| Section | Title | Purpose | Topic | Question # | Source | Modified Source |
Added to Source |
| C | Background Information | To confirm identity of respondent and contact information | Identifiers and contact information | C1-C8 | New | N/A | N/A |
| D | Clean-up Related Tasks and Exposures During Clean-up | To assess exposure to oil and dispersants | Exposure | D0-D61 | New | N/A | N/A |
| E | Demographics | To measure covariates | Gender | E1 | PhenX / CHIS Adult Questionnaire | No | No |
| Ethnicity | E2 | PhenX / NHANES | Yes | No | |||
| Place of Birth | E3,a,b | PhenX / American Community Survey | Yes | Yes | |||
| Race | E4 | PhenX / NHANES | Yes | No | |||
| Parental Country of Origin | E4a,b | PhenX / American Community Survey | Yes | No | |||
| Education | E5 | PhenX / NHANES | No | No | |||
| Marital Status | E6 | PhenX / NHANES | No | No | |||
| Children in Household | E7 | BRFSS | Yes | Yes | |||
| F | Health | To measure covariates and health outcomes | Height/Weight | F1-F2 | PhenX / NHANES | Yes | No |
| Self reported Health Status | F3-F4 | CDC - Gulf State Population Survey | No | Yes | |||
| Health Symptoms while Working on the Oil Spill | F5-F24 | New | N/A | N/A | |||
| Health Symptoms (Past 30 days) | F25-F43c | ATS | Yes | Yes | |||
| Medical History | F44-F66c | NHANES | Yes | Yes | |||
| G | Mental Health | To measure covariates and health outcomes | Social Context | G1-G3a | CDC - Gulf State Population Survey | Yes | Yes |
| Lifetime Anxiety and Depression | G4-G5b | CDC - Gulf State Population Survey | Yes | Yes | |||
| Perceived Stress | G6-G9 | Cohen Perceived Stress Scale | No | No | |||
| H | Reproductive History and Menopausal Status | To measure covariates | Menstrual History | H1 | NHANES | No | No |
| Pregnancy Status | H2,a,b | PhenX / NHANES | Yes | Yes | |||
| Births | H3,a,b | PhenX / NCI Women's Interview Study of Health | Yes | No | |||
| Menstrual History | H4 | PhenX / SWAN | No | Yes | |||
| I | Lifestyle-Alcohol | To measure covariates | Lifetime Use | I1 | PhenX / NIAAA NESCAR | Yes | No |
| Age of First Use | I2, a | PhenX / NIAAA NESCAR | No | Yes | |||
| Past Alcohol Consumption | I3-I3d.1 | NHANES | Yes | Yes | |||
| 12 Month Alcohol History | I4-6a | NHANES | Yes | Yes | |||
| 30 Day Alcohol History | I7-I8 | PhenX / National Survey on Drug Use and Health | No | No | |||
| Largest Amount | I9-I10 | PhenX / AUDADIS | No | Yes | |||
| J | Lifestyle-Tobacco | To measure covariates | Smoking Status | J1, J3 | PhenX / NCI, CDC Current Population Survey | No | No |
| Age of Initiation | J2 | PhenX / NCI, CDC Current Population Survey | No | No | |||
| Quantity and Frequency | J4-J9 | PhenX / NCI, CDC Current Population Survey / NHANES | No | No | |||
| Other tobacco use | J10-J10d | PhenX / NIAAA NESARC and AUDADIS | No | No | |||
| K | Socioeconomic Factors | To measure covariates | Income | K1 | NHANES + American Community Survey sources | Yes | Yes |
| Household Size for Income | K2 | Sister's Study | No | No | |||
| Income Comparison | K3 | New | N/A | N/A | |||
| Job History | K4-K22c | PhenX / Census Bureau | Yes | Yes | |||
| Employment in Oil Industry | K23-24c | New | N/A | N/A | |||
| Advanced Occupational Training | K25-K26 | New | N/A | N/A | |||
| Military Service | K27 | American Community Survey | Yes | Yes | |||
| Occupational Exposure | K28 | PhenX / NHANES | Yes | Yes |
| Section | Title | Purpose | Topic | Question # | Source | Modified Source |
Added to Source |
| E | Clean-up Related Tasks and Exposures During Cleanup | To measure exposure to oil and dispersants | Exposure | E1-E5 | New | N/A | N/A |
| F | Health | To measure covariates and health outcomes | Medication | F1, a, b | Sister's Study? | Yes | Yes |
| Infections diseases | F2 - F7b | NHANES | Yes | Yes | |||
| Respiratory Symptoms | F8 - F39 | PhenX / ATS Questionnaire | Yes | Yes | |||
| Recent acute illness | F40 - F47 | New | N/A | N/A | |||
| G | Access to Healthcare | To measure covariates | Insurance | G1 - G4 | BRFSS | No | Yes |
| H | Family Medical History | To measure covariates | Family History | H1 - H32 | PhenX / Women's Health Initiative Family History Questionnaire | Yes | Yes |
| I | Mental Health | To measure covariates and outcomes | Anxiety | I1 - I7 | CDC - Gulf State Population Survey | No | No |
| Depression | I8 - I15 | CDC - Gulf State Population Survey | No | No | |||
| PTSD | I16 - I19 | PC-PTSD Scale | Yes | No | |||
| Resiliency and Coping | I20 - I23 | CDC - Gulf State Population Survey | Yes | No | |||
| Social Support | I24 - I26 | CDC - Gulf State Population Survey (not in final ver. of CDC survey) | Yes | No | |||
| Received Mental Health Care | I27 - I30 | CDC - Gulf State Population Survey | Yes | Yes | |||
| J | Occupational History | To measure covariates | Occupational history | J1-J7 | PhenX / NHANES | Yes | Yes |
| K | Non-occupational exposures | To measure covariates | Hobbies | K1a - K1j | PhenX / Long Island Breast Cancer Study | Yes | Yes |
| L | Lifestyle | To measure covariates for biologic measures interpretation | Smoking | L1 - L2 | New | N/A | N/A |
| Alcohol | L3 | New | N/A | N/A | |||
| M | Residential History | To measure covariates | Residential history | M1 - M7 | PhenX / Parkinson’s Disease, Environment, and Genes Study | Yes | No |
| N | Katrina Experience | To measure covariates | Katrina experience | N1 - N9a | CDC - Gulf State Population Survey | Yes | Yes |
| O | Physical Activity | To measure covariates | Physical Activity | O1 - O7 | IPAQ | No | No |
| P | Fish Consumption | To measure covariates | Raw Seafood | P1, a | New | N/A | N/A |
| Cooked Seafood | P2, a | New | N/A | N/A |
| File Type | application/vnd.ms-excel |
| Author | SRA |
| Last Modified By | juras |
| File Modified | 2011-01-21 |
| File Created | 2011-01-12 |