(04) Wiring
(05) Motor vehicle battery caps,radiator caps
(06) Fireworks
(07) Other explosive
(08) Water or steam
(09) Food
(10) Chemicals
(11) Other
(97) Refused
(99) DK
(Go to FIJ.200)
(02) Cooking unit
(03) Heater
(04) Wiring
(05) Motor vehicle battery caps,radiator caps
(06) Fireworks
(07) Other explosive
(08) Water or steam
(09) Food
(10) Chemicals
(11) Other
(97) Refused
(99) DK
(Go to FIJ.200)
What body of water was involved?
WATER
(1) Bathtub
(2) Swimming pool
(3) Lake,pond
(4) Bay,ocean,sea
(5) River, creek
(6) Other
(7) Refused
(9) DK
(Go to FIJ.200)
(2) Swimming pool
(3) Lake,pond
(4) Bay,ocean,sea
(5) River, creek
(6) Other
(7) Refused
(9) DK
(Go to FIJ.200)
How did {you/subject's name} fall? Anything else?
FR: SHOW CARD F3. RECORD UP TO 2 RESPONSES. ENTER 'N' FOR NO MORE.
On or down or from:
Card F3FR: SHOW CARD F3. RECORD UP TO 2 RESPONSES. ENTER 'N' FOR NO MORE.
On or down or from:
On or down or from:
1. Escalator
2. Stairs or steps
3. Floor/Level ground
4. Curb (including sidewalk)
5. Ladder or scaffolding
6. Playground equipment
7. Building or other structure
8. Chair, bed, sofa or other furniture
9. Tree
10. Toilet, commode
11. Bathtub, shower
2. Stairs or steps
3. Floor/Level ground
4. Curb (including sidewalk)
5. Ladder or scaffolding
6. Playground equipment
7. Building or other structure
8. Chair, bed, sofa or other furniture
9. Tree
10. Toilet, commode
11. Bathtub, shower
Into:
12.Swimming pool
13.Hole or other opening
14. Other
13.Hole or other opening
14. Other
FALL
(1) Escalator
(2) Stairs or steps
(3) Floor/level ground
(4) Curb, including sidewalk
(5) Ladder or scaffolding
(6) Playground equipment
(7) Building or other structure
(8) Chair, bed, sofa or other furniture
(9) Tree
(10) Toilet, commode
(11) Bathtub, shower
Into:
(12) Swimming pool
(13) Hole or other opening
(14) Other
(97) Refused
(99) DK
[ ]
[ ]
(2) Stairs or steps
(3) Floor/level ground
(4) Curb, including sidewalk
(5) Ladder or scaffolding
(6) Playground equipment
(7) Building or other structure
(8) Chair, bed, sofa or other furniture
(9) Tree
(10) Toilet, commode
(11) Bathtub, shower
Into:
(12) Swimming pool
(13) Hole or other opening
(14) Other
(97) Refused
(99) DK
[ ]
[ ]
[p. 26]
What caused {you/subject's name} to fall? Was it due to:
FWHY
(1) Slipping, tripping or stumbling
(2) Jumping or diving
(3) Collision with/pushing,shoving by another person
(4) Loss of balance/dizziness/becoming faint/seizure
(5) Or something else
(7) Refused
(9) DK
(Go to FIJ.200)
(2) Jumping or diving
(3) Collision with/pushing,shoving by another person
(4) Loss of balance/dizziness/becoming faint/seizure
(5) Or something else
(7) Refused
(9) DK
(Go to FIJ.200)
What kind of gun was it?
GUNTP
(1) Firearm (handgun, shotgun, rifle)
(2) BB or pellet gun
(3) Dart gun
(4) Other
(7) Refused
(9) DK
(2) BB or pellet gun
(3) Dart gun
(4) Other
(7) Refused
(9) DK
What {were/was} {you/subject's name} doing when the injury(s) happened?
FR: SHOW CARD F4. RECORD UP TO 2 RESPONSES. ENTER 'N' FOR NO MORE.
Card F4FR: SHOW CARD F4. RECORD UP TO 2 RESPONSES. ENTER 'N' FOR NO MORE.
