Start
alspac_01_yays
YOU AND YOUR SURROUNDINGS
All answers are confidential
This questionnaire is for the study child's mother or the person taking the role of mother
Please answer as much as you can. Just tick the box which is most accurate in your opinion.
There are no good or bad answers, just tell us what is true for you. If there is a question you don't want to answer or it doesn't apply to you - put a line through it.
We know there are some questions you have answered before but we need to ask them regularly so we can track the changes that have happened to you and your family. In time we will be able to tell whether the changes have had an effect on your health and that of your family.
We understand that this may be boring for you, but hope you will be patient.
THANK YOU FOR YOUR HELP
SECTION A: THINGS YOU DO
In the last 12 months, how often have you used any of the following, whether at work, at home or as a hobby:
-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once a week

5 - Not at all

dental amalgam
ceramics/enamels
dry cleaning fluids
electroplating
glues
leather working
fabric/textiles
dyes
insecticides
plastics
metal cleaners/ degreasers,polishers
petrol
paint
photographic chemicals
electrical wiring
machining
soldering
radiation(X-ray or other)

In the last 12 months, how often have you used any of the following, whether at work, at home or as a hobby: other chemicals (please tick and specify)

1
Every day
2
Most days
3
About once a week
4
Less than once a week
5
Not at all
Other
In the last 12 months, how often have you done the following:
-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once a week

5 - Not at all

domestic work in other people's homes
hairdressing
farm work
hospital work
shift work
gardening
What jobs have you had since the study child was 5 that involved exposure to chemicals or machines? Include part-time and voluntary work. If you have not had a job that involved chemicals or machines write 'None'.
Job Materials/chemicals/machines used Date started (month-year) Date stopped (month-year)
Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date
1
2
3
4
5
6
7
8
9
10
11
12
13
If there is not enough space please continue on the back cover or on a separate sheet.
SECTION B: YOUR HOME
Below are a number of questions about your home. They are similar to some you answered 3 years ago, and will be used to see how your circumstances might have changed.

When did you move to your present address?

Generic date

How many times have you moved home since your study child was 7 years old ?

How many

Is your home:

0
being bought/mortgaged
1
being bought from council
2
owned - with no mortgage to pay
3
rented from council
4
rented from private landlord - furnished
5
rented from private landlord - unfurnished
6
rented from housing association
7
other (please tick describe)
Other

If you know your council tax band (A,B,C etc.) please write it here

Tax band

Do you live in your own home or do you live with your parents or others?

1
live in own home
2
live in partner's home
3
live with your parents in their home
4
live with your partner's parents in their home
5
other situation (please tick describe)
Other

Do you currently live in:

1
a whole detached house (or bungalow)
2
a whole semi-detached house/bungalow
3
an end of terrace house
4
a whole terraced house
5
a flat/maisonette (self contained)
6
room in someone else's house
7
other (please tick describe)
Other

What is the lowest level of your living accommodation: 2nd floor or above, give floor

78
basement
0
ground floor
1
1st floor
Floor

In the coldest time of year, describe the temperature in your: living rooms

1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold

In the coldest time of year, describe the temperature in your: the room where the study child sleeps

1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold

Does your home have the following? kitchen where there is space to sit and eat

1
Yes sole use
2
Yes shared with other household(s)
3
No

Does your home have the following? kitchen for cooking only

1
Yes sole use
2
Yes shared with other household(s)
3
No

Does your home have the following? indoor flushing toilet

1
Yes sole use
2
Yes shared with other household(s)
3
No

Apart from the kitchen, how many rooms do you have for living and/or sleeping ?

How many
Do you have sole use of the following amenities or are they shared with other household(s)?
-

1 - Yes sole use

2 - Yes shared

3 - No, don't have at all

running hot water
bath
shower
garden or yard
balcony

Is there a working telephone in your home (include mobiles)?

1
No
2
Yes, but for incoming calls only
3
Yes, a fully working phone or mobile phone
If yes, go to B12a on page 9
If no,
qc_B11_a == 1 || qc_B11_a == 2

Where is the nearest working telephone that you can use in an emergency?

1
pay phone in the building
2
pay phone in the street
3
neighbour's phone
4
none within 5 minutes walk
5
other (please tick describe)
Other

Is there ever any damp, condensation or mould in your home?

1
Yes
2
No
If no, go to B13a on page 10
If yes,
qc_B12_a == 1

How much of a problem is damp or condensation?

1
no damp or condensation
2
not serious
3
fairly serious
4
very serious

How much of a problem is mould?

1
no mould
2
not serious
3
fairly serious
4
very serious

Does your roof leak at all? (If you have another flat above yours, please tick 'does not apply')

7
does not apply
1
no leak
2
yes, slight leak
3
yes, serious leak

In wet weather, does water get in from anywhere else, such as through badly fitting windows or doors?

1
no leaks
2
yes, slight leaks
3
yes, serious leaks

Taking everything into account, which of the following best describes your feeling about your home?

