3 Occupational Exposure Qx (complete set)

Attachment 5: Asia Lymph All Job Modules (OccIDEAS)*

OMB #: 0925-XXXX

Expiration date: XX/XX/20XX

Public reporting for this collection of information is estimated to average 45 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. An agency may not conduct or sponsor, and a person is not required to respond to, a collection of information unless it displays a currently valid OMB control number. Send comments regarding this burden estimate or any other aspect of this collection of information, including suggestions for reducing this burden, to: NIH, Project Clearance Branch, 6705 Rockledge Drive, MSC 7974, Bethesda, MD 20892-7974, ATTN: PRA (0925-XXXX). Do not return the completed form to this address.

Note – We estimate that 50% of subjects will not be asked any of these modules and that 50% of subjects will be asked 1-3 of these modules.

	CHEMIST (CH) MODULE
1	In this job, did you work in a lab?
	Yes
	No	[go to 2]
	DK	[go to 2]
1.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2	Did you work in the production area of a plant?
	Yes
	No	[go to 3]
	DK	[go to 3]
2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2	Did you collect process samples in a production area?
	Yes
	No
	DK
3	Did you use chlorinated solvents?
	Yes
	No	[go to 4]
	DK	[go to 4]
3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2	What chlorinated solvents did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Dichloromethane
	Other chlorinated solvent
	DK
4	Did you use benzene?
	Yes
	No	[go to 5]
	DK	[go to 5]
4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	Did you use any other aromatic compounds, such as xylene or toluene?
	Yes
	No	[go to 6]
	DK	[go to 6]
5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6	Did you use formaldehyde or a formaldehyde solution?
	Yes
	No	[go to 7]
	DK	[go to 7]
6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
7	Did you use dyes?
	Yes
	No	[go to 8]
	DK	[go to 8]
7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
7.2	Were these dyes usually in solid or liquid form?
	Solid	[go to 8]
	Liquid	[go to 7.2.1]
	Both	[go to 8]
	DK	[go to 8]
7.2.1	What did these dyes contain? Did they contain…? (allow multiple)
	Benzene
	Toluene or xylene
	Trichloroethylene
	Formaldehyde
	Something else
	DK
8	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
9	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
10	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK
	JANITOR (JA) MODULE
1	In this job, did you ever clean office areas?
	Yes
	No	[go to 2]
	DK	[go to 2]
1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2	In this job, did you ever polish furniture with liquid cleaning chemicals?
	Yes
	No	[go to 3]
	DK	[go to 3]
2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	In this job, did you ever strip floors with liquid cleaning chemicals?
	Yes
	No	[go to 4]
	DK	[go to 4]
3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	In this job, did you ever clean in a production area of the plant?
	Yes
	No	[go to 5]
	DK	[go to 5]
4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	Did you ever work in an area where materials containing solvents, such as paints, varnishes, glues, or degreasers were used?
	Yes
	No	[go to 6]
	DK	[go to 6]
5.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6	In this job, did you ever repair or maintain equipment or property??
	Yes
	No	[go to 7]
	DK	[go to 7]
6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.2	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes
	No	[go to 6.3]
	DK	[go to 6.3]
6.2.1	How many hours per week did you do this?
	< 2
	2-9
	10-19
	20 or more
	DK
6.2.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
6.2.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
6.2.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
6.2.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
6.3	Did other workers clean or degrease parts in the area where you worked?
	Yes
	No	[go to 6.4]
	DK	[go to 6.4]
6.3.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
6.4	In this job, did you ever handle or pump fuel?
	Yes
	No	[go to 7]
	DK	[go to 7]
6.4.1	How many hours per week did you do this?
	< 2
	2-9
	10-19
	20 or more
	DK
7	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
8	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
9	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK

	HEALTH PROFESSION (HP) MODULE
1	In this job, did you work in a room where instruments or other equipment was being sterilized?
	Yes
	No	[go to 2]
	DK	[go to 2]
1.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.2	How were these instruments and equipment sterilized? (allow multiple)
	In a solution
	In an autoclave or sterilizing unit
	Something else
	DK
1.3	What sterilizing agent was usually used in the solution? (allow multiple)
	Formaldehyde
	Phisohex
	Something else
	DK
2	In this job, did you use disinfectants or antiseptics?
	Yes
	No	[go to 3]
	DK	[go to 3]
2.1	What disinfectant or antiseptic did you use? Did you use…? (allow multiple)
	Formaldehyde
	Phisohex
	Something else
	DK
3	In this job, did you clean dialysis machines?
	Yes
	No	[go to 4]
	DK	[go to 4]
3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	In this job, did you clean endoscopes?
	Yes
	No	[go to 5]
	DK	[go to 5]
4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	In this job, did you work in a lab?
	Yes
	No	[go to 6]
	DK	[go to 6]
5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.2	Did you use dyes?
	Yes
	No	[go to 5.3]
	DK	[go to 5.3]
5.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.3	Did you use benzene?
	Yes
	No	[go to 5.4]
	DK	[go to 5.4]
5.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.4	Did you use trichloroethylene?
	Yes
	No	[go to 5.5]
	DK	[go to 5.5]
5.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.5	Did you use any formaldehyde or formalin?
	Yes
	No	[go to 6]
	DK	[go to 6]
5.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6	In this job, did you ever repair or maintain equipment or property?
	Yes
	No	[go to 7]
	DK	[go to 7]
6.1	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes
	No	[go to 6.2]
	DK	[go to 6.2]
6.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.1.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
6.1.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
6.1.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
6.1.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
6.2	Did other workers clean or degrease parts in the area where you worked?
	Yes
	No	[go to 6.3]
	DK	[go to 6.3]
6.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
6.3	In this job, did you ever use paint?
	Yes
	No	[go to 6.4]
	DK	[go to 6.4]
6.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.3.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
6.3.3	Did you paint indoors or inside a ship?
	Yes
	No	[go to 6.3.4]
	DK	[go to 6.3.4]
6.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.3.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
6.3.3.3	Did you paint in a production area of a manufacturing plant?
	Yes
	No	[go to 6.3.4]
	DK	[go to 6.3.4]
6.3.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.3.4	Did you paint outdoors?
	Yes
	No	[go to 6.4]
	DK	[go to 6.4]
6.3.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.4	Did other workers use paints in the area where you worked?
	Yes
	No	[go to 6.5]
	DK	[go to 6.5]
6.4.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
6.5	In this job, did you ever strip paint from metal or wood objects?
	Yes,
	No	[go to 6.6]
	DK	[go to 6.6]
6.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.5.2	To strip paint, what did you use? Did you use…? (allow multiple)
	Methylene chloride
	Acids, alkalis, or caustic solutions?
	Any other chemical
	Something else, such as a heat gun or scraper
	DK
6.6	Did other workers strip paint from metal or wood objects in the area where you worked?
	Yes
	No	[go to 6.7]
	DK	[go to 6.7]
6.6.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
6.7	In this job, did you ever use glues or adhesives?
	Yes
	No	[go to 6.8]
	DK	[go to 6.8]
6.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.7.2	What material were the things you were gluing made of? (allow multiple)
	Wood
	Metal
	Plastic
	Paper
	Fabrics
	Other
	DK
6.7.3	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
6.7.4	Did you use water-based glues or adhesives, for example, vinyl or acrylic resins?
	Yes
	No	[go to 6.7.5]
	DK	[go to 6.7.5]
6.7.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.7.5	Did you use glues or adhesives that you heated with a gun or other heated device?
	Yes,
	No	[go to 6.7.6]
	DK	[go to 6.7.6]
6.7.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.7.6	Did you use contact glues or adhesives where you apply the glue to both pieces being glued, let it dry for a short time, and then join the two pieces together?
	Yes
	No	[go to 6.7.7]
	DK	[go to 6.7.7]
6.7.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.7.7	Did you use glues or adhesives that require mixing two parts of the glue together before applying? (epoxy resins)
	Yes
	No	[go to 6.7.8]
	DK	[go to 6.7.8]
6.7.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.7.8	Did you use urea, phenol or melamine-based glues or adhesives?
	Yes
	No	[go to 6.8]
	DK	[go to 6.8]
6.7.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.8	Did other workers use glues or adhesives in the area where you worked?
	Yes
	No	[go to 6.9]
	DK	[go to 6.9]
6.8.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
6.9	In this job, did you ever handle or use particle board, plywood, or veneered wood?
	Yes
	No	[go to 6.10]
	DK	[go to 6.10]
6.9.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.10	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes
	No	[go to 6.11]
	DK	[go to 6.11]
6.10.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
6.11	In this job, did you ever handle or pump fuel?
	Yes
	No	[go to 7]
	DK	[go to 7]
6.11.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
7	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
8	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
9	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK

	CHEMICAL INDUSTRY (CHI) MODULE
1	What did the employer make? (allow multiple)
	Paints
	Pesticides or fertilizers	[go to 1.1-1.2]
	Drugs or pharmaceuticals	[go to 1.3-1.4]
	Dyes or pigments	[go to 2]
	Other chemicals	[go to 2]
	DK	[go to 2]
1.1	Did the company make fumigants?
	Yes
	No
	DK
1.2	Did the company make insecticides?
	Yes	[go to 2]
	No	[go to 2]
	DK	[go to 2]
1.3	Did the company make vaccines?
	Yes
	No
	DK
1.4	Did the company make antiseptics, germicides or antibacterials?
	Yes
	No
	DK
2	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2.1-2.6]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 2.7-2.12]
	Quality Control, Environmental Control, Engineering or Research	[go to 2.13-2.14]
	Shipping, Receiving or Storage	[go to 2.15-2.18]
	Administration	[go to 3]
	DK	[go to 3]
2.1	Was the part of the plant where you worked making chemicals primarily indoors or outdoors?
	Indoors
	Outdoors
	Both
	DK
2.2	Did you spend time in a control room?
	Yes	[go to 2.2.1]
	No
	DK
2.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3	Did you spend time in any production areas (other than a control room)?
	Yes	[to go 2.3.1]
	No
	DK
2.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.4	How would you describe most of the equipment that you ran or that was in the area where you worked?
	Closed (meaning that the equipment had covers to them and pipes were used to transport most of the materials)
	Open (no covers on the equipment and pipes were not used)
	Both
	DK
2.5	Did you add chemicals by any means (hand, scoop, shovel, or by emptying bags, drums, or other containers) into the equipment?
	Yes	[go to 2.5.1]
	No
	DK
2.5.1	[Ask Vent Mini-module]
2.6	Did you pack or package chemicals?
	Yes	[go to 2.6.1-2.6.2]
	No	[go to 3]
	DK	[go to 3]
2.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.6.2	[Vent mini-module]	[go to 3]
2.7	[Degrease Mini-Module]
2.8	[Paint Mini-Module]
2.9	[Strip Mini-Module]
2.10	[Glue Mini-Module]
2.11	[Board Mini-Module]
2.12	[Fuel Mini-Module]	[go to 3]
2.13	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 2.13.1]
	No
	DK
2.13.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.14	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 2.14.1]
	No	[go to 3]
	DK	[go to 3]
2.14.1	How many hours per week did you do this?
	< 2	[go to 3]
	2 - 9	[go to 3]
	10 - 19	[go to 3]
	20 or more	[go to 3]
	DK	[go to 3]
2.15	[Paint Mini-Module]
2.16	[Glue Mini-Module]
2.17	[Board Mini-Module]
2.18	[Fuel Mini-Module]
3	[Hands mini-module]

