University of Michigan Dioxin Exposure Study

Transcription

1 University of Michigan Dioxin Exposure Study Respondent Booklet Version

2 Copyright University of Michigan All rights reserved.

3 D4. Waste disposal, including incinerator, wastewater, solid waste and scrapped equipment Foundry General Motors foundry in Saginaw Spraying chemicals to kill plants or weeds Metal scrap yards other than for automobiles Water treatment facility Paper industry 1

4 D12. Chlorophenol Agent Orange Vietnam era herbicides other than Agent Orange such as Agent Purple, Agent Pink, and Agent Green Other herbicides, weed killers, or brush killers PCP or pentachlorophenol 2,4-D Trichlorophenol and its derivatives, such as 2,4,5-T 2

5 E13. Activities in the water: Water skiing Swimming Snorkeling Water tubing Activities on the water Boating Canoeing Kayaking Rafting Activities in areas surrounding the water Camping Jogging Walking Using parks along the river Picnicking Biking Any other activity 3

6 E14. E days or less per year days per year (less than 1 day/month) days per year (1-2 days/month) days per year (2-4 days/month) days per year (4-8 days/month), or 6. More than 96 days per year (More than 8 days/ month)? 4

7 F1. Meat or Poultry Chicken Turkey Domesticated Duck or Goose Beef (including steak or burgers) Veal Pork (including ham or bacon) Lamb 5

8 F2. Wild Game Whitetail Deer or Venison Wild Turkey, Pheasant, Grouse, Quail, or Woodcock Wild Duck or Goose Raccoon, Opossum, Groundhog, Woodchuck, or Muskrat Squirrel or Wild Rabbit Wild Turtle or Frog Any Other Game Meat 6

9 F4. Fish Catfish, Bullhead, Carp or Suckers Walleye or Perch Pike, Pickerel or Muskellunge Small Mouth Bass Large Mouth Bass White Bass Pan Fish such as Bluegill, Sunfish, or Crappie Steelhead, Trout or Salmon Any other freshwater fish (such as Smelt or Lamprey) 7

10 F13., F I started trimming the belly meat 2. I started trimming the fat from the sides or back of the fish 3. I started removing or puncturing the skin of the fish 4. I stopped trimming the belly meat 5. I stopped trimming the fat from the sides or back of the fish 6. I stopped removing or puncturing the skin of the fish 7. Other. Specify: 8

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12 G1 G10d Examples of types of products, dishes or food items containing meat or poultry: Sausage, blood sausage (include turkey, pork, beef, venison or other meat sausage) Ground meat or burger (including turkey, chicken and venison burger) Jerky Lunch or sandwich meats (any meat eaten in a sandwich) Hot dogs (includes turkey, pork, beef or venison) Casseroles Stew or soup Stir fry Steaks Roasts Ribs Smoked meats Bacon Meat loaf Spam Paté Sauces, such as spaghetti sauce 10

13 Section G Week Month MEALS: per Year 5 Years 11

14 G51 G51d Examples of types of products, dishes or food items containing eggs: Fried eggs Poached eggs Scrambled eggs Omelettes Hard or soft-boiled eggs Deviled eggs Quiches Egg salad Other salads Egg McMuffin, or other breakfast egg sandwich Eggs Benedict 12

15 Section G Week Month MEALS: per Year 5 Years 13

16 G54 G54e Examples of types of products, dishes or meals that contain root vegetables: Stew or soup Casseroles Gratins Salads, including Jello salads Stir Fry Vegetables prepared boiled, broiled, baked, fried, par boiled, sautéed Preserved or canned vegetables Pickled vegetables Dried vegetables (such as dried carrot chips) Juices (tomato, carrot) 14

17 Section G Week Month MEALS: Per Year 5 Years 15

18 G55 G55e Examples of types of products, dishes or meals that contain fruits or other vegetables: Fruits Juices Ciders Jellies, Jams, Preserves Pies Cakes Sauces Cobblers or coffee-cakes Fruit or Jello salads Other Vegetables: Stew or soup Casseroles Gratins Salads, including Jello salads Stir Fry Vegetables boiled, broiled, baked, fried, par boiled, sautéed Preserved or canned vegetables Pickled vegetables Dried vegetables 16

19 Section G Week Month MEALS: per Year 5 Years 17

20 H2. White or Caucasian Black or African American American Indian or Alaskan Native Asian or Pacific Islander Other Specify: 18

21 H3. 1. Less than 1st grade 2. 1 st, 2 nd, 3 rd, or 4 th grade 3. 5 th or 6 th grade 4. 7 th or 8 th grade 5. 9 th grade th grade th grade th grade NO DIPLOMA 9. HIGH SCHOOL GRADUATE -- high school DIPLOMA, or the equivalent (For example: GED) 10. Some college but no degree 11. Associate degree in college -- Occupational/vocational program 12. Associate degree in college -- Academic program 13. Bachelor's degree (For example: BA, AB, BS) 14. Master's degree (For example: MA, MS, MEng, MEd, MSW, MBA) 15. Professional School Degree (For example: MD, DDS, DVM, LLB, JD) 16. Doctorate degree (For example: PhD, EdD) 19

22 H4. 1. LESS THAN $9, $10,000 19, $20,000 - $29, $30,000 - $39, $40,000 - $49, $50,000 - $59, $60,000 - $69, $70,000 - $79, $80,000 - $89, $90,000 99, $100,000 - $119, $120,000 AND OVER 20