1
satisfied
2
fairly satisfied
3
dissatisfied
4
very dissatisfied

In the past year have you done any of the following: sanded floors

1
Yes, in own home
2
Yes, elsewhere
3
Yes, both home and elsewhere
4
No, not at all

In the past year have you done any of the following: stripped wallpaper

1
Yes, in own home
2
Yes, elsewhere
3
Yes, both home and elsewhere
4
No, not at all

In the past year have you done any of the following: removed paint or varnish

1
Yes, in own home
2
Yes, elsewhere
3
Yes, both home and elsewhere
4
No, not at all
In the past year have any of the following rooms been decorated or had any brand new furniture?
-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture
In the past year have any of the following rooms been decorated or had any brand new furniture?
-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture
In the past year have any of the following rooms been decorated or had any brand new furniture?
-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture
In the past year have any of the following rooms been decorated or had any brand new furniture?
-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture

which room (s)?

Generic text

How would you rate your home in relation to that of other homes with children?

1
much cleaner
2
a bit cleaner
3
about the same
4
less clean
5
much less clean
9
don't know

How would you rate your home in relation to that of other homes with children?

1
much tidier
2
a bit tidier
3
about the same
4
less tidy
5
much less tidy
9
don't know
Here is a list of some things that can be a problem in people's homes or in the neighbourhood. How much of a problem are the following for you and your family:
-

1 - Serious problem

2 - Minor problem

3 - Not a problem

4 - No opinion

Badly fitted doors and windows
Poor ventilation
Noise travelling between the rooms of your home
Noise from other homes
Noise from outside in the street
Rubbish or litter dumped around your neighbourhood
Dog dirt on pavement/walkways
Worry about vandalism
Worry about burglaries
Worry about muggings or attacks
Disturbance from teenagers or youths

Here is a list of some things that can be a problem in people's homes or in the neighbourhood. How much of a problem are the following for you and your family: Other problems (please tick & describe)

1
Serious problem
2
Minor problem
3
Not a problem
4
No opinion
Other

Do the other people in your neighbourhood: visit your home

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do the other people in your neighbourhood: argue with you

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do the other people in your neighbourhood: look after your children

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do the other people in your neighbourhood: keep to themselves

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: visit the home of your neighbours

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: argue with your neighbours

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: look after your neighbour's children

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

Do you: keep to yourself

1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always

What do you think of your neighbourhood as a place to live?

1
a very good place to live
2
a fairly good place to live
3
not a very good place to live
4
not at all a good place to live

How heavy is the traffic on the street where you live?

1
very heavy
2
quite heavy
3
not very heavy
4
hardly any traffic
To heat your home in winter what methods do you mainly use?
central heating or storage heaters wood stoves or wood fires coal fires paraffin heaters gas fires (mains gas) gas fires (bottled gas) other type of heating (please tick describe) other type of heating (please tick describe) no heating in this room

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

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Other

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In main living room
In study child's bedroom
In other rooms

If your home is centrally heated in winter, please describe:

7
no central heating
If no central heating to question B23 Go to B24 below
qc_B23 == 7
Else

If your home is centrally heated in winter, please describe: type:

1
solid fuel
2
oil
3
gas
4
electricity
5
other (please tick describe)
Other

How is heating distributed?

1
Radiators
2
warm air
3
storage heaters
4
under floor heating
5
other please describe
Other

Where is the boiler?

1
kitchen
2
living room
3
no boiler
4
other (please tick describe)
Other

Do you use gas for cooking?

1
Yes, ring(s) only
2
yes, oven only
3
yes, rings and oven
4
no, not at all

Do you use the cooker (whether gas or electric) for any other purpose than cooking (e.g. drying clothes, heating the room)?

1
Yes
2
No
7
Don't have a cooker
If yes,
qc_B24_b == 1

please describe:

Generic text

How old is your cooker?

1
more than 20 years
2
10-19 years old
3
5-9 years old
4
2-4 years old
5
less than 2 years old
6
don't know

When you first got your present cooker - was it:

1
brand new
2
second hand

When someone is cooking, how often do they get rid of the smells and steam in the kitchen using the following:

7
Never cook
If Never cook to question B25 Go to B26 on page 18
qc_B25 == 7
Else
When someone is cooking, how often do they get rid of the smells and steam in the kitchen using the following:
-

1 - Usually

2 - Sometimes

3 - Not at all

open windows
ventaxia/air extractor
extractor hood which vents to outside
extractor hood that doesn't vent to outside

When someone is cooking, how often do they get rid of the smells and steam in the kitchen using the following: other (please tick and describe)

1
Usually
2
Sometimes
3
Not at all
Other

How often do you have any windows open in your home: In summer: day

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

How often do you have any windows open in your home: In summer: night

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

How often do you have any windows open in your home: In winter: day

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

How often do you have any windows open in your home: In winter: night

1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open

Are any of your windows double glazed? (including secondary double glazing)

1
yes, all of them
2
yes, some of them
3
no, none of them
9
don't know

Does your home have chimneys?