	DRY CLEANING TEXTILE INDUSTRY MODULE
1	In this job, what best describes your work location?
	A cleaning service where fabric and cloth items were washed or dry cleaned	[go to SECTION A]
	A mill, factory, workshop or warehouse where yarn, textiles and clothing were made, packaged or shipped	[go to SECTION B]
	None of the above	[go to SECTION D - SECTION J]
	SECTION A [aDLI]
A.1	Did your employer wash clothes on the premises?
	Yes
	No
	DK
A.2	Did your employer dry clean on the premises?
	Yes	[go to A.2.1-A.2.3]
	No
	DK
A.2.1	Did you ever transfer dry cleaned fabric items from the washer to the dryer (please say no if the machines both washed and dried the fabric items in the same machine)?
	Yes	[go to A.2.1.1]
	No
	DK
A.2.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
A.2.2	Did you ever transfer dry cleaning fluid from a storage container to a dry cleaning machine, using a bucket or other type of container? (dry cleaning fluid is the chemical used to dry clean fabric items)
	Yes	[go to A.2.2.1]
	No
	DK
A.2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
A.2.3	To dry clean, what chemicals were used? Did you use…? (allow multiple)
	Perchloroethylene (perc) or tetrachloroethylene (tetra)?
	Trichloroethylene (TCE)?
	Trichloroethane (TCA)?
	Carbon tetrachloride?
	Stoddard solvent?
	Gasoline?
	Something else?
	DK
A.3	Did you ever spot clean fabric items?
	Yes	[go to A.3.1-A.3.2]
	No
	DK
A.3.1	About how many items did you spot clean?
	15 items/week or less
	15 to 100 items/week
	more than 100 items/week
	DK
A.3.2	To spot clean, what chemicals did you use? Did you use…? (allow multiple)
	Perchloroethylene (perc) or tetrachloroethylene (tetra)?
	Trichloroethylene (TCE)?
	Trichloroethane (TCA)?
	Carbon tetrachloride?
	Stoddard solvent?
	A remover formulated to remove paint, grease or oils?
	Gasoline?
	Something else?
	DK
A.4	In this job, did you ever repair or maintain equipment or property?
	Yes	[go to A.4.1-A.4.7]
	No
	DK
A.4.1	Did you ever repair the dry cleaning equipment or maintain the dry cleaning fluid?
	Yes	[go to A.4.1.1]
	No
	DK
A.4.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
A.4.2	[Degrease Mini-Module]
A.4.3	[Paint Mini-Module]
A.4.4	[Strip Mini-Module]
A.4.5	[Glue Mini-Module]
A.4.6	[Board Mini-Module]
A.4.7	[Fuel Mini-Module]
A.5	[Hands mini-module]	[END]
	SECTION B TEXTILE INDUSTRY MODULE
B.1	Was fabric, clothing or other cloth products, or both made at your employer?
	Fabric
	Clothing or other cloth products
	Both
	Something else
	DK
B.2	Was the product made of leather, fur or hair?
	Yes	[go to SECTION C]
	No	[go to SECTION B.2.2]
	DK	[go to SECTION B.2.3]
	SECTION C LEATHER INDUSTRY MINI MODULE
C.1	Did your employer make leather, make a leather product, or do both?
	Make leather
	Make leather product
	Both
	DK
C.2	What color was the leather? (allow multiple)
	Brown
	Pale cream or white
	Other
	DK
C.3	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to C.3.1 - C.3.2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to C.3.3-C.3.8]
	Quality Control, Environmental Control, Engineering or Research	[go to C.4]
	Shipping, Receiving or Storage	[go to C.3.9-C.3.12]
	Administration	[go to C.4]
	DK	[go to C.4]
C.3.1	Was the leather or leather product from animal hides or skins, or was the leather synthetic or man-made?
	Animal hide	[go to C.3.1.1-C.3.1.3]
	Synthetic or man-made	[go to C.3.1.4-C.3.1.6]
	Both	[go to C.3.1.7 - C.3.1.12]
	Something else	[go to C.4]
	DK	[go to C.4]
C.3.1.1	Was the leather already tanned or prepared, or did hides or skin come into the plant that had to have the hair and flesh removed and tanning done to the hides and skins?
	Already tanned
	Hair still on/needed tanning	[go to C.3.1.1.1-C.3.1.1.3]
	Other
	DK
C.3.1.1.1	Did you work in the area where the hide or skin was prepared for tanning ?
	Yes	[go to C.3.1.1.1.1]
	No
	DK
C.3.1.1.1.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.1.2	Did you work in the area where the hides and skins were tanned?
	Yes	[go to C.3.1.1.2.1]
	No
	DK
C.3.1.1.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.1.3	Did you work in the area where the tanned leather was stuffed or fat liquored?
	Yes	[go to C3.1.1.3.1]
	No
	DK
C.3.1.1.3.1	Did you apply the chemicals to stuff or fat liquor the leather?
	Yes	[go to C.3.1.1.3.1.1-C.3.1.1.3.1.2]
	No
	DK
C.3.1.1.3.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.1.3.1.2	What chemicals did you use? (allow multiple)
	Oils
	TCE or trichloroethylene
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Some other chemicals
	DK
C.3.1.2	Did you apply a chemical to the leather?
	Yes	[go to C.3.1.2.1]
	No
	DK
C.3.1.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.3	Did you work in the area where the tanned leather was dried, set out, stretched and softened?
	Yes	[go to C.3.1.3.1]
	No
	DK
C.3.1.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.4	Did you work in the area where chemicals were mixed to make a leather-like resin or plastic?
	Yes	[go to C.3.1.4.1]
	No
	DK
C.3.1.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.5	Did you work in the area where chemicals were heated to make a leather-like resin or plastic?
	Yes	[go to C.3.1.5.1]
	No
	DK
C.3.1.5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.6	Did you work in the area where chemicals were extruded to make a leather-like resin or plastic?
	Yes	[go to C.3.1.6.1]
	No
	DK
C.3.1.6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.7	Was the leather already tanned or prepared, or did hides or skin come into the plant that had to have the hair and flesh removed and tanning done to the hides and skins?
	Already tanned
	Hair still on/needed tanning	[go to C.3.1.7.1-3.1.7.3]
	Other
	DK
C.3.1.7.1	Did you work in the area where the hide or skin was prepared for tanning?
	Yes	[go to C.3.1.7.1.1]
	No
	DK
C.3.1.7.1.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.7.2	Did you work in the area where the hides and skins were tanned?
	Yes	[go to C.3.1.7.2.1]
	No
	DK
C.3.1.7.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.7.3	Did you work in the area where the tanned leather was stuffed or fat liquored?
	Yes	[go to C.3.1.7.3.1]
	No
	DK
C.3.1.7.3.1	Did you apply the chemicals to stuff or fat liquor the leather?
	Yes	[go to C.3.1.7.3.1.1-C.3.1.7.3.1.2]
	No
	DK
C.3.1.7.3.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.7.3.1.2	What chemicals did you use? (allow multiple)
	Oils
	TCE or trichloroethylene
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Some other chemicals
	DK
C.3.1.8	Did you apply a chemical to the leather?
	Yes	[go to C.3.1.8.1]
	No
	DK
C.3.1.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.9	Did you work in the area where the tanned leather was dried, set out, stretched and softened?
	Yes	[go to C.3.1.9.1]
	No
	DK
C.3.1.9.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.10	Did you work in the area where chemicals were mixed to make a leather-like resin or plastic?
	Yes	[go to C.3.1.10.1]
	No
	DK
C.3.1.10.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.11	Did you work in the area where chemicals were heated to make a leather-like resin or plastic?
	Yes	[go to C.3.1.11.1]
	No
	DK
C.3.1.11.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.1.12	Did you work in the area where chemicals were extruded to make a leather-like resin or plastic?
	Yes	[go to C.3.1.12.1]
	No
	DK
C.3.1.12.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.2	Did you work in the area where the leather pieces were glued together or glued to metal or plastic pieces?
	Yes	[go to C.3.2.1 - C.3.2.2]
	No
	DK
C.3.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.3.2.2	Did you do the gluing?
	Yes	[go to C.3.2.2.1]
	No
	DK
C.3.2.2.1	How many hours per week did you do this?
	< 2	[go to C.4]
	2 - 9	[go to C.4]
	10 - 19	[go to C.4]
	20 or more	[go to C.4]
	DK	[go to C.4]
C.3.3	[Degrease Mini-Module]
C.3.4	[Paint Mini-Module]
C.3.5	[Strip Mini-Module]
C.3.6	[Glue Mini-Module]
C.3.7	[Board Mini-Module]
C.3.8	[Fuel Mini-Module]	[go to C.4]
C.3.9	[Paint Mini-Module]
C.3.1	[Glue Mini-Module]
C.3.11	[Board Mini-Module]
C.3.12	[Fuel Mini-Module]
C.4	[Hands mini-module]	[END]
	SECTION B.2.2 CONTINUE TEXTILE INDUSTRY MODULE
B.2.2	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to B.2.2.1 - 2.2.8]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to B.2.2.9-B.2.2.15]
	Quality Control, Environmental Control, Engineering or Research	[go to B.2.2.16-B.2.2.17]
	Shipping, Receiving or Storage	[go to B.2.2.18-B.2.2.22]
	Administration	[END]
	DK	[END]
B.2.2.1	What was the product made of ? (allow multiple)
	Cotton
	Wool
	Man-made or synthetic
	Something else
	DK
B.2.2.2	Did you work in the area where scouring or cleaning was done?
	Yes	[go to 2.2.2.1-2.2.2.2]
	No
	DK
B.2.2.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.2.2.2	Was perchloroethylene (perc) or tetrachloroethylene (tetra) used to scour or clean the products?
	Yes
	No
	DK
B.2.2.3	Did you work in the area where dyeing was done?
	Yes	[go to B.2.2.3.1]
	No
	DK
B.2.2.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.2.4	Did you work in the area where printing was done?
	Yes	[go to B.2.2.4.1]
	No
	DK
B.2.2.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.2.5	Did you work in the area where trimming, cleaning, drying, or other finishing operations and inspecting of the products was done?
	Yes	[go to B.2.2.5.1-B.2.2.5.2]
	No
	DK
B.2.2.5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.2.5.2	While working in this area, did you spot clean the fabrics or clothing?
	Yes	[go to B.2.2.2.5.1-B.2.2.2.5.2]
	No
	DK
B.2.2.2.5.1	About how many items did you spot clean?
	15 items/week or less
	15 to 100 items/week
	more than 100 items/week
	DK
B.2.2.2.5.2	To spot clean, what chemicals did you use? Did you use…? (allow multiple)
	Perchloroethylene (perc) or tetrachloroethylene (tetra)?
	Trichloroethylene (TCE)?
	Carbon tetrachloride?
	Stoddard solvent?
	A remover formulated to remove paint, grease or oils?
	Gasoline?
	Something else?
	DK
B.2.2.6	Did you work in the area where fabric was made resistant to wrinkles, flame, stains, soil, shrinkage, water, moths, mildew, or something else?
	Yes	[go to B.2.2.6.1-B.2.2.6.2]
	No
	DK
B.2.2.6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.2.6.2	What type of treatment was being done to the fabric? (allow multiple)
	Wrinkle resistance or durable or permanent press
	Flame resistance
	Stain resistance
	Soil resistance
	Shrink resistance
	Water resistance
	Moth resistance
	Mildew resistance
	Other
	DK
B.2.2.7	Did you clean the screens used to transfer color to the fabric?
	Yes	[go to B.2.2.7.1]
	No
	DK
B.2.2.7.1	What chemicals did you use to do this? (allow multiple)
	Carbon tetrachloride
	Trichloroethylene
	Trichloroethane
	Chloroform
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Some other chemical
	DK
B.2.2.8	[Hands mini-module]	[END]
B.2.2.9	[Degrease Mini-Module]
B.2.2.10	[Paint Mini-Module]
B.2.2.11	[Strip Mini-Module]
B.2.2.12	[Glue Mini-Module]
B.2.2.13	[Board Mini-Module]
B.2.2.14	[Fuel Mini-Module]
B.2.2.15	[Hands mini-module]	[END]
B.2.2.16	Did you take samples from the process or production line for testing purposes?
	Yes	[go to B.2.2.16.1]
	No
	DK
B.2.2.16.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.2.17	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to B.2.2.17.1]
	No	[END]
	DK	[END]
B.2.2.17.1	How many hours per week did you do this?
	< 2	[END]
	2 - 9	[END]
	10 - 19	[END]
	20 or more	[END]
	DK	[END]
B.2.2.18	[Paint Mini-Module]
B.2.2.19	[Glue Mini-Module]
B.2.2.20	[Board Mini-Module]
B.2.2.21	[Fuel Mini-Module]
B.2.2.22	[Hands mini-module]	[END]
	SECTION B.2.3 CONTINUE TEXTILE INDUSTRY MODULE
B.2.3	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to B.2.3.1 - B.2.3.8]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to B.2.3.9-B.2.3.15]
	Quality Control, Environmental Control, Engineering or Research	[go to B.2.3.16-B.2.3.17]
	Shipping, Receiving or Storage	[go to B.2.3.18-B.2.3.22]
	Administration	[END]
	DK	[END]
B.2.3.1	What was the product made of ? (allow multiple)
	Cotton
	Wool
	Man-made or synthetic
	Something else
	DK
B.2.3.2	Did you work in the area where scouring or cleaning was done?
	Yes	[go to B.2.3.2.1-B.2.3.2.2]
	No
	DK
B.2.3.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.3.2.2	Was perchloroethylene (perc) or tetrachloroethylene (tetra) used to scour or clean the products?
	Yes
	No
	DK
B.2.3.3	Did you work in the area where dyeing was done?
	Yes	[go to B.2.3.3.1]
	No
	DK
B.2.3.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.3.4	Did you work in the area where printing was done?
	Yes	[go to B.2.3.4.1]
	No
	DK
B.2.3.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.3.5	Did you work in the area where trimming, cleaning, drying, or other finishing operations and inspecting of the products was done?
	Yes	[go to B.2.3.5.1-B.2.3.5.2]
	No
	DK
B.2.3.5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.3.5.2	While working in this area, did you spot clean the fabrics or clothing?
	Yes	[go to B.2.3.5.2.1-B.2.3.5.2.2]
	No
	DK
B.2.3.5.2.1	About how many items did you spot clean?
	15 items/week or less
	15 to 100 items/week
	More than 100 items/week
	DK
B.2.3.5.2.2	To spot clean, what chemicals did you use? Did you use…? (allow multiple)
	Perchloroethylene (perc) or tetrachloroethylene (tetra)?
	Trichloroethylene (TCE)?
	Carbon tetrachloride?
	Stoddard solvent?
	A remover formulated to remove paint, grease or oils?
	Gasoline?
	Something else?
	DK
B.2.3.6	Did you work in the area where fabric was made resistant to wrinkles, flame, stains, soil, shrinkage, water, moths, mildew, or something else?
	Yes	[go to B.2.3.6.1-B.2.3.6.2]
	No
	DK
B.2.3.6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.3.6.2	What type of treatment was being done to the fabric? (allow multiple)
	Wrinkle resistance or durable or permanent press
	Flame resistance
	Stain resistance
	Soil resistance
	Shrink resistance
	Water resistance
	Moth resistance
	Mildew resistance
	Other
	DK
B.2.3.7	Did you clean the screens used to transfer color to the fabric?
	Yes	[go to B.2.3.7.1]
	No
	DK
B.2.3.7.1	What chemicals did you use to do this? (Allow multiple)
	Carbon tetrachloride
	Trichloroethylene
	Trichloroethane
	Chloroform
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Some other chemical
	DK
B.2.3.8	[Hands mini-module]	[END]
B.2.3.9	[Degrease Mini-Module]
B.2.3.10	[Paint Mini-Module]
B.2.3.11	[Strip Mini-Module]
B.2.3.12	[Glue Mini-Module]
B.2.3.13	[Board Mini-Module]
B.2.3.14	[Fuel Mini-Module]
B.2.3.15	[Hands mini-module]	[END]
B.2.3.16	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 2.3.16.1]
	No
	DK
B.2.3.16.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2.3.17	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 2.3.17.1]
	No	[END]
	DK	[END]
B.2.3.17.1	How many hours per week did you do this?
	< 2	[END]
	2 - 9	[END]
	10 - 19	[END]
	20 or more	[END]
	DK	[END]
B.2.3.18	[Paint Mini-Module]
B.2.3.19	[Glue Mini-Module]
B.2.3.20	[Board Mini-Module]
B.2.3.21	[Fuel Mini-Module]
B.2.3.22	[Hands mini-module]	[END]
SECTION D	[Degrease Mini-Module]
SECTION E	[Paint Mini-Module]
SECTION F	[Strip Mini-Module]
SECTION G	[Glue Mini-Module]
SECTION H	[Board Mini-Module]
SECTION I	[Fuel Mini-Module]
SECTION J	[Hands mini-module]
	EMBALMER (EM) MODULE
1	Did you perform or assist with embalmings?
	Yes	[go to 1.1-1.2]
	No
	DK
1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.2	[Vent Mini-module]

