Health Effects of Microbial Pathogens in Recreational Waters; National Epidemiological and Environmental Assessment of Recrea- tional (NEEAR) Water Study (Renewal)

BEACH INTERVIEW

OMB Control No.: 2080-0068

Expiration Date: xx/xx/xxxx

Site ID ______

Friday _______ Saturday _______ Sunday______ Monday _________

Date:__-__-____

Time: _________

18Have you been interviewed by the National Beaches Survey in the last 28 days?

19Would you be willing to participate in a study on illnesses associated with recreation at

the beach?

Yes (give brochure with consent form, inform about 2 follow-up calls)

No (Terminate Interview).

2a. Our survey is primarily for households of one or more persons that live together at the same address; Do you all live at the same address?

20How many members in your party are at the beach today including yourself?

21What time did you and your household arrive at the beach today?

22We are interested in asking about the health of your household during the few weeks

following your beach visit. Could you please give me your telephone number so we can get in touch with you in 10-12 days from now?

5a. If “NO” Is it fror one of the following reasons? Too busy, no longer interested, will not be available, specify, other reason?

5b. 10-12 days from now which phone number(s) should we call?

5c. Is this your home, vacation, or cell phone number?

5d. Additional phone numbers?

6. What are the best times to reach you during week days?

6a. Can I please have your mailing address so that we can send you your $25 Thank you check? We will destroy your identifying information after we mail the check.

7. Please tell me the first name of the members of your household at the beach today, their birth dates, gender race ethnicity, and whether they are in diapers.

8. Will (you/all these people with you at the beach today) be living (with you) at the same

address (es) during the next two weeks?

9. Have any of these household members at the beach today been ill in the past 3 days with:

Diarrhea or loose bowels

Urinary tract infection or burning sensation

Throwing-up or vomiting

Sore throat or cough

Earache, ear infection or runny ears

Eye infection

Rash or itchy skin

Sunburn

23Are there any household members NOT present at the beach today?

10a. Have any household members NOT present at the beach today been ill in the past 3 days with:

Diarrhea or loose bowels

Urinary tract infection or burning sensation

Throwing-up or vomiting

Sore throat or cough

Earache, ear infection or runny ears

Eye infection

Rash or itchy skin

Sunburn

11. Do you or any household members at the beach today, not including anyone who stayed at home, suffer from any of the following chronic long-term conditions:

Gastrointestinal problems such as Crohn’s disease or irritable bowel syndrome

Chronic respiratory diseases such as asthma or emphysema

Allergies, other than drug allergies

Skin problems such as psoriasis or eczema

12. How many times do you usually come to this beach each summer (Memorial Day to Labor Day)?

13. How many miles did you travel to the beach today?

14. During the past two weeks, did you (anyone in your household at the beach today) go bathing or swimming anywhere - at this or some other beach, pool or lake?

14a. Did you go bathing or swimming anywhere in the past one week (Monday through Friday) at this or some other beach, pool or lake?

14b. Did you actually get your head or face wet?

14c. During the past 2 weeks, did you get a sunburn that lasted more that 12 hours?

PART B– Exit Beach Interview

15. Were you the person that we interview on the beach or earlier today?

16a. Did you or anyone in your household wade, swim, or play in the water today?

16a1. Did you immerse your body, not necessarily you head, in the water today?

16a2. Did you put your face in the water or submerge head in the water today?

16a3. Did you get water in the mouth today?

16a4. Did you swallow the water?

16b. Were you in the water at the following times today? {time charts given}

16b1. If “YES” what part of the beach did you swim in? {include all beach areas}

16b2. If “YES” what part of the beach did you swim in most of the time?

16c. What total time did you stay in the water? We are only interested in time actually in the water, not the total time at the beach?

16d. Did you engage in any of the following water-related activities while at the beach today?

{Dropdown list of water activities}

17. What would you estimate your total time in direct sunlight was? This does not include being indoors or under umbrellas, etc.?

18. Did you engage in any of the following activities while at the beach today?

a. Collecting sea shells, rocks, feathers, etc?

b. Digging in sand or building sand castles?

c. Had their body buried in the sand?

18c1. Did person get sand in their mouth

After digging in sand, or building sand castles…did person eat or drink anywhere (not necessarily at the beach)?