1
Yes
2
No
If yes,
qc_B26_d == 1

have they been blocked up?

1
yes, all of them
2
yes, some of them
3
no
9
don't know

Do you use a thermometer or thermostat to help keep the temperature at the level you want in winter? In main living room:

1
thermostat on radiators
2
room thermostat
3
room thermometer
4
none of these
5
other (please describe)
Other

Do you use a thermometer or thermostat to help keep the temperature at the level you want in winter? In your study child's bedroom:

1
thermostat on radiators
2
room thermostat
3
room thermometer
4
none of these
5
other (please describe)
Other
What temperature do you try to maintain in winter? (If you don't try to maintain any particular temperature put 97)
day night
TemperatureTemperatureTemperatureTemperature TemperatureTemperatureTemperatureTemperature
in living rooms
in room where your study child sleeps
This question is about whether various appliances in your home were fitted by professionals or by you, your family or friends.
Fitted by professionals

1 - Yes

2 - No

3 - Don't know

7 - Don't have this

central heating boiler
gas fires
cooker

Do you have these appliances regularly serviced? central heating boiler

1
Regularly serviced
2
Serviced occasionally
3
Not serviced
7
Don't have this

Do you have these appliances regularly serviced? gas fires

1
Regularly serviced
2
Serviced occasionally
3
Not serviced
7
Don't have this

Do you have these appliances regularly serviced? cooker

1
Regularly serviced
2
Serviced occasionally
3
Not serviced
7
Don't have this

Do you have a tumble dryer?

1
yes, gas
2
yes, electric
3
no, don't have

How often do you drive a car, van or lorry ?

1
almost every day
2
2-5 times a week
3
once a week
4
rarely
5
never
If never to question B30a Go to Section C on page 21
qc_B30_a == 5
Else

What type of fuel is used?

1
diesel
2
lead free petrol
3
other petrol
SECTION C: YOUR HOUSEHOLD

How many people live in your household now? (including yourself) adults (over 18 years)

How many

How many people live in your household now? (including yourself) young adults (16-18 years)

How many

How many people live in your household now? (including yourself) children (less than 16 years)

How many

Please indicate who the adults over 18 are: yourself

1
Yes

Please indicate who the adults over 18 are: your husband/partner

1
Yes

Please indicate who the adults over 18 are: your parent(s)

1
Yes

Please indicate who the adults over 18 are: your husband's/partner's parent(s)

1
Yes

Please indicate who the adults over 18 are: other relation(s) of yourself

1
Yes

Please indicate who the adults over 18 are: other relation(s) of your husband/partner

1
Yes

Please indicate who the adults over 18 are: friend(s)

1
Yes

Please indicate who the adults over 18 are: lodger

1
Yes

Please indicate who the adults over 18 are: other (please tick and describe)

1
Yes
Other

Do you have a rule that smoking never happens in particular rooms?

1
no smoking in house at all
2
smoking only allowed in some rooms
3
smoking allowed anywhere

How many people living in your household (including yourself) are smokers?

How many

What is your present marital status?

1
never married
2
widowed
3
divorced
4
separated
5
married (once only)
6
married for second or third time
If married,
qc_C3_a == 5 || qc_C3_a == 6

what was the date of the most recent marriage?

Generic date

Does the biological (natural) father of the 10 year old study child live with the study child?

1
No
2
Yes
If yes, go to C4c on page 23
If no,
qc_C4_a == 1

How old was the child when the natural father stopped living with the child? ... months

Age in months

How often does the natural father see the study child?

1
not at all
2
less than once a month
3
about once a month
4
about once a fortnight
5
once or twice a week
6
nearly every day
7
child's father is dead
If child's father is dead to question C4bii Go to C4c on page 23
qc_C4_b_ii == 7
Else

Does he help support the child financially?

1
yes, on a regular basis
2
yes, occasionally
3
no

Does the biological (natural) mother of the 10 year old study child live with the study child?

1
No
2
Yes
If yes, go to C5 on page 24
If no,
qc_C4_c == 1

How old was the child when the natural mother stopped living with the child? ... months

Age in months

How often does the natural mother see the study child?

1
not at all
2
less than once a month
3
about once a month
4
about once a fortnight
5
once or twice a week
6
nearly every day
7
child's mother is dead
If child's mother is dead to question C4cii Go to C5 on page 24
qc_C4_c_ii == 7
Else

Does she help support the child financially ?