	FOUNDRY INDUSTRY (FOI) MODULE
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.6]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.7-1.8]
	Shipping, Receiving or Storage	[go to 1.9-1.12]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Glue Mini-Module]
1.5	[Board Mini-Module]
1.6	[Fuel Mini-Module]	[go to 2]
1.7	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.7.1]
	No
	DK
1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.8.1]
	No	[go to 2]
	DK	[go to 2]
1.8.1	How many hours per week did you do this?
	< 2	[go to 2]
	2 - 9	[go to 2]
	10 - 19	[go to 2]
	20 or more	[go to 2]
	DK	[go to 2]
1.9	[Paint Mini-Module]
1.1	[Glue Mini-Module]
1.11	[Board Mini-Module]
1.12	[Fuel Mini-Module]	[go to 2]
2	Did you ever spend time in a production area of the plant, such as the core making, mold making, metal pouring, cooling, shakeout or fettling areas?
	Yes	[go to 2.1-2.5]
	No	[go to 3]
	DK	[go to 3]
2.1	Did you ever spend time working in the core making area?
	Yes	[go to 2.1.1-2.1.3]
	No
	DK
2.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.1.2	Did the cores have to be heated in an oven or furnace before they set up, or were chemicals used to set up the core? By set up, I mean the process of hardening sand to form a core.
	Heated in an oven or furnace
	Chemicals were used
	Both
	Other
	DK
2.1.3	Did you ever run a muller or other machine to mix sand and chemicals used to make the core ?
	Yes	[go to 2.1.3.1 - 2.1.3.3]
	No
	DK
2.1.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.1.3.2	What chemicals were used to make the core? Was it…? (allow multiple)
	Epoxy resins
	Phenolic resins
	Urethane resins
	Furan resins
	Isocyanates
	Formaldehyde
	Something else
	DK
2.1.3.3	[Vent Mini-module]
2.2	Did you ever spend time working in the mold making area?
	Yes	[go to 2.2.1-2.2.5]
	No
	DK
2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2.2	[Vent Mini-module]
2.2.3	Did the molds have to be heated in an oven or furnace before they set up, or were chemicals used to set up the molds? By set up, I mean the process of hardening sand to form a core.
	Heated in an oven or furnace
	Chemicals were used
	Both
	Other
	DK
2.2.4	Did you ever add or mix chemicals or other materials to the sand?
	Yes	[go to 2.2.4.1]
	No
	DK
2.2.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2.5	Did you dump the molds?
	Yes	[go to 2.2.5.1]
	No
	DK
2.2.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3	Did you ever spend time working in the metal pouring area?
	Yes	[go to 2.3.1]
	No
	DK
2.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.4	Did you ever spend time working in the cooling area where the hot metal cooled?
	Yes	[go to 2.4.1]
	No
	DK
2.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.5	Did you ever spend time working in the shakeout or fettling area?
	Yes	[go to 2.5.1]
	No
	DK
2.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	[Hands mini-module]