After digging in sand, or building sand castles…did person wash their hands before eating? Washing of hands may include the use of personal water-free hand sanitizer?

18c1b. Was the sand the person dug in or played with dry or wet?

18d. Did you engage in any of the following activities while at the beach today?

Playing with algae or seaweed

18d1. Did you get any seaweed in their mouth?

18d1a. After playing with algae or seaweed…did you eat or drink anywhere (not necessarily at the beach)?

18d1b. After playing with algae or seaweed… did person wash their hands before eating? Washing of hands may include the use of personal water free hand sanitizer?

19. Did you cut yourself today or have an open cut when you came to beach today?

20. Did you wear sunscreen/sunblock today?

21. What was the SPF rating of the sunscreen/sunblock you used most often today?

21a. When you used sunscreen/sunblock today, how did you apply it? Only to certain areas of my body? All exposed skin?

24Did you reapply at least once today?

23. Did you wear a hat today?

23a. Did the hat have a wide brim or another way to shade face, ears, and back of the neck from the sun?

23a1. Did you use protective equipment such as a canopy, umbrella or other type of sunshade today?

23b. Did you wear protective clothing, such as a long-sleeved shirt or cover-up?

25During the summer, if you go out in the sun repeatedly without sunscreen or protective

clothing, which one of these things most usually happens to your skin?

A dark tan

Some tanning

No tan, maybe some freckles

Repeated sunburns

Other (specify)

Never go out in the sun

26Did you wear insect repellant today?

27Did your or any member of your household consume food while at the beach today?

26a. Was the food brought from home?

26b. Was the food purchased from vending machines or a vendor at the beach?

26c. Was the food purchased from a vendor outside the beach?

28Did your or any member of your household consume drinks while at the beach today?

27a. Were the drinks brought from home?

27b. Were the drinks purchased from vending machines or a vendor at the beach?

27c. Were the drinks purchased from a vendor outside the beach?

28. In the past 48 hours has anyone who is at the beach today done the following…

29Have you come in contact with any unknown animals?

30Come in contact with someone who has complained of diarrhea, vomiting, or stomach illness?

31Consumed raw shellfish?

32Consumed rare/raw meat?

33Consumed runny or raw eggs?

Telephone Interview - follow-up (10-12 days)

Is this person (primary respondent from beach interview)?

Yes (continue)

No (reschedule or continue)

Were you at the beach on (give date) with (primary respondent)?

Yes - Continue

I’m going to ask questions about any swimming you’ve done and illnesses you’ve experienced in the last week for the following people:

A1. May I have your first name please?

During your beach visit where you enrolled in this study on __________

A2. Did you wear ear plugs while in the water? Ask for all household members at the beach.

A3. Did you wear nose plugs while in the water? Ask for all household members at the beach.

A4. Did you wear eye goggles while in the water? Ask for all household members at the beach.

A5. During the beach interview, did you have contact with an animal? Ask for all household members at the beach.

A6. Between your beach visit on ______ date and today were you menstruating or pregnant? Ask for all household members at the beach.

We are now going to switch and ask you questions about activities that have occurred since the Beach Interview.

B1. Have you, or any of the people I just mentioned, gone bathing or swimming anywhere since we talked to you at the beach interview on ______? Please include any bathing or swimming such as at a beach, waterpark, public pool, private pool, or wading pool.

B2. Who was it that went bathing or swimming? Ask for all household members at the beach.

B3a. Did you go bathing or swimming at the beach (where the interview was taken) since the beach interview on this date {BEACH INTERVIEW DATE}.

B3b. Did you go bathing or swimming at any other beach since the beach interview on this date {BEACH INTERVIEW DATE}.

B3c. Was this beach at a:

Lake

River

Ocean

Other, specify

B3d. Did you go bathing or swimming at a waterpark?

B3e. Did you go bathing or swimming at a public pool?

B3f. Did you go bathing or swimming at a private pool?

B3g. Did you go bathing or swimming in a wading pool?

B3h. Did you go bathing or swimming any other place?

B3i. Swim location of any other place?

B4. Did you actually get your face wet while bathing or swimming? Ask for all household members at the beach.

B5. On which days did you go bathing or swimming? Ask for all household members at the beach.