1
yes, on a regular basis
2
yes, occasionally
3
no
To make the questions less complicated, for the rest of this section, for partner we mean husband or partner.
Please indicate how many of the children living in your household have:
Number of children
How many
you and your partner as their natural parents
their natural mother present (but their natural father is not present)
the natural father present (but not their natural mother)

Please indicate how many of the children living in your household have: neither natural parent present (please describe whether you have adopted, fostered etc.) Number of children

How many
Generic text
Are there other children of yourself or your partner who visit (whether to play or to stay)?
- Number of children

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many
Children of my partner but not me
Children of myself but not my partner
Children of me and my partner

Do any of the people living in your household, including yourself and your study child, have a chronic illness or disabling condition (for example asthma, arthritis, epilepsy, depression)

1
Yes
2
No
If no, go to C8 on page 25
If yes,
qc_C7 == 1
please describe:
Nature of condition(s) Person(s) involved (state relationship to you - husband/ partner, child, mother, etc.)
Generic textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric text
1
2
3
4

Do you have any pets in the household?

1
Yes
2
No
If no, go to C9 below
If yes,
qc_C8_a == 1

How many of the following pets do you have? Number cats

How many

How many of the following pets do you have? Number dogs

How many

How many of the following pets do you have? Number rabbits

How many

How many of the following pets do you have? Number rodents (mice, hamster, gerbil etc.)

How many

How many of the following pets do you have? Number birds (budgerigar, parrot, etc.)

How many

How many of the following pets do you have? Number fish

How many

How many of the following pets do you have? Number turtles/tortoises/terrapins

How many

How many of the following pets do you have? Number other pets (please say how many and describe)

How many
Other
The other children in the household:
How many brothers and sisters does your 10 year old study child have that live with you or visit at least 1 day a week? (include half-brothers and half sisters, step-brothers and stepsisters, fostered or adopted children.)
younger same age (e.g. twin of the study child) older
How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many
Brothers
Sisters
How would you describe the noise level in your home?
-

1 - Yes

2 - No

there is usually music or television on in our home
the noises from outside our home are disturbing (neighbours, traffic, factory)
it is often so noisy at home it is difficult to hold a conversation
SECTION D: PILLS AND POTIONS
Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months.
Yes in past 12 months If yes, give name of substance 1 If yes, give name of substance 2 How often did you take/use this? 1 How often did you take/use this? 2
Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Headache or or migraine
Backache
Period pain
Other pain
Indigestion
Nausea
Vomiting
Diarrhoea
Piles or haemorrhoids
Constipation
Depression
Anxiety or nerves
Sleeping
Psoriasis
Eczema
Asthma
Hay fever
Other allergies
Sore throat
Cough
A cold
Flu
Other infection
Thrush
Cystitis
Diabetes
Epilepsy
High blood pressure
Oral contraceptive
HRT (hormone replacement therapy)
Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months.
Yes in past 12 months If yes, give name of substance How often did you take/use this?

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months. Took/used no medicines, pills, drops or ointment

1
Yes in past 12 months
Please include medicines prescribed by your doctor and also those you may have purchased over the counter. (Do not include vitamins and supplements unless taken for a specific medical condition, as these are covered in the next section).
If possible give the full name of the medicine and indicate how often it was used. If you need more lines for a particular category please include the additional medicines under the 'Other conditions' section at the end of this question on page 30.
Vitamin, mineral and other supplements are widely used. Some people take them regularly for their health, whereas others may use them more sporadically to try to improve a specific area of their health. Please indicate below whether you have used such supplements regularly, occasionally or not at all in the last 12 months.
Used in last 12 months

1 - Regularly

2 - Occasionally

3 - Not at all

Vitamins
Minerals (e.g. calcium, iron)
Oil supplements e.g. fish oils, evening primrose oil
Other supplements e.g. Ginseng
Please describe below any vitamins, minerals such as iron or calcium or other supplements taken for your health in the past month and indicate how often you used them.
Vitamins -

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text
1
2
3
Please describe below any vitamins, minerals such as iron or calcium or other supplements taken for your health in the past month and indicate how often you used them.
Mineral supplements -

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text
1
2
3
Please describe below any vitamins, minerals such as iron or calcium or other supplements taken for your health in the past month and indicate how often you used them.
Oil supplements -

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text
1
2
3
Please describe below any vitamins, minerals such as iron or calcium or other supplements taken for your health in the past month and indicate how often you used them.
Other supplements -

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic text
1
2
3
Some of these questions may seem familiar
Please bear with us- but we need to ask them again
SECTION E: YOUR OCCUPATION AND LIFESTYLE

Since the study child was 5 years old have you worked at all? (please tick all that apply).

7
No, not at all
If no, go to Question E8 on page 38
qc_E1_a == 7
Else
Since the study child was 5 years old have you worked at all? (please tick all that apply).
-

1 - Yes

yes, paid work at home
yes, paid work outside home
yes, voluntary work

Have you been working all the time since you started work after the study child was 5?

1
yes, same job all the time
2
yes, but not always the same job
3
no, stopped started again
4
no, do not work now
If no, stopped & started again to question E1b or no, do not work now to question E1b
qc_E1_b == 3 || qc_E1_b == 4

when did you last stop?