1. Driving
2. Working at a paid job
3. Working around the house or yard
4. Attending school
5. Unpaid work (including, housework, shopping, volunteer work)
6. Sports (organized team or individual sport such as running, biking, skating)
7. Leisure activity (excluding sports)
8. Sleeping, resting, eating, drinking
9. Cooking
10. Being cared for (hands-on care from other person)
11. Other
2. Working at a paid job
3. Working around the house or yard
4. Attending school
5. Unpaid work (including, housework, shopping, volunteer work)
6. Sports (organized team or individual sport such as running, biking, skating)
7. Leisure activity (excluding sports)
8. Sleeping, resting, eating, drinking
9. Cooking
10. Being cared for (hands-on care from other person)
11. Other
WHAT
(1) Driving
(2) Working at paid job
(3) Working around the house or yard
(4) Attending school
(5) Unpaid work (incl.housework,shopping, volunteer work)
(6) Sports (organized team or individual sport such as running, biking, skating)
(7) Leisure activity (excluding sports)
(8) Sleeping, resting,eating, drinking
(9) Cooking
(10) Being cared for (hands on care from other person)
(11) Other
(97) Refused
(99) DK
[ ]
[ ]
(2) Working at paid job
(3) Working around the house or yard
(4) Attending school
(5) Unpaid work (incl.housework,shopping, volunteer work)
(6) Sports (organized team or individual sport such as running, biking, skating)
(7) Leisure activity (excluding sports)
(8) Sleeping, resting,eating, drinking
(9) Cooking
(10) Being cared for (hands on care from other person)
(11) Other
(97) Refused
(99) DK
[ ]
[ ]
Where (were/was} {you/subject's name} when the injury(s) happened?
FR: SHOW CARD F5. RECORD UP TO 2 RESPONSES. ENTER 'N' FOR NO MORE.
Card F5FR: SHOW CARD F5. RECORD UP TO 2 RESPONSES. ENTER 'N' FOR NO MORE.
1. Home (inside)
2. Home (outside)
3. School (not residential)
4. Child care center or Preschool
5. Residential institution (excluding hospital)
6. Health care facility (including hospital)
7. Street/highway
8. Parking lot
9. Sport facility, athletic field or playground
10. Trade and service area (restaurant, store, bank, gas station)
11. Farm
12. Park/recreation area (fields, bike or jog path)
13. River/lake/stream/ocean
14. Swimming pool
15. Industrial or construction area
16. Mine/quarry
17. Other public building
18. Other
2. Home (outside)
3. School (not residential)
4. Child care center or Preschool
5. Residential institution (excluding hospital)
6. Health care facility (including hospital)
7. Street/highway
8. Parking lot
9. Sport facility, athletic field or playground
10. Trade and service area (restaurant, store, bank, gas station)
11. Farm
12. Park/recreation area (fields, bike or jog path)
13. River/lake/stream/ocean
14. Swimming pool
15. Industrial or construction area
16. Mine/quarry
17. Other public building
18. Other
WHER
(1) Home (inside)
(2) Home (outside)
(3) School (not residential)
(4) Child care center or Preschool
(5) Residential institution (excl.hosp.)
(6) Health care facility (incl.hospital)
(7) Street/highway
(8) Parking lot
(9) Sport facility, ath.field or playground
(10) Trade and service areas (restaurant,store, bank, gas station)
(11) Farm
(12) Park/recreation area (fields, bike or jog path)
(13) River/lake/stream/ocean
(14) Swimming pool
(15) Industrial or construction area
(16) Mine/quarry
(17) Other public building
(18) Other
(97) Refused
(99) DK
[ ]
[ ]
(2) Home (outside)
(3) School (not residential)
(4) Child care center or Preschool
(5) Residential institution (excl.hosp.)
(6) Health care facility (incl.hospital)
(7) Street/highway
(8) Parking lot
(9) Sport facility, ath.field or playground
(10) Trade and service areas (restaurant,store, bank, gas station)
(11) Farm
(12) Park/recreation area (fields, bike or jog path)
(13) River/lake/stream/ocean
(14) Swimming pool
(15) Industrial or construction area
(16) Mine/quarry
(17) Other public building
(18) Other
(97) Refused
(99) DK
[ ]
[ ]
[p. 27]
{Were/Was} {you/subject's name} hospitalized for at least one night as a result of this injury/these injuries?