B6. Have you or anyone else had a stomachache or abdominal cramping since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B6a. Who had a stomachache or abdominal cramping since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B7. Have you or anyone else had diarrhea or loose bowels since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B7a. Who had diarrhea or loose bowels since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B8. Have you or anyone else had nausea since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B8a. Who had nausea since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B9. Have you or anyone else had throwing-up or vomiting since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B9a. Who had throwing-up or vomiting since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B10. Have you or anyone else had urinary tract infection or burning sensation when urinating since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B10a. Who had urinary tract infection or burning sensation when urinating since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B11. Have you or anyone else had fever since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B11a. Who had fever since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B12. Have you or anyone else had headache lasting more than a few hours since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B12a. Who had headache lasting more than a few hours since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B13. Have you or anyone else had sore throat since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B13a. Who had sore throat since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B14. Have you or anyone else had a bad cough since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B14a. Who had a bad cough since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B15. Have you or anyone else had a cold since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B15a. Who had a cold since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B16. Have you or anyone else had a runny or stuffy nose since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B16a. Who had a runny or stuffy nose since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B17. Have you or anyone else had an earache, ear infection, or runny ears since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B17a. Who had an earache, ear infection, or runny ears since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B18. Have you or anyone else had watery eyes since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B18a. Who had watery eyes since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B19. Have you or anyone else had an eye infection since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B19a. Who had an eye infection since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B20. Have you or anyone else had an infected cut since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B20a. Who had an infected cut since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B21. Have you or anyone else had a rash or itchy skin since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B21a. Who had a rash or itchy skin since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B22. Have you or anyone else had a sunburn since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B22a. Who had a sunburn since the interview at {STUDY BEACH} ON {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

We will now ask about some activities people may have done since the day of the beach interview on the {BEACH INTERVIEW DATE}

B23a. Since the day of the beach interview, have you or anyone else come in contact with any animals? Ask for all household members at the beach.

B23b. Who came into contact with animals since {BEACH INTERVIEW DATE}? Ask for all household members at the beach.

B23c. Was this animal or any of these animals unfamiliar to you?

B23d. What kind of animals were they?

B24a. Since the day of the beach interview has anyone come into contact with someone who has complained of diarrhea, vomiting, or stomach illness?

B24b. Who had contact with someone complaining of diarrhea, vomiting, or stomach illness since {BEACH INTERVIEW DATE}?

B25a. Since the day of the beach interview has anyone eaten raw shell fish, such as oysters, clams, mussels, crabs?

B25b. Who has eaten raw shell fish, such as oysters, clams, mussels, crabs since {BEACH INTERVIEW DATE}?

B26a. Since the day of the beach interview has anyone rare or raw meat?

B26b. Who has eaten rare or raw meat since {BEACH INTERVIEW DATE}?

B27a. Since the day of the beach interview has anyone eaten raw or runny eggs?

B27b. Who has eaten raw or runny eggs since {BEACH INTERVIEW DATE}?

SECTION C

This section is for all persons that experience symptoms.

C1. On what day did your stomachache or abdominal cramping start?

C1a. Do you still have a stomachache or abdominal cramping?

C1b. (For persons that still have symptom) For how many days did you have a stomachache or abdominal cramping?

C2. On what day did your diarrhea or loose bowels start?

C2a. Do you still have a diarrhea or loose bowels cramping?

C2b. For how many days did you have a diarrhea or loose bowels cramping?

C2c. What was the maximum number of bouts or episodes of diarrhea experienced in a 24-hour period? Ask for each person with symptom.

C3. On what day did your nausea start?

C3a. Do you still have nausea?

C3b. For how many days did you have nausea?

C4. On what day did your throwing-up or vomiting start?

C4a. Do you still have throwing-up or vomiting?

C4b. For how many days did you have throwing-up or vomiting?

C4c. What was the maximum number of bouts or episodes of throwing-up or vomiting experienced in a 24-hour period? Ask for each person with symptom.

C5. On what day did your urinary tract infection or burning sensation start?

C5a. Do you still have a urinary tract infection or burning sensation?

C5b. For how many days did you have urinary tract infection or burning sensation?

C6. On what day did your fever start?

C6a. Do you still have a fever?