Generic date
If do not work now go to E7 on page 38
qc_E1_b == 4
Else

when did you start again?

Generic date

how many jobs are you now doing?

How many

Whether or not you are self-employed, what job(s) are you doing? (please describe the job(s) you do and the type of industry/employer(s) you work for). If you are self-employed please also say so.

Generic text

How many hours did you work last week ? ... hours

Hours in week

Was this a typical week?

1
Yes
2
No, usually work more hours
3
No, usually work less hours
If no,
qc_E1_c_i == 2 || qc_E1_c_i == 3

how many hours in a usual week? ... hours

Hours in week

Does your work include weekends?

1
Yes, usually
2
Yes, sometimes
3
No, never

Do you work in the evenings or at night?

1
Yes, often
2
Yes, sometimes
3
No

How would you describe the physical effort you need for your current job(s)?

1
very little effort, mostly sitting
2
some physical effort
3
quite a lot of physical effort
4
considerable physical effort

Do you usually work:

1
the basic no. of hours per week
2
basic hours plus paid overtime
3
longer than basic hours (but not paid extra)
4
self-employed - as long as necessary

Which of the following best describes how you are paid in your present job?

1
Monthly salary plus performance
2
Monthly salary only
3
Weekly wage
4
Hourly paid
5
Piecework
6
Self-employed
7
Other (please describe)
Other

Are you on a recognised pay scale with increments, either automatic or performance related?

1
Yes
2
No
9
Don't know

If you decided to leave your job, how much notice are you officially required to give?

1
Less than one week
2
1, 2 or 3 weeks
3
1 or 2 months
4
3 months or more
5
not relevant (self-employed)
9
Don't know

In your sort of work, are there opportunities for promotion either in your current organisation or by changing employers?

1
Yes
2
No
9
Don't know

Who decides what time you start and leave work?

1
Flexitime system
2
Employer decides
3
I decide, within certain limits
4
Negotiated with employer

Does your job require you to design and plan important aspects of your own work, or is your work largely specified for you?

1
I am required to design/plan my work
2
Work is largely specified by others
3
Other

How much influence do you personally have in deciding what tasks you are to do?

1
A great deal
2
A fair amount
3
Not much
4
None
What are the main reasons you work? (tick all that apply)
-

1 - Yes

financial, I am important as a breadwinner
financial, for family extras
career
enjoyment
to get out of the home

What are the main reasons you work? (tick all that apply) other (please tick & describe)

1
Yes
Other

Are you working at the same status as you did before the study child was born?

7
didn't work before
1
no, lower level
2
yes, same level
3
no, higher level

Do you find your job satisfying?

1
Yes
2
No
3
Sometimes

Do you wish that you could generally spend more time with your study child?

1
yes, often
2
yes, sometimes
3
yes, but rarely
4
no, not at all

How do you usually travel to work? (Tick all that apply)

7
Work at home
If Work at home to question E6a Go to E7 on page 38
qc_E6_a == 7
Else
How do you usually travel to work? (Tick all that apply)
-

1 - Yes

public transport (bus, train)
car
cycle
walk

How do you usually travel to work? (Tick all that apply) other (please tick and describe)

1
Yes
Other

How long does it usually take: to travel to work

1
Less than 15 mins
2
15-29 mins
3
30-59 mins
4
An hour or more

How long does it usually take: to travel home from work

1
Less than 15 mins
2
15-29 mins
3
30-59 mins
4
An hour or more
Please list all jobs you have had since your study child's 7th birthday, apart from your present job if you are currently working.
Age of child at start of job Job Hours worked in usual week
Hours in weekAgeGeneric textHours in weekAgeGeneric textAgeGeneric textHours in week Hours in weekAgeGeneric textHours in weekAgeGeneric textAgeGeneric textHours in week Hours in weekAgeGeneric textHours in weekAgeGeneric textAgeGeneric textHours in week
1
2
3
4
5
If you are working now please go to Question E9 on page 39
If you are not working now:
qc_E1_a == 7 || qc_E1_b == 4

Have you chosen not to work so that you can stay at home with your children?

1
No
2
Yes
If yes, go to E9 on page 39
If no,
qc_E8 == 1

Have you been looking for work?

1
Yes
2
No
If no, go to E8c on page 39
If yes
qc_E8_a == 1

How long have you been seeking work? ... months

How many
If you have not been looking for work, please give reasons (tick all that apply):
-

1 - Yes

do not want to work
looking after family
on maternity leave
not well enough

If you have not been looking for work, please give reasons (tick all that apply): other (please tick describe)

1
Yes
Other
In the past 2 years have you taken any courses or educational training?
-

1 - Yes

2 - No

training within my job
evening classes
university course

In the past 2 years have you taken any courses or educational training? other (please tick describe)

1
Yes
2
No
Other
What is your job like? (If you are no longer working answer for your most recent job)
-

1 - Yes, always

2 - Yes, mostly

3 - Sometimes

4 - Not very often

5 - Never

Do you enjoy your job?
Do you have problems at work?
Are the people at your work friendly?
Are the people at your work supportive?
Is it very noisy?
Do you work in a smoky atmosphere?
Although we asked a lot about you when you were pregnant, now that we are looking at the ears and hearing of all the study children, we find there are some questions we need to ask.
Please think back to the time when you were pregnant with your 10 year old study child. If you find this impossible to remember please write NK beside the appropriate question.