	FURNITURE INDUSTRY (FUI) MODULE
1	What type of furniture did your employer make? (allow multiple)
	Plastic furniture?	[go to 1.1]
	Wood furniture?	[go to 1.2]
	Metal furniture?	[go to 2]
	Kitchen or bathroom countertops?	[go to 1.3-1.6]
	Another type of furniture?	[go to 2]
	DK	[go to 2]
1.1	Did you personally make or mold the plastic, or did you assemble the furniture?
	Make or mold plastic
	Assembled furniture
	Both
	Neither
	Something Else
	DK
1.2	What type of wood product did you work with? (allow multiple)
	Solid wood
	Plywood, particleboard, or composite board
	Veneered wood
	Other wood
	DK
1.3	Did you work in the chemical mixing area?
	Yes	[go to 1.3.1-1.3.2]
	No
	DK
1.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.3.2	What chemicals did you mix? (allow multiple)
	Phenol
	Formaldehyde
	Something else
	DK
1.4	Did you work in the area where sheets of paper were coated with chemicals?
	Yes	[go to 1.4.1]
	No
	DK
1.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.5	Did you work in the area where the sheets of coated papers were stacked?
	Yes	[go to 1.5.1]
	No
	DK
1.5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.6	Did you work in the area where the coated stacks of paper were pressed together?
	Yes	[go to 1.6.1-1.6.2]
	No
	DK
1.6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.6.2	Was the pressing of the paper done under heat?
	Yes
	No
	DK
2	Did you ever work in the area where paints, stains, varnishes, lacquers, waxes, or other chemicals were applied?
	Yes	[go to 2.1-2.6]
	No
	DK
2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2	Did you ever degrease the furniture?
	Yes	[ask 2.2.1-2.2.2]
	No
	DK
2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2.2	How did you degrease the furniture? (allow multiple)
	By hand
	Some other way
	DK
2.3	In this job, did you ever use paint?
	Yes	[go to 2.3.1-2.3.3]
	No
	DK
2.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
2.3.3	[Vent Mini-module]
2.3.4	Did other workers use paints in the area where you worked?
	Yes	[go to 2.3.4.1]
	No
	DK
2.3.4.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.4	[Stain mini-module]
2.5	Did you ever lacquer the furniture?
	Yes	[go to2.5.1-2.5.2]
	No
	DK
2.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.5.2	How did you usually apply the lacquer? (allow multiple)
	Brush
	Rag
	Spray gun
	Electrostatic gun
	Roller
	Dipping
	Other
	DK
2.6	Did you ever apply wax to the furniture?
	Yes	[go to 2.6.1]
	No
	DK
2.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	Did you ever work in the area where paint, stains, varnishes, lacquers, or waxes were removed?
	Yes	[go to 3.1-3.2]
	No
	DK
3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2	How did you usually remove it? Was it with? (allow multiple)
	Chemicals
	A rag
	A brush
	Some other way
	DK
4	Did you ever work in the area where a chemical or wax was drying on the furniture?
	Yes	[go to 4.1-4.2]
	No
	DK
4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4.2	Which chemicals were being dried on the furniture? Was it…? (allow multiple):
	Paints
	Stains
	Varnishes
	Lacquers
	Waxes
	Something else
	DK
5	[Glue Mini-module]
6	In this job, did you ever repair or maintain equipment or property??
	Yes	[go to 6.1-6.3]
	No
	DK
6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.2	[Degrease Mini-Module]
6.3	[ Fuel Mini-Module]
7	[Hands mini-module]