IHOSP
(1) Yes (FIJ.250)
(2) No (FIJCCI1)
(7) Refused (FIJCCI1)
(9) DK (FIJCCI1)
(2) No (FIJCCI1)
(7) Refused (FIJCCI1)
(9) DK (FIJCCI1)
How many nights {were/was} {you/subject's name} in the hospital?
FR: IF "STILL IN HOSPITAL," ASK HOW MANY NIGHTS UP TO TODAY.
FR: IF "STILL IN HOSPITAL," ASK HOW MANY NIGHTS UP TO TODAY.
IHNO
(01-94) 1-94 nights
(95) 95+ nights
(97) Refused
(99) DK
(95) 95+ nights
(97) Refused
(99) DK
Check item FIJCCI1:If AGE is greater than 13 then go to FIJ.260; Else
If AGE is greater than 4 and less than 14 then go to FIJ.270; Else
If AGE is less than 5 then return to FIJ.040 for next injury episode or next person.
If there are no more persons and no more injury episodes, go to FIJ.300.
FIJ.260
If AGE is greater than 4 and less than 14 then go to FIJ.270; Else
If AGE is less than 5 then return to FIJ.040 for next injury episode or next person.
If there are no more persons and no more injury episodes, go to FIJ.300.
As a result of this injury/these injuries, how much work did{you/subject's name} miss?
FR: SHOW CARD F6.
Card F6FR: SHOW CARD F6.
Not employed at the time of the injury/poisoning
None
Less than 1 day
1 to 5 days
6 or more days
None
Less than 1 day
1 to 5 days
6 or more days
WKLS
(0) None
(1) Less than 1 day
(2) 1 to 5 days
(3) Six or more days
(6) Not employed at the time of the injury
(7) Refused
(9) DK
(1) Less than 1 day
(2) 1 to 5 days
(3) Six or more days
(6) Not employed at the time of the injury
(7) Refused
(9) DK
As a result of this injury/these injuries, how much school did {you/subject's name} miss?
FR: SHOW CARD F7.
Card F7FR: SHOW CARD F7.
Not in school at the time of the injury/poisoning
None
Less than 1 day
1 to 5 days
6 or more days
None
Less than 1 day
1 to 5 days
6 or more days
SCLS
(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 the injury
(7) Refused
(9) DK
(1) Less than 1 day
(2) One to five days
(3) Six or more days
(6) Not in school at the time of the injury
(7) Refused
(9) DK
As a result of this injury/theses injuries {do/does}{you/subject's name} now need the help of other persons with {your/his/her} personal care needs, such as eating, bathing, dressing or getting around this home?
IJADL
(1) Yes (FIJ.285)
(2) No (FIJ.290)
(7) Refused (FIJ.290)
(9) DK (FIJ.290)
(2) No (FIJ.290)
(7) Refused (FIJ.290)
(9) DK (FIJ.290)
Do you expect {you/subject's name} will need this help for a total of 6 months or longer?
LIMTM
(1) Yes
(2) No
(7) Refused
(9) DK
(2) No
(7) Refused
(9) DK
[p.28]
As a result of this injury/these injuries {do/does} {you/subject's name} now need the help of other persons in handling routine needs such as everyday household chores, doing necessary business, shopping or getting around for other purposes?
IJIAD
(1) Yes (FIJ.295)
(2) No (FIJCCI1A)
(7) Refused (FIJCCI1A))
(9) DK (FIJCCI1A)
(2) No (FIJCCI1A)
(7) Refused (FIJCCI1A))
(9) DK (FIJCCI1A)
Do you expect {you/subject's name} will need this help for a total of 6 months or longer?
HLIMT
(1) Yes
(2) No
(7) Refused
(9) DK
(2) No
(7) Refused
(9) DK
Check item FIJCCI1A: Return to FIJ.040 for next injury episode or next person.
If there are no more persons and no more injury episodes, go to FIJ.300.
If there are no more persons and no more injury episodes, go to FIJ.300.
ijep