If you are not the child's biological mother just tick N/A here:

1
N/A
If N/A to question sectionEi Then go straight to Section G on Page 56.
qc_sectionE_i == 1
Else
SECTION F: NOISE DURING PREGNANCY
Noise at work

Were you exposed to noise at work during pregnancy? (not including guns/explosives)

1
Yes
2
No
If no, go to F2a on page 44
If yes,
qc_F1_a == 1

Describe what noisy job you had during pregnancy:

Generic text

About how many months pregnant were you when you stopped work? ... months

How many
List the different noisy tasks you were doing (or were going on really close to you) in your work, starting with the noisiest:
-
Generic text
Task 1
Task 2
Task 3
For Task 1

Approximately how many hours per week at work did you spend on Task 1? ... hours

Hours in week

What was the source of noise?

Generic text
When trying to talk to another worker (who was also used to the conditions), without wearing hearing protection what sort of voice did you have to use:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

After performing Task 1, did you notice any of the following effects on your hearing, and if so, were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

After performing Task 1, did you notice any of the following effects on your hearing, and if so, were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

Did you wear hearing protection during Task 1?

1
Yes
2
No
If no, go to F1m on page 42
If yes,
qc_F1_j == 1

What type of hearing protection did you wear?

Generic text

Approximately how many hours per week performing Task 1 did you wear hearing protection? ... hours

Hours in week
For Task 2

Approximately how many hours per week at work did you spend on Task 2? ... hours

Hours in week

What was the source of noise?

Generic text
When trying to talk in this working environment to another worker (who was also used to the conditions), what sort of voice did you have to use:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

After performing Task 2, did you notice any of the following effects on your hearing, and if so, were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

After performing Task 2, did you notice any of the following effects on your hearing, and if so, were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

Did you wear hearing protection during Task 2?

1
Yes
2
No
If no, go to F1t on page 43
If yes,
qc_F1_q == 1

What type of hearing protection did you wear?

Generic text

Approximately how many hours per week performing Task 2 did you wear hearing protection? ... hours

Hours in week
For Task 3

Approximately how many hours per week at work did you spend on Task 3? ... hours

Hours in week

What was the source of noise?

Generic text
When trying to talk in this working environment to another worker (who was also used to the conditions), what sort of voice did you have to use:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

After performing Task 3, did you notice any of the following effects on your hearing, and if so, were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

After performing Task 3, did you notice any of the following effects on your hearing, and if so, were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

Did you wear hearing protection during task 3?

1
Yes
2
No
If no, go to F2a on page 44
If yes,
qc_F1_x == 1

What type of hearing protection did you wear?

Generic text

Approximately how many hours per week performing Task 3 did you wear hearing protection? ... hours

Hours in week
Social noise exposure during pregnancy

Did you attend pop/rock concerts with live amplified music during pregnancy?

1
Yes
2
No
If no, go to F3a below
If yes,
qc_F2_a == 1

About how many times during pregnancy? ... times

How many

Roughly how many hours did you spend at each concert? ... hours

How many
If you were with another person at a concert, how loud did you have to talk to understand each other:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after attending concerts, and if so, were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after attending concerts, and if so, were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

Did you attend nightclubs or discos with music amplified through speakers during pregnancy?

1
Yes
2
No
If no, go to F4a on page 45
If yes,
qc_F3_a == 1

For approximately how many hours per day? ... hours/ day

Hours in day

For approximately how many days per week? ... days/week

Days in week

About how many months pregnant were you when you stopped doing this? ... months

How many
To talk with another person at a nightclub (at the place in the nightclub where you spend most of the time), how loud did you have to talk to understand each other:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after attending nightclubs, and if so, were they temporary or permanent? Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after attending nightclubs, and if so, were they temporary or permanent? Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy, did you listen to music using earphones with a personal music system or hi-fi?

1
Yes
2
No
If no, go to F5a on page 46
If yes, when you did so:
qc_F4_a == 1

For approximately how many hours per day? ... hours/day

Hours in day

For approximately how many days per week? ... days/week

Days in week
When with another person while you were listening to music using earphones, with the volume at your normal level, how loud did they have to talk for you to understand them:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after listening to music using earphones, and were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after listening to music using earphones, and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy, did you listen to the TV or computer games using earphones?