	GENERAL FARMING - FOOD INDUSTRY MODULE (LONG)
1	In this job, what best describes your work location? (allow multiple)
	A farm where crops were grown or livestock were raised	[go to SECTION A]
	A factory, warehouse, or processing center where food products were processed or packaged	[go to SECTION B]
	A restaurant or other food service location where food was prepared or sold
	None of the above	[go to SECTION C - SECTION I]
	SECTION A [aGF]
A.1	On the farms you worked, were crops raised to sell or to feed animals?
	Yes	[go to A.1.1-A.1.4]
	No
	DK
A.1.1	In this job, did you ever apply any type of chemicals to kill weeds, bugs, fungus or molds, or rodents such as rats?
	Yes	[go to A.1.1.1-A.1.1.5]
	No
	DK
A.1.1.1	Did you apply herbicides or weed killers?
	Yes	[go to A.1.1.1.1-A.1.1.1.3]
	No
	DK
A.1.1.1.1	On average, how many times a year did you apply herbicides or weed killers?
	[number 0-1000]
	DK
A.1.1.1.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
A.1.1.1.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the weed killers or herbicides that you mixed?
	Yes
	No
	DK
A.1.1.2	Did you apply insecticides or bug killers?
	Yes	[go to A.1.1.2.1-A.1.1.2.3]
	No
	DK
A.1.1.2.1	On average, how many times a year did you apply insecticides or bug killers?
	[number 0-1000]
	DK
A.1.1.2.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
A.1.1.2.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the insecticides or bug killers that you mixed?
	Yes
	No
	DK
A.1.1.3	Did you apply fumigants?
	Yes	[go to A.1.1.3.1-A.1.1.3.3]
	No
	DK
A.1.1.3.1	On average, how many times a year did you apply fumigants?
	[number 0-1000]
	DK
A.1.1.3.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
A.1.1.3.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the fumigants that you mixed?
	Yes
	No
	DK
A.1.1.4	Did you apply fungicides to kill mold or fungus?
	Yes	[go to A.1.1.4.1-A.1.1.4.3]
	No
	DK
A.1.1.4.1	On average, how many times a year did you apply fungicides?
	[number 0-1000]
	DK
A.1.1.4.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
A.1.1.4.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the fungicides that you mixed?
	Yes
	No
	DK
A.1.1.5	Did you apply rodenticides to kill rodents, such as rats?
	Yes	[go to A.1.1.5.1-A.1.1.5.3]
	No
	DK
A.1.1.5.1	On average, how many times a year did you apply rodenticides?
	[number 0-1000]
	DK
A.1.1.5.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
A.1.1.5.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the rodenticides that you mixed?
	Yes
	No
	DK
A.1.1.6	Did you work in an area where someone else applied any type of chemicals to kill weeds, bugs, fungus or molds, or rodents such as rats?
	Yes	[go to A.1.1.6.1]
	No
	DK
A.1.1.6.1	What type of chemicals were used? (allow multiple)
	Herbicides or weed killers
	Insecticides or bug killers
	Fumigants
	Fungicides to kill mold or fungus
	Rodenticides to kill rodents, such as rats
	Something else
	DK
A.1.1.7	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
A.1.1.8	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
A.1.1.9	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK
A.1.2	Did you apply a disinfectant or preservative to the crop? I don't mean a chemical used to kill weeds or bugs.
	Yes	[go to A.1.2.1-A.1.2.3]
	No
	DK
A.1.2.1	On average, how many days a year did you apply it?
	[number 0-365]
	DK
A.1.2.2	On average, how many hours a day did you apply it?
	[number 0-24]
	DK
A.1.2.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the weed killers you mixed?
	Yes
	No
	DK
A.1.3	Did you apply fertilizer to the crop?
	Yes	[go to A.1.3.1-A.1.3.3]
	No
	DK
A.1.3.1	On average, how many days a year did you apply it?
	[number 0-365]
	DK
A.1.3.2	On average, how many hours a day did you apply it?
	[number 0-24]
	DK
A.1.3.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the fertilizer you mixed?
	Yes
	No
	DK
A.1.4	Did you apply any chemical products into the soil to make the plants grow better? Please say no if you only added fertilizer.
	Yes	[go to A.1.4.1-A.1.4.4]
	No
	DK
A.1.4.1	What did you add? (allow multiple)
	Polystyrene flakes
	Urea-formaldehyde resin
	Phenolic resin foam
	Polyurethane foam
	Something else
	DK
A.1.4.2	On average, how many days a year did you apply it?
	[number 0-365]
	DK
A.1.4.3	On average, how many hours a day did you apply it?
	[number 0-24]
	DK
A.1.4.4	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the chemical products you mixed?
	Yes
	No
	DK
A.2	On the farms you worked, were animals raised?
	Yes	[go to A.2.1]
	No
	DK
A.2.1	Were the animals ever housed in a building?
	Yes	[go to A.2.1.1]
	No
	DK
A.2.1.1	Did you or anyone else ever fumigate the area where the animals were housed?
	Yes	[go to A.2.1.1.1]
	No
	DK
A.2.1.1.1	What fumigant was used?
	Formaldehyde
	Carbon tetrachloride
	Phosphine
	Other fumigant
	DK
A.3	In this job, did you ever repair or maintain equipment or property??
	Yes	[go to A.3.1-A.3.3]
	No
	DK
A.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
A.3.2	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes	[go to A.3.2.1-A.3.2.5]
	No
	DK
A.3.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
A.3.2.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
A.3.2.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
A.3.2.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
A.3.2.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
A.3.2.6	Did other workers clean or degrease parts in the area where you worked?
	Yes	[go to A.3.2.6.1]
	No
	DK
A.3.2.6.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
A.3.3	In this job, did you ever handle or pump fuel?
	Yes	[go to A.3.3.1]
	No
	DK
A.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
A.4	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
A.5	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
A.6	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK
	SECTION B [aFDI]
B.1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to B.1.1-B.1.6]
	Quality Control, Environmental Control, Engineering or Research
	Shipping, Receiving or Storage	[go to B.1.7-B.1.10]
	Administration
	DK
B.1.1	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes	[go to B.1.1.1-B.1.1.5]
	No
	DK
B.1.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.1.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
B.1.1.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
B.1.1.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
B.1.1.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
B.1.1.6	Did other workers clean or degrease parts in the area where you worked?
	Yes	[go to B.1.1.6.1]
	No
	DK
B.1.1.6.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.2	In this job, did you ever use paint?
	Yes	[go to B.1.2.1-B.1.2.5]
	No
	DK
B.1.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.2.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
B.1.2.3	Did you paint indoors or inside a ship?
	Yes	[go to B.1.2.3.1-B.1.2.3.2]
	No
	DK
B.1.2.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.2.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
B.1.2.3.3	Did you paint in a production area of a manufacturing plant?
	Yes	[go to B.1.2.3.3.1]
	No
	DK
B.1.2.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.2.4	Did you paint outdoors?
	Yes	[go to B.1.2.4.1]
	No
	DK
B.1.2.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.2.5	Did other workers use paints in the area where you worked?
	Yes	[go to B.1.2.5.1]
	No
	DK
B.1.2.5.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.3	In this job, did you ever strip paint from metal or wood objects?
	Yes	[go to B.1.3.1-B.1.3.2]
	No
	DK
B.1.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.3.2	To strip paint, what did you use? Did you use…? (allow multiple)
	Methylene chloride
	Acids, alkalis, or caustic solutions?
	Any other chemical
	Something else, such as a heat gun or scraper
	DK
B.1.3.3	Did other workers strip paint from metal or wood objects in the area where you worked?
	Yes	[go to B.1.3.3.1]
	No
	DK
B.1.3.3.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.4	In this job, did you ever use glues or adhesives?
	Yes	[go to B.1.4.1-B.1.4.8]
	No
	DK
B.1.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.4.2	What material were the things you were gluing made of? (allow multiple)
	Wood
	Metal
	Plastic
	Paper
	Fabrics
	Other
	DK
B.1.4.3	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
B.1.4.4	Did you use water-based glues or adhesives, for example, vinyl or acrylic resins?
	Yes	[go to B.1.4.4.1]
	No
	DK
B.1.4.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.4.5	Did you use glues or adhesives that you heated with a gun or other heated device?
	Yes	[ go to B.1.4.5.1]
	No
	DK
B.1.4.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.4.6	Did you use contact glues or adhesives where you apply the glue to both pieces being glued, let it dry for a short time, and then join the two pieces together?
	Yes	[go to B.1.4.6.1]
	No
	DK
B.1.4.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.4.7	Did you use glues or adhesives that require mixing two parts of the glue together before applying? (epoxy resins)
	Yes	[go to B.1.4.7.1]
	No
	DK
B.1.4.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.4.8	Did you use urea, phenol or melamine-based glues or adhesives?
	Yes	[go to B.1.4.8.1]
	No
	DK
B.1.4.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.4.9	Did other workers use glues or adhesives in the area where you worked?
	Yes	[ask B.1.4.9.1]
	No
	DK
B.1.4.9.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.5	In this job, did you ever handle or use particle board, plywood, or veneered wood?
	Yes	[go to B.1.5.1]
	No
	DK
B.1.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.5.2	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes	[go to B.1.5.2.1]
	No
	DK
B.1.5.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.6	In this job, did you ever handle or pump fuel?
	Yes	[go to B.1.6.1]
	No
	DK
B.1.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.7	In this job, did you ever use paint?
	Yes	[go to B.1.7.1-B.1.7.4]
	No
	DK
B.1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.7.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
B.1.7.3	Did you paint indoors or inside a ship?
	Yes	[go to B.1.7.3.1-B.1.7.3.2]
	No
	DK
B.1.7.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.7.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
B.1.7.3.3	Did you paint in a production area of a manufacturing plant?
	Yes	[go to B.1.7.3.3.1]
	No
	DK
B.1.7.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.7.4	Did you paint outdoors?
	Yes	[go to B.1.7.1.4.1]
	No
	DK
B.1.7.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.7.5	Did other workers use paints in the area where you worked?
	Yes	[go to B.1.7.5.1]
	No
	DK
B.1.7.5.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.8	In this job, did you ever use glues or adhesives?
	Yes	[go to B.1.8.1-B.1.8.8]
	No
	DK
B.1.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.8.2	What material were the things you were gluing made of? (allow multiple)
	Wood
	Metal
	Plastic
	Paper
	Fabrics
	Other
	DK
B.1.8.3	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
B.1.8.4	Did you use water-based glues or adhesives, for example, vinyl or acrylic resins?
	Yes	[go to B.1.8.4.1]
	No
	DK
B.1.8.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.8.5	Did you use glues or adhesives that you heated with a gun or other heated device?
	Yes	[ go to B.1.8.5.1]
	No
	DK
B.1.8.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.8.6	Did you use contact glues or adhesives where you apply the glue to both pieces being glued, let it dry for a short time, and then join the two pieces together?
	Yes	[go to B.1.8.6.1]
	No
	DK
B.1.8.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.8.7	Did you use glues or adhesives that require mixing two parts of the glue together before applying? (epoxy resins)
	Yes	[go to B.1.8.7.1]
	No
	DK
B.1.8.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.8.8	Did you use urea, phenol or melamine-based glues or adhesives?
	Yes	[go to B.1.8.8.1]
	No
	DK
B.1.8.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.8.9	Did other workers use glues or adhesives in the area where you worked?
	Yes	[ask B.1.8.9.1]
	No
	DK
B.1.8.9.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.9	In this job, did you ever handle or use particle board, plywood, or venered wood?
	Yes	[go to B.1.9.1]
	No
	DK
B.1.9.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.1.9.2	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes	[go to B.1.9.2.1]
	No
	DK
B.1.9.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
B.1.10	In this job, did you ever handle or pump fuel?
	Yes	[go to B.1.10.1]
	No
	DK
B.1.10.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.2	Did you work in an area where preservatives were added to the food?
	Yes	[go to B.2.1]
	No
	DK
B.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.3	Did you work in an area where disinfectants were added to the food?
	Yes	[go to B.3.1]
	No
	DK
B.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.4	Did you work in an area where fumigants were used?
	Yes	[go to B.4.1]
	No
	DK
B.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
B.5	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
B.6	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
B.7	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK
	SECTION C [Degrease Mini-Module]
C.1	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes	[go to C.1.1-C.1.5]
	No
	DK
C.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
C.1.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
C.1.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
C.1.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
C.1.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
C.2	Did other workers clean or degrease parts in the area where you worked?
	Yes	[go to C.2.1]
	No
	DK
C.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
	SECTION D [Paint Mini-Module]
D.1	In this job, did you ever use paint?
	Yes	[go to D.1.1-D.1.5]
	No
	DK
D.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
D.1.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
D.1.3	Did you paint indoors or inside a ship?
	Yes	[go to D.1.3.1-D.1.3.2]
	No
	DK
D.1.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
D.1.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
D.1.3.3	Did you paint in a production area of a manufacturing plant?
	Yes	[go to D.1.3.3.1]
	No
	DK
D.1.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
D.1.4	Did you paint outdoors?
	Yes	[go to D.1.4.1]
	No
	DK
D.1.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
D.2	Did other workers use paints in the area where you worked?
	Yes	[go to D.2.1]
	No
	DK
D.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
	SECTION E [Strip Mini-Module]
E.1	In this job, did you ever strip paint from metal or wood objects?
	Yes	[go to E.1.1-E.1.3]
	No
	DK
E.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
E.1.2	To strip paint, what did you use? Did you use…? (allow multiple)
	Methylene chloride
	Acids, alkalis, or caustic solutions?
	Any other chemical
	Something else, such as a heat gun or scraper
	DK
E.2	Did other workers strip paint from metal or wood objects in the area where you worked?
	Yes	[go to E.2.1]
	No
	DK
E.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
	SECTION F [Glue Mini-Module]
F.1	1. In this job, did you ever use glues or adhesives?
	Yes	[go to F.1.1-F.1.8]
	No
	DK
F.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
F.1.2	What material were the things you were gluing made of? (allow multiple)
	Wood
	Metal
	Plastic
	Paper
	Fabrics
	Other
	DK
F.1.3	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
F.1.4	Did you use water-based glues or adhesives, for example, vinyl or acrylic resins?
	Yes	[go to F.1.4.1]
	No
	DK
F.1.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
F.1.5	Did you use glues or adhesives that you heated with a gun or other heated device?
	Yes	[ go to F.1.5.1]
	No
	DK
F.1.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
F.1.6	Did you use contact glues or adhesives where you apply the glue to both pieces being glued, let it dry for a short time, and then join the two pieces together?
	Yes	[go to F.1.6.1]
	No
	DK
F.1.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
F.1.7	Did you use glues or adhesives that require mixing two parts of the glue together before applying? (epoxy resins)
	Yes	[go to F.1.7.1]
	No
	DK
F.1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
F.1.8	Did you use urea, phenol or melamine-based glues or adhesives?
	Yes	[go to F.1.8.1]
	No
	DK
F.1.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
F.2	Did other workers use glues or adhesives in the area where you worked?
	Yes	[ask F.2.1]
	No
	DK
F.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
	SECTION G [Board Mini-Module]
G.1	In this job, did you ever handle or use particle board, plywood, or veneered wood?
	Yes	[go to G.1.1]
	No
	DK
G.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
G.2	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes	[go to G.2.1]
	No
	DK
G.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2-9
	10-19
	20 or more
	DK
	SECTION H [Fuel Mini-Module]
H.1	In this job, did you ever handle or pump fuel?
	Yes	[go to H.1.1]
	No
	DK
H.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
	SECTION I [Hands mini-module]
I.1	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
I.2	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
I.3	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK

	INDUSTRY SOLVENT (INSOL) MODULE
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.6]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.7-1.8]
	Shipping, Receiving or Storage	[go to 1.9-1.12]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Glue Mini-Module]
1.5	[ Board Mini-Module]
1.6	[Fuel Mini-Module]	[go to 2]
1.7	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.7.1]
	No
	DK
1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.8.1]
	No	[go to 2]
	DK	[go to 2]
1.8.1	How many hours per week did you do this?
	< 2	[go to 2]
	2 - 9	[go to 2]
	10 - 19	[go to 2]
	20 or more	[go to 2]
	DK	[go to 2]
1.9	[Paint Mini-Module]
1.10	[Glue Mini-Module]
1.11	[Board Mini-Module]
1.12	[Fuel Mini-Module]
2	[Hands mini-module]
	LEATHER INDUSTRY (LEI) MODULE
1	Did your employer make leather, make a leather product, or do both?
	Make leather
	Make leather product
	Both
	DK
2	What color was the leather? (allow multiple)
	Brown
	Pale cream or white
	Other
	DK
3	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 3.1 - 3.2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 3.3-3.8]
	Quality Control, Environmental Control, Engineering or Research	[go to 4]
	Shipping, Receiving or Storage	[go to 3.9-3.12]
	Administration	[go to 4]
	DK	[go to 4]
3.1	Was the leather or leather product from animal hides or skins, or was the leather synthetic or man-made?
	Animal hide	[go to 3.1.1-3.1.3]
	Synthetic or man-made	[go to 3.1.4-3.1.6]
	Both	[go to 3.1.7 - 3.1.12]
	Something else	[go to 4]
	DK	[go to 4]
3.1.1	Was the leather already tanned or prepared, or did hides or skin come into the plant that had to have the hair and flesh removed and tanning done to the hides and skins?
	Already tanned
	Hair still on/needed tanning	[go to 3.1.1.1-3.1.1.3]
	Other
	DK
3.1.1.1	Did you work in the area where the hide or skin was prepared for tanning ?
	Yes	[go to 3.1.1.1.1]
	No
	DK
3.1.1.1.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.1.2	Did you work in the area where the hides and skins were tanned?
	Yes	[go to 3.1.1.2.1]
	No
	DK
3.1.1.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.1.3	Did you work in the area where the tanned leather was stuffed or fat liquored?
	Yes	[go to 3.1.1.3.1]
	No
	DK
3.1.1.3.1	Did you apply the chemicals to stuff or fat liquor the leather?
	Yes	[go to 3.1.1.3.1.1-3.1.1.3.1.2]
	No
	DK
3.1.1.3.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.1.3.1.2	What chemicals did you use? (allow multiple)
	Oils
	TCE or trichloroethylene
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Some other chemicals
	DK
3.1.2	Did you apply a chemical to the leather?
	Yes	[go to 3.1.2.1]
	No
	DK
3.1.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.3	Did you work in the area where the tanned leather was dried, set out, stretched and softened?
	Yes	[go to 3.1.3.1]
	No
	DK
3.1.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.4	Did you work in the area where chemicals were mixed to make a leather-like resin or plastic?
	Yes	[go to 3.1.4.1]
	No
	DK
3.1.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.5	Did you work in the area where chemicals were heated to make a leather-like resin or plastic?
	Yes	[go to 3.1.5.1]
	No
	DK
3.1.5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.6	Did you work in the area where chemicals were extruded to make a leather-like resin or plastic?
	Yes	[go to 3.1.6.1]
	No
	DK
3.1.6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.7	Was the leather already tanned or prepared, or did hides or skin come into the plant that had to have the hair and flesh removed and tanning done to the hides and skins?
	Already tanned
	Hair still on/needed tanning	[go to 3.1.7.1-3.1.7.3]
	Other
	DK
3.1.7.1	Did you work in the area where the hide or skin was prepared for tanning?
	Yes	[go to 3.1.1.7.1]
	No
	DK
3.1.7.1.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.7.2	Did you work in the area where the hides and skins were tanned?
	Yes	[go to 3.1.7.2.1]
	No
	DK
3.1.7.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.7.3	Did you work in the area where the tanned leather was stuffed or fat liquored?
	Yes	[go to 3.1.7.3.1]
	No
	DK
3.1.7.3.1	Did you apply the chemicals to stuff or fat liquor the leather?
	Yes	[go to 3.1.7.3.1.1-3.1.7.3.1.2]
	No
	DK
3.1.7.3.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.7.3.1.2	What chemicals did you use? (allow multiple)
	Oils
	TCE or trichloroethylene
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Some other chemicals
	DK
3.1.8	Did you apply a chemical to the leather?
	Yes	[go to 3.1.8.1]
	No
	DK
3.1.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.9	Did you work in the area where the tanned leather was dried, set out, stretched and softened?
	Yes	[go to 3.1.9.1]
	No
	DK
3.1.9.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.10	Did you work in the area where chemicals were mixed to make a leather-like resin or plastic?
	Yes	[go to 3.1.10.1]
	No
	DK
3.1.10.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.11	Did you work in the area where chemicals were heated to make a leather-like resin or plastic?
	Yes	[go to 3.1.11.1]
	No
	DK
3.1.11.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.1.12	Did you work in the area where chemicals were extruded to make a leather-like resin or plastic?
	Yes	[go to 3.1.12.1]
	No
	DK
3.1.12.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2	Did you work in the area where the leather pieces were glued together or glued to metal or plastic pieces?
	Yes	[go to 3.2.1 - 3.2.2]
	No
	DK
3.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2.2	Did you do the gluing?
	Yes	[go to 3.2.2.1]
	No
	DK
3.2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.3	[Degrease Mini-Module]
3.4	[Paint Mini-Module]
3.5	[Strip Mini-Module]
3.6	[Glue Mini-Module]
3.7	[Board Mini-Module]
3.8	[Fuel Mini-Module]
3.9	[Paint Mini-Module]
3.10	[Glue Mini-Module]
3.11	[Board Mini-Module]
3.12	[Fuel Mini-Module]
4	[Hands mini-module]

	LUMBER INDUSTRY (LUI) MODULE
1	What did the employer do? (allow multiple)
	Cut trees	[go to 2]
	Cut up logs in a sawmill	[go to 2]
	Make plywood, particle board, or other type of composite board	[go to 1.1]
	Make veneered wood	[go to 1.2]
	Make cork	[go to 2]
	Something else	[go to 2]
	DK	[go to 2]
1.1	In the factory where plywood, particle board or other type of composite board were made, did you operate a machine?
	Yes	[go to 1.1.1-1.1.3]
	No
	DK
1.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.1.2	What did the machine do?
	Saw
	Coat or treat with chemicals
	Heat press
	Something else
	DK
1.1.3	Did the machine have direct ventilation that removed the dust, fumes, or vapors from your area?
	Yes
	No
	DK
1.2	In the factory where veneered wood was made, did you operate a machine?
	Yes	[go to 1.2.1-1.2.3]
	No
	DK
1.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.2.2	What did the machine do?
	Saw
	Coat or treat with chemicals
	Heat press
	Something else
	DK
1.2.3	Did the machine have direct ventilation that removed the dust, fumes, or vapors from your area?
	Yes
	No
	DK
2	In this job, did you ever repair or maintain equipment or property??
	Yes	[go to 2.1-2.6]
	No	[go to 3]
	DK	[go to 3]
2.1	[Degrease Mini-Module]
2.2	[Paint Mini-Module]
2.3	[Stain Mini-Module]
2.4	[Strip Mini-Module]
2.5	[Glue Mini-Module]
2.6	[Fuel Mini-Module]
3	[Hands mini-module]

	OIL REFINING INDUSTRY (ORI)
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.6]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.7-1.8]
	Shipping, Receiving or Storage	[go to 1.9-1.12]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Glue Mini-Module]
1.5	[Board Mini-Module]
1.6	[Fuel Mini-Module]	[go to 2]
1.7	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.7.1]
	No
	DK
1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.8.1]
	No	[go to 2]
	DK	[go to 2]
1.8.1	How many hours per week did you do this?
	< 2	[go to 2]
	2 - 9	[go to 2]
	10 - 19	[go to 2]
	20 or more	[go to 2]
	DK	[go to 2]
1.9	[Paint Mini-Module]
1.10	[Glue Mini-Module]
1.11	[Board Mini-Module]
1.12	[Fuel Mini-Module]
2	Did you work in FRACTIONATION? (This is where the crude oil is processed to remove water, organic salts, and sulfur)
	Yes	[go to 2.1]
	No
	DK
2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	Did you work in CRACKING? (This is where cracking occurs)
	Yes	[go to 3.1]
	No
	DK
3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	Did you work in COKING? (very heavy residual oils formed into gasoline and diesel fuel, leaving petroleum coke as a residual product)
	Yes	[go to 4.1]
	No
	DK
4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	Did you work in LIQUID FUEL BLENDING? (This is where fuels are blended)
	Yes	[go to 5.1]
	No
	DK
5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6	Did you work in an area where benzene or benzole was produced?
	Yes	[go to 6.1]
	No
	DK
6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
7	Did you work in the TANK FARM? (This is where the products are stored)
	Yes	[go to 7.1]
	No
	DK
7.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
8	Did you work in LOADING? (This is where barges, trains, trucks were loaded)
	Yes	[go to 8.1]
	No
	DK
8.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
9	[Hands mini-module]

	PESTICIDE (PE) MODULE
1	In this job, did you ever apply any type of chemicals to kill weeds, bugs, fungus or molds, or rodents such as rats?
	Yes	[go to 1.1-1.5]
	No	[go to 1.6]
	DK	[go to 2]
1.1	Did you apply herbicides or weed killers?
	Yes	[go to 1.1.1-1.1.3]
	No
	DK
1.1.1	On average, how many times a year did you apply herbicides or weed killers?
	[number 0-1000]
	DK
1.1.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
1.1.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the weed killers or herbicides that you mixed?
	Yes
	No
	DK
1.2	Did you apply insecticides or bug killers?
	Yes	[go to 1.2.1-1.2.3]
	No
	DK
1.2.1	On average, how many times a year did you apply insecticides or bug killers?
	[number 0-1000]
	DK
1.2.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
1.2.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the insecticides or bug killers that you mixed?
	Yes
	No
	DK
1.3	Did you apply fumigants?
	Yes	[go to 1.3.1-1.3.3]
	No
	DK
1.3.1	On average, how many times a year did you apply fumigants?
	[number 0-1000]
	DK
1.3.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
1.3.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the fumigants that you mixed?
	Yes
	No
	DK
1.4	Did you apply fungicides to kill mold or fungus?
	Yes	[go to 1.4.1-1.4.3]
	No
	DK
1.4.1	On average, how many times a year did you apply fungicides?
	[number 0-1000]
	DK
1.4.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
1.4.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the fungicides that you mixed?
	Yes
	No
	DK
1.5	Did you apply rodenticides to kill rodents, such as rats?
	Yes	[go to 1.5.1-1.5.3]
	No
	DK
1.5.1	On average, how many times a year did you apply rodenticides?
	[number 0-1000]
	DK
1.5.2	Each time you did this, how many hours did it take?
	[number 0-24]
	DK
1.5.3	Did you add kerosene, diesel fuel, Stoddard solvent or oil to the rodenticides that you mixed?
	Yes
	No
	DK
1.6	Did you work in an area where someone else applied any type of chemicals to kill weeds, bugs, fungus or molds, or rodents such as rats?
	Yes	[go to 1.6.1]
	No
	DK
1.6.1	What type of chemicals were used? (allow multiple)
	Herbicides or weed killers
	Insecticides or bug killers
	Fumigants
	Fungicides to kill mold or fungus
	Rodenticides to kill rodents, such as rats
	Something else
	DK
2	[Hands mini-module ]