C6b. For how many days did you have a fever?

C6c. Was your temperature taken using a thermometer?

C6d. What is the highest temperature that you had since your beach interview on {BEACH INTERVIEW DATE}?

C7. On what day did your headache start?

C7a. Do you still have a headache?

C7b. For how many days did you have headache?

C8. On what day did your sore throat start?

C8a. Do you still have a sore throat?

C8b. (For persons that still have symptom) For how many days did you have sore throat?

C8c. (For persons that still have symptom) Was this sore throat related to allergies?

C9. On what day did your bad cough start?

C9a. Do you still have a bad cough?

C9b. For how many days did you have a bad cough?

C9c. Was this bad cough related to allergies?

C10. On what day did your cold start?

C10a. Do you still have a cold?

C10b. For how many days did you have a cold?

C10c. Was this cold related to allergies?

C11. On what day did your runny or stuffy nose start?

C11a. Do you still have a runny or stuffy nose?

C11b. For how many days did you have a runny or stuffy nose?

C11c. Was this runny or stuffy nose related to allergies?

C12. On what day did your earache, ear infection or runny ears start?

C12a. Do you still have an earache, ear infection or runny ears?

C12b. For how many days did you have an earache, ear infection or runny ears?

C12c. Was this earache, ear infection or runny ears related to allergies?

C13. On what day did your watery eyes start?

C13a. Do you still have watery eyes?

C13b. For how many days did you have watery eyes?

C13c. Was this watery eyes related to allergies?

C14. On what day did your eye infection start?

C14a. Do you still have eye infection?

C14b. For how many days did you have eye infection?

C15. On what day did your cut first get infected?

C15a. Do you still have an infected cut?

C15b. For how many days did you have an infected cut?

C15c. Where were you cut? Mark all that apply

C16. On what day did your rash, itchy skin, or skin infection start?

C16a. Do you still have a rash, itchy skin, or skin infection?

C16b. For how many days did you have a rash, itchy skin, or skin infection?

C16c. Where did you have a rash, itchy skin, or skin infection? Mark all that apply

C17. On which parts of the body were you sunburned? Mark all that apply

Drop down list

SECTION D

Ask only once for each person reporting symptoms

D1. When your condition began, were you working for pay either inside or outside the home? Please include jobs for which you were self-employed.

D2. During your illness, did you miss any time from work, for example because you called in sick or took time off to see a doctor?

D3. How many days?

D4. Did this illness prevent you from performing daily activities such as school, recreation, or vacation activities, or work around the home?

D5. How many days?

D6. Did this illness cause other household members to lose time at work?

D7. How many days?

D8a. Did you consult a healthcare provider over the phone about this illness/condition?

D8b. Did you visit a healthcare provider?

D8c. How many times?

D8d. What illness did the healthcare provider say you had?

D8e. Did you visit an emergency room?

D8f How many times?

D8g. Were you admitted to a hospital?

D8h. How many days were you hospitalized?

D8i. Were you given intravenous fluids?

D9a. Did you receive a prescription for an antibiotic or other drug for this illness/condition?

D9b. About how much of your own or your household’s money was spent altogether for these prescription medicines? Amount to nearest dollar.

D10a. Did you use any over-the-counter medications, including things like special drinks, only because of this illness/condition?

D10b. About how much of your own or your household’s money was spent altogether for these over-the-counter medications? Amount to nearest dollar.

SECTION E

E1. Before today, were you aware that people could become ill by swimming at the beach?

E2. After today, will you change the way you use the water at the beach?

SECTION Q

These are questions from beach interview to ensure data collection for important exposures. Ask for all households.

Q1. Did you or anyone in your household wade, swim, or play in the water on {BEACH INTERVIEW DATE}?

Q1a.1. Did you immerse your body, not necessarily your head in the water {BEACH INTERVIEW DATE}?

Q1a.2. Did you put your face in the water or submerge head in the water on {BEACH INTERVIEW DATE}?

Q1a.3. Did you get water in your mouth on {BEACH INTERVIEW DATE}?

Q1a.4. Did you gag or cough after getting water in your mouth on {BEACH INTERVIEW DATE}?

Q1a.5. Did you swallow the water on {BEACH INTERVIEW DATE}?

5