1
Yes
2
No
If no, go to F6a on page 47
If yes,
qc_F5_a == 1

For approximately how many hours per day? ... hours/day

Hours in day

For approximately how many days per week? ... days/week

Days in week
On average, to communicate with another person while you were listening to the TV/computer games using earphones, with the volume at your normal listening level, how loud did they have to talk for you to understand them:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after listening to the TV/computer games using earphones, and were they temporary or permanent: Dullness of hearing

1
Normal voice
2
Raised voice
3
Very loud voice
4
Shout
5
Impossible to communicate

Did you notice any of the following effects on your hearing after listening to the TV/computer games using earphones, and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy, did you listen to music through speakers (in your home or elsewhere)?

1
Yes
2
No
If no, go to F7a on page 48
If yes,
qc_F6_a == 1

Approximately how many hours per day? ... hours/day

Hours in day

Approximately how many days per week? ... days/week

Days in week
On average, to communicate with another person while you were listening to music through speakers, with the volume at your normal listening level, how loud did you have to talk to understand each other:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after listening to music through speakers, and were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after listening to music through speakers, and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy, did you listen to in-car music?

1
Yes
2
No
If no, go to F8a on page 49
If yes,
qc_F7_a == 1

For approximately how many hours per day? ... hours/day

Hours in day

For approximately how many days per week? ... days/week

Days in week
On average, to communicate with another person in the car, with the volume at your normal listening level, how loud did you have to talk to understand each other:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after listening music in the car, and were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after listening music in the car, and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy did you carry out DIY using power tools?

1
Yes
2
No
If no, go to F9a on page 50
If yes,
qc_F8_a == 1

For approximately how many hours in total? ... hours

How many

About how many months pregnant were you when you did it for the last time? ... months

How many
On average, to communicate with another person whilst using power tools, how loud did you have to talk to understand each other:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing after using power tools, and were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after using power tools, and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy, did you ride a motor cycle?

1
Yes
2
No
If no, go to F10a on page 51
If yes,
qc_F9_a == 1

About how many hours per day? ... hours/day

Hours in day

For approximately how many days per week? ... days/week

Days in week

How many months pregnant were you when you did this for the last time? ... months

How many

Did you notice any of the following effects on your hearing after riding a motor cycle, and were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing after riding a motor cycle, and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No

During pregnancy, apart from guns and explosions, were you exposed to any other loud noise?

1
Yes
2
No
If no, go to F11a below
If yes,
qc_E10_a == 1

Please give details

Generic text

For approximately how many hours per day? ... hours/day

Hours in day

For approximately how many days per week? ... days/week

Days in week
On average, to communicate with another person how loud did you have to talk to understand each other:
-

1 - Normal voice

2 - Raised voice

3 - Very loud voice

4 - Shout

5 - Impossible to communicate

4 feet away from you
2 feet away from you
Close to your ear

Did you notice any of the following effects on your hearing and were they temporary or permanent: Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following effects on your hearing and were they temporary or permanent: Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No
Gun shots during pregnancy

Did you fire guns during pregnancy?

1
Yes
2
No
If no, go to F12 on page 54
qc_F11_a == 2
Else
Name the make and model of each gun you fired:
-
Generic text
1
2
3
For Gun 1

Approximately how many rounds did you fire during pregnancy?

How many

Did you wear hearing protection?

1
Yes
2
No
If no, go to F11g below
If yes,
qc_F11_d == 1

Which type of hearing protection did you use?

Generic text

How many rounds did you fire wearing hearing protection?

How many

How many rounds did you fire without wearing hearing protection?

How many

Did you notice any immediate effect on your hearing after firing?

1
Yes
2
No
If no, go to F11 part l) at the top of page 53
If yes,
qc_F11_h == 1

Which ear?

1
Left
2
Right
3
Both

What was the effect?

1
Slight
2
Moderate
3
Severe

Was it a temporary or permanent effect?

1
Temporary
2
Permanent
For Gun 2

Approximately how many rounds did you fire during pregnancy?

How many

Did you wear hearing protection?

1
Yes
2
No
If no, go to F11p below
If yes,
qc_F11_m ==1

Which type of hearing protection did you use?

Generic text

How many rounds did you fire wearing hearing protection?

How many

How many rounds did you fire without wearing hearing protection?

How many

Did you notice any immediate effect on your hearing after firing?

1
Yes
2
No
If no, go to F11u below
If yes,
qc_F11_q == 1

Which ear?

1
Left
2
Right
3
Both

What was the effect?

1
Slight
2
Moderate
3
Severe

Was it a temporary or permanent effect?

1
Temporary
2
Permanent
For Gun 3

Approximately how many rounds did you fire during pregnancy?

How many

Did you wear hearing protection?

1
Yes
2
No
If no, go to F11y on page 54
If yes,
qc_F11_v == 1

Which type of hearing protection did you use?

Generic text

How many rounds did you fire wearing hearing protection?

How many

How many rounds did you fire without wearing hearing protection?

How many

Did you notice any immediate effect on your hearing after firing?