	PHOTOGRAPHIC INDUSTRY (PHI) MODULE
1	Did your employer make photographic film?
	Yes	[go to 1.1-1.4]
	No	[go to 2]
	DK	[go to 2]
1.1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 1.2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1.1-1.1.6]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.1.7-1.1.8]
	Shipping, Receiving or Storage	[go to 1.1.9-1.1.12]
	Administration	[go to 1.2]
	DK	[go to 1.2]
1.1.1	[Degrease Mini-Module]
1.1.2	[Paint Mini-Module]
1.1.3	[Strip Mini-Module]
1.1.4	[Glue Mini-Module]
1.1.5	[Board Mini-Module]
1.1.6	[Fuel Mini-Module]	[go to 1.2]
1.1.7	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.1.7.1]
	No
	DK
1.1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.1.8	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.1.8.1]
	No	[go to 1.2]
	DK	[go to 1.2]
1.1.8.1	How many hours per week did you do this?
	< 2	[go to 1.2]
	2 - 9	[go to 1.2]
	10 - 19	[go to 1.2]
	20 or more	[go to 1.2]
	DK	[go to 1.2]
1.1.9	[Paint Mini-Module]
1.1.10	[Glue Mini-Module]
1.1.11	[Board Mini-Module]
1.1.12	[Fuel Mini-Module]
1.2	Did you work in the area where the film was made from chemicals?
	Yes	[go to 1.2.1]
	No
	DK
1.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.3	Did you work in the drying area?
	Yes	[go to 1.3.1]
	No
	DK
1.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.4	Did you work in the area where the film was rolled onto a canister?
	Yes	[go to 1.4.1]
	No
	DK
1.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2	Did your employer develop photographic film?
	Yes	[go to 2.1]
	No
	DK
2.1	Did you develop the film?
	Yes	[go to 2.1.1]
	No
	DK
2.1.1	Did you use formaldehyde during the processing of the film?
	Yes	[go to 2.1.1.1]
	No
	DK
2.1.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	[Hands mini-module]

	PLASTICS INDUSTRY (PLI) MODULE
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.6]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.7-1.8]
	Shipping, Receiving or Storage	[go to 1.9-1.12]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Glue Mini-Module]
1.5	[Board Mini-Module]
1.6	[Fuel Mini-Module]	[go to 2]
1.7	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.7.1]
	No
	DK
1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.8.1]
	No	[go to 2]
	DK	[go to 2]
1.8.1	How many hours per week did you do this?
	< 2	[go to 2]
	2 - 9	[go to 2]
	10 - 19	[go to 2]
	20 or more	[go to 2]
	DK	[go to 2]
1.9	[Paint Mini-Module]
1.10	[Glue Mini-Module]
1.11	[Board Mini-Module]
1.12	[Fuel Mini-Module]
2	What type of plastics were being made by your employer? (allow multiple)
	polystyrene
	phenol-formaldehyde
	polypropylene
	urea-formaldehyde
	polyester
	melamine
	Something else
	DK
3	Did you work in the area where the plastic was being formed, either by a mold machine or a press?
	Yes	[go to 3.1]
	No
	DK
3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	Did you work in the finishing or packing area?
	Yes	[go to 4.1]
	No
	DK
4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	Did you work in some other area?
	Yes	[go to 5.1]
	No
	DK
5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6	[Hands mini-module]

	PULP AND PAPER INDUSTRY (PPI) MODULE
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.6]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.7-1.8]
	Shipping, Receiving or Storage	[1.9-1.12]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Glue Mini-Module]
1.5	[Board Mini-Module]
1.6	[Fuel Mini-Module]	[go to 2]
1.7	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.7.1]
	No
	DK
1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.8.1]
	No	[go to 2]
	DK	[go to 2]
1.8.1	How many hours per week did you do this?
	< 2	[go to 2]
	2 - 9	[go to 2]
	10 - 19	[go to 2]
	20 or more	[go to 2]
	DK	[go to 2]
1.9	[Paint Mini-Module]
1.10	[Glue Mini-Module]
1.11	[Board Mini-Module]
1.12	[Fuel Mini-Module]
2	Did you work in a paper mill?
	Yes	[go to 2.1-2.4]
	No
	DK
2.1	Did you work in an area where recycled paper was prepared for the papermaking process?
	Yes	[go to 2.1.1]
	No
	DK
2.1.1	Did you remove ink from waste paper?
	Yes	[go to 2.1.1.1]
	No
	DK
2.1.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2	Did you work in the area where the paper machine was located?
	Yes	[go to 2.2.1]
	No
	DK
2.2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3	Did you work in the drying area?
	Yes	[go to 2.3.1]
	No
	DK
2.3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.4	Did you work in the coating area?
	Yes	[go to 2.4.1]
	No
	DK
2.4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	Did you work in a pulp mill?
	Yes	[go to 3.1]
	No
	DK
3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	[Hands mini-module]

	PRINTING INDUSTRY (PRI) MODULE
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.6]
	Quality Control, Environmental Control, Engineering or Research
	Shipping, Receiving or Storage	[go to 1.7-1.10]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Glue Mini-Module]
1.5	[Board Mini-Module]
1.6	[Fuel Mini-Module]	[go to 2]
1.7	[Paint Mini-Module]
1.8	[Glue Mini-Module]
1.9	[Board Mini-Module]
1.10	[Fuel Mini-Module]
2	Did you ever work in the plate making, plate engraving, or screen preparation area?
	Yes	[go to 2.1-2.3]
	No
	DK
2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2	Did you clean the printing plates?
	Yes	[go to 2.2.1]
	No
	DK
2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2.2	What chemicals did you use to clean the plates? (allow multiple)
	Carbon tetrachloride
	Trichloroethylene
	Trichloroethane
	Chloroform
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Gasoline or other fuels
	Some other chemical
	DK
2.3	Did you wash or clean screens that are used in a silkscreen-like process?
	Yes	[go to 2.3.1-2.3.2]
	No
	DK
2.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3.2	What chemicals did you use to clean the screens? (allow multiple)
	Carbon tetrachloride
	Trichloroethylene
	Trichloroethane
	Chloroform
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Gasoline or other fuels
	Some other chemical
	DK
3	Did you ever work in the area where the ink was prepared?
	Yes	[go to 3.1-3.2]
	No
	DK
3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2	Did you prepare or mix the ink?
	Yes	[go to 3.2.1-3.2.2]
	No
	DK
3.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2.2	Did you use solvents or chemicals other than water to dilute the ink?
	Yes
	No
	DK
4	Did you ever work in the printing room or area?
	Yes	[go to 4.1-4.2]
	No
	DK
4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4.2	Did you run the press?
	Yes	[go to 4.2.1]
	No
	DK
4.2.1	Did you wash or clean the plates or presses?
	Yes	[go to 4.2.1.1-4.2.1.2]
	No
	DK
4.2.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4.2.1.2	What chemicals did you use to clean the plates or presses? (allow multiple)
	Carbon tetrachloride
	Trichloroethylene
	Trichloroethane
	Chloroform
	Perchloroethylene (perc) or tetrachloroethylene (tetra)
	Gasoline or other fuels
	Some other chemical
	DK
5	Did you ever work in the area where the ink was cured or the printing material was dried?
	Yes	[go to 5.1-5.2]
	No
	DK
5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.2	[Vent Mini-module]
6	Did you ever work in the bookbinding area or an area where paper was folded, trimmed, glued, stapled, or stitched?
	Yes	[go to 6.1-6.2]
	No
	DK
6.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.2	Did you run the gluing machine?
	Yes	[go to 6.2.1]
	No
	DK
6.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
7	[Hands mini-module]

	RUBBER INDUSTRY (RUI)
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.1-1.5]
	Quality Control, Environmental Control, Engineering or Research	[go to 1.6-1.7]
	Shipping, Receiving or Storage	[go to 1.8-1.10]
	Administration	[go to 2]
	DK	[go to 2]
1.1	[Degrease Mini-Module]
1.2	[Paint Mini-Module]
1.3	[Strip Mini-Module]
1.4	[Board Mini-Module]
1.5	[Fuel Mini-Module]	[go to 2]
1.6	Did you take samples from the process or production line for testing purposes?
	Yes	[go to 1.6.1]
	No
	DK
1.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.7	Did you perform chemical or physical tests on process or product samples?
	Yes	[go to 1.7.1]
	No	[go to 2]
	DK	[go to 2]
1.7.1	How many hours per week did you do this?
	< 2	[go to 2]
	2 - 9	[go to 2]
	10 - 19	[go to 2]
	20 or more	[go to 2]
	DK	[go to 2]
1.8	[Paint Mini-Module]
1.9	[Board Mini-Module]
1.10	[Fuel Mini-Module]
2	Did you work in the weighing area?
	Yes	[go to 2.1]
	No
	DK
2.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	Did you work in the modeling area. (This is the area where rubber parts are glued or cemented together)?
	Yes	[go to 3.1 - 3.3]
	No
	DK
3.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2	Did you make rubber cement by mixing rubber and solvents or gasoline together?
	Yes
	No
	DK
3.3	Did you glue rubber and metal together to make rubber-to-metal bonds?
	Yes	[go to 3.3.1]
	No
	DK
3.3.1	[Degrease mini-module]
4	Did you work in the curing area?
	Yes	[go to 4.1]
	No
	DK
4.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	Did you work in the finishing/ repair area?
	Yes	[ask 5.1 - 5.2]
	No
	DK
5.1	How many hours per week did you do work in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.2	Did you use a solvent or gasoline to 'polish' the rubber?
	Yes
	No
	DK
6	[Hands Mini-module]