1
Yes
2
No
If no, go to F12 below
If yes,
qc_F11_z == 1

Which ear?

1
Left
2
Right
3
Both

What was the effect?

1
Slight
2
Moderate
3
Severe

Was it a temporary or permanent effect?

1
Temporary
2
Permanent
Explosions

Were you exposed to any explosions during pregnancy?

1
Yes
2
No
If no, go to Section G on page 56
If yes,
qc_F12_a == 1

How many explosions

How many

Describe the type of explosion

Generic text

Did you wear hearing protection?

1
Yes
2
No

Did you notice any of the following after any of the explosions? Dullness of hearing

1
Yes temporary
2
Yes permanent
3
No

Did you notice any of the following after any of the explosions? Tinnitus (noises in the ear or head)

1
Yes temporary
2
Yes permanent
3
No
SECTION G:

This questionnaire was completed by: (Please tick all that apply) child's biological mother

1
Yes

This questionnaire was completed by: (Please tick all that apply) child's mother figure

1
Yes

This questionnaire was completed by: (Please tick all that apply) someone else (please describe)

1
Yes
Other

Do you live in the same house as the study child?

1
Yes
2
No

Please give the date on which you completed this questionnaire:

Generic date

Please give your date of birth:

Date of birth

Please give your study child's date of birth:

Date of birth
THANK YOU VERY MUCH FOR YOUR HELP

Space for any additional comments you would like to make.

Long text
N.B. Please remember we cannot reply to any comment unless you sign it.
When completed, please return the questionnaire to: Professor Jean Golding Children of the Nineties - ALSPAC Institute of Child Health
End

alspac_01_yays

YOU AND YOUR SURROUNDINGS
All answers are confidential
This questionnaire is for the study child's mother or the person taking the role of mother
Please answer as much as you can. Just tick the box which is most accurate in your opinion.
There are no good or bad answers, just tell us what is true for you. If there is a question you don't want to answer or it doesn't apply to you - put a line through it.
We know there are some questions you have answered before but we need to ask them regularly so we can track the changes that have happened to you and your family. In time we will be able to tell whether the changes have had an effect on your health and that of your family.
We understand that this may be boring for you, but hope you will be patient.
THANK YOU FOR YOUR HELP

SECTION A: THINGS YOU DO

In the last 12 months, how often have you used any of the following, whether at work, at home or as a hobby:

-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once a week

5 - Not at all

dental amalgam
ceramics/enamels
dry cleaning fluids
electroplating
glues
leather working
fabric/textiles
dyes
insecticides
plastics
metal cleaners/ degreasers,polishers
petrol
paint
photographic chemicals
electrical wiring
machining
soldering
radiation(X-ray or other)
In the last 12 months, how often have you used any of the following, whether at work, at home or as a hobby: other chemicals (please tick and specify)
1
Every day
2
Most days
3
About once a week
4
Less than once a week
5
Not at all
Other

In the last 12 months, how often have you done the following:

-

1 - Every day

2 - Most days

3 - About once a week

4 - Less than once a week

5 - Not at all

domestic work in other people's homes
hairdressing
farm work
hospital work
shift work
gardening

What jobs have you had since the study child was 5 that involved exposure to chemicals or machines? Include part-time and voluntary work. If you have not had a job that involved chemicals or machines write 'None'.

Job Materials/chemicals/machines used Date started (month-year) Date stopped (month-year)
Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date Generic textGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric dateGeneric textGeneric textGeneric date
1
2
3
4
5
6
7
8
9
10
11
12
13
If there is not enough space please continue on the back cover or on a separate sheet.

SECTION B: YOUR HOME

Below are a number of questions about your home. They are similar to some you answered 3 years ago, and will be used to see how your circumstances might have changed.
When did you move to your present address?
Generic date
How many times have you moved home since your study child was 7 years old ?
How many
Is your home:
0
being bought/mortgaged
1
being bought from council
2
owned - with no mortgage to pay
3
rented from council
4
rented from private landlord - furnished
5
rented from private landlord - unfurnished
6
rented from housing association
7
other (please tick describe)
Other
If you know your council tax band (A,B,C etc.) please write it here
Tax band
Do you live in your own home or do you live with your parents or others?
1
live in own home
2
live in partner's home
3
live with your parents in their home
4
live with your partner's parents in their home
5
other situation (please tick describe)
Other
Do you currently live in:
1
a whole detached house (or bungalow)
2
a whole semi-detached house/bungalow
3
an end of terrace house
4
a whole terraced house
5
a flat/maisonette (self contained)
6
room in someone else's house
7
other (please tick describe)
Other
What is the lowest level of your living accommodation: 2nd floor or above, give floor
78
basement
0
ground floor
1
1st floor
Floor
In the coldest time of year, describe the temperature in your: living rooms
1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold
In the coldest time of year, describe the temperature in your: the room where the study child sleeps
1