	SHOE MANUFACTURING INDUSTRY (SHI) (LONG)
1	How would you best describe your job at this employer?
	Production (make, assemble, or process materials or parts into products or finished goods)	[go to 1.1 - 1.2]
	Maintenance or Utilities (maintain or repair equipment, tools, property or utilities)	[go to 1.3-1.7]
	Quality Control, Environmental Control, Engineering or Research
	Shipping, Receiving or Storage	[go to 1.8-1.10]
	Administration	[go to 2]
	DK	[go to 2]
1.1	What type of shoes did you make? (allow multiple)
	Leather shoes
	Textile shoes
	Rubber/plastic shoes or boots
	Other
	DK
1.2	In this job, what part of the shoe-making process did you do? Did you…? (allow multiple)
	Cut the upper part of the shoe
	Sew the upper part of the shoe
	Use a model (or last) to shape the upper part of the shoe
	Glue the upper part of the shoe to the sole
	Finish or polish the assembled shoe
	Something else
	DK
1.3	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes	[go to 1.3.1-1.3.5]
	No
	DK
1.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.3.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
1.3.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
1.3.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
1.3.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
1.3.6	Did other workers clean or degrease parts in the area where you worked?
	Yes	[go to 1.3.6.1]
	No
	DK
1.3.6.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.4	In this job, did you ever use paint?
	Yes	[go to 1.4.1-1.4.5]
	No
	DK
1.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.4.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
1.4.3	Did you paint indoors or inside a ship?
	Yes	[go to 1.3.1-1.3.2]
	No
	DK
1.4.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.4.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
1.4.3.3	Did you paint in a production area of a manufacturing plant?
	Yes	[go to 1.4.3.3.1]
	No
	DK
1.4.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.4.4	Did you paint outdoors?
	Yes	[go to 1.4.4.1]
	No
	DK
1.4.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.4.5	Did other workers use paints in the area where you worked?
	Yes	[go to 1.4.5.1]
	No
	DK
1.4.5.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.5	In this job, did you ever strip paint from metal or wood objects?
	Yes,	[go to 1.5.1-1.5.3]
	No
	DK
1.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.5.2	To strip paint, what did you use? Did you use…? (allow multiple)
	Methylene chloride
	Acids, alkalis, or caustic solutions?
	Any other chemical
	Something else, such as a heat gun or scraper
	DK
1.5.3	Did other workers strip paint from metal or wood objects in the area where you worked?
	Yes	[go to 1.5.3.1]
	No
	DK
1.5.3.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.6	In this job, did you ever handle or use particle board, plywood, or veneered wood?
	Yes	[go to 1.6.1]
	No
	DK
1.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.6.2	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes,	[go to 1.6.2.1]
	No
	DK
1.6.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.7	In this job, did you ever handle or pump fuel?
	Yes	[go to 1.7.1]
	No
	DK
1.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8	In this job, did you ever use paint?
	Yes	[go to 1.8.1-1.8.5]
	No
	DK
1.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
1.8.3	Did you paint indoors or inside a ship?
	Yes	[go to 1.8.3.1-1.8.3.2]
	No
	DK
1.8.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
1.8.3.3	Did you paint in a production area of a manufacturing plant?
	Yes	[go to 1.8.3.3.1]
	No
	DK
1.8.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8.4	Did you paint outdoors?
	Yes	[go to 1.8.4.1]
	No
	DK
1.8.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.8.5	Did other workers use paints in the area where you worked?
	Yes	[go to 1.8.5.1]
	No
	DK
1.8.5.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.9	In this job, did you ever handle or use particle board, plywood, or veneered wood?
	Yes	[go to 1.9.1]
	No
	DK
1.9.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.9.2	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes,	[go to 1.9.2.1]
	No
	DK
1.9.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.10	In this job, did you ever handle or pump fuel?
	Yes	[go to 1.10.1]
	No
	DK
1.10.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2	In this job, did you ever use glues or adhesives?
	Yes,	[go to 2.1-2.3]
	No
	DK
2.1	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
2.2	Did you use solvent-based glues or adhesives, for example, rubber cement?
	Yes,	[go to 2.2.1]
	No
	DK
2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3	Did you use water-based glues or adhesives, for example, vinyl or acrylic resins?
	Yes	[go to 2.3.1]
	No
	DK
2.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	In this job, did other workers use glues or adhesives in the area where you worked?
	Yes	[go to 3.1]
	No
	DK
3.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
5	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
6	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK

	Solvent (SOL) (LONG)
1	In this job, did you ever clean or degrease metal or plastic parts with chemicals?
	Yes	[go to 1.1-1.5]
	No
	DK
1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
1.2	When you cleaned metal or plastic parts, what did you use? Did you use…? (allow multiple)
	Trichloroethylene
	Gasoline or other fuels
	Benzene, toluene, or xylene
	Mineral spirits, stoddard solvent, turpentine or naphtha
	Paint thinner
	Any other solvent
	Any other degreaser
	DK
1.3	Were the chemicals at room temperature or were they heated in a tank, vat, or vapor degreaser? (allow multiple)
	Room temperature
	Heated in vapor degreaser
	Heated in vat or tank
	Other
	DK
1.4	How did you clean the parts? Did you …? (allow multiple)
	Wipe with rag/cloth
	Wipe with brush
	Put in basket and manually dipped into tank
	Put in basket and dipped into tank using automated system
	Put into tank or bucket with hands
	Other
	DK
1.5	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
1.6	Did other workers clean or degrease parts in the area where you worked?
	Yes	[go to 1.6.1]
	No
	DK
1.6.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2	In this job, did you ever use paint?
	Yes	[go to 2.1-2.5]
	No
	DK
2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2	What did you usually use to apply the paint? (allow multiple)
	Brush
	Roller
	Electrostatic gun
	Spray gun
	Dip item into paint
	Other
	DK
2.3	Did you paint indoors or inside a ship?
	Yes	[go to 2.3.1-2.3.2]
	No
	DK
2.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3.2	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
2.3.3	Did you paint in a production area of a manufacturing plant?
	Yes	[go to 2.3.3.1]
	No
	DK
2.3.3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.4	Did you paint outdoors?
	Yes	[go to 2.4.1]
	No
	DK
2.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.5	Did other workers use paints in the area where you worked?
	Yes	[go to 2.5.1]
	No
	DK
2.5.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3	In this job, did you use stains or varnishes?
	Yes	[go to 3.1-3.3]
	No
	DK
3.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
3.2	What type of stains or varnishes did you use? Did you use…? (allow multiple)
	Water-based stains
	Water-based varnishes
	Oil-based stains
	Oil-based varnishes
	Something else
	DK
3.3	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
3.4	Did other workers use stains or varnishes in the area where you worked?
	Yes	[go to 3.4.1]
	No
	DK
3.4.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4	In this job, did you ever strip paint from metal or wood objects?
	Yes,	[go to 4.1-4.3]
	No
	DK
4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
4.2	To strip paint, what did you use? Did you use…? (allow multiple)
	Methylene chloride
	Acids, alkalis, or caustic solutions?
	Any other chemical
	Something else, such as a heat gun or scraper
	DK
4.3	Did other workers strip paint from metal or wood objects in the area where you worked?
	Yes	[go to 4.3.1]
	No
	DK
4.3.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5	In this job, did you ever use glues or adhesives?
	Yes,	[go to 5.1-5.8]
	No
	DK
5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.2	What material were the things you were gluing made of? (allow multiple)
	Wood
	Metal
	Plastic
	Paper
	Fabrics
	Other
	DK
5.3	Was there a local exhaust system to remove the dust, fumes or vapors that was produced?
	Yes
	No
	DK
5.4	Did you use water-based glues or adhesives, for example, vinyl or acrylic resins?
	Yes	[go to 5.4.1]
	No
	DK
5.4.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.5	Did you use glues or adhesives that you heated with a gun or other heated device?
	Yes,	[ go to 5.5.1]
	No
	DK
5.5.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.6	Did you use contact glues or adhesives where you apply the glue to both pieces being glued, let it dry for a short time, and then join the two pieces together?
	Yes	[go to 5.6.1]
	No
	DK
5.6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.7	Did you use glues or adhesives that require mixing two parts of the glue together before applying? (epoxy resins)
	Yes	[go to 5.7.1]
	No
	DK
5.7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.8	Did you use urea, phenol or melamine-based glues or adhesives?
	Yes	[go to 5.8.1]
	No
	DK
5.8.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
5.9	Did other workers use glues or adhesives in the area where you worked?
	Yes	[ask 5.9.1]
	No
	DK
5.9.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6	In this job, did you ever handle or use particle board, plywood, or veneered wood?
	Yes	[go to 6.1]
	No
	DK
6.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
6.2	Did other workers work with particle board, plywood, or veneered wood in the area where you worked?
	Yes,	[go to 6.2.1]
	No
	DK
6.2.1	How many hours per week did other workers perform this task while you were working in this area?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
7	In this job, did you ever handle or pump fuel?
	Yes	[go to 7.1]
	No
	DK
7.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
8	Were your hands ever immersed in a solvent, a solvent-based product, or fuel?
	Yes
	No
	DK
9	Did you wear gloves while using solvents or solvent-based products?
	Yes
	No
	Not applicable - did not use solvents
	DK
10	Did you clean your hands with a solvent, a solvent-based product or with fuel, such as gasoline?
	Yes
	No
	DK

	TEACHER (TE) MODULE
1	What grade level did you teach? (allow multiple)
	Elementary or below
	Junior high/middle school
	High school
	Vocational or technical school
	College or university
	Other
	DK
2	What subjects did you teach? (allow multiple)
	Art			[END]
	Biology			[go to 2.1]
	Chemistry			[go to 2.2]
	Industrial shop			[go to 2.3-2.5]
	Other			[END]
	DK			[END]
2.1	Did you teach a lab component for this subject?
	Yes			[go to 2.1.1]
	No
	DK
2.1.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.2	Did you teach a lab component for this subject?
	Yes			[go to 2.2.1]
	No
	DK
2.2.1	How many hours per week did you do this?
	< 2
	2 - 9
	10 - 19
	20 or more
	DK
2.3	[Degrease Mini-module]
2.4	[Paint Mini-Module]
2.5	[Hands mini-module]

*Note: The numbering in this document may not match the tablet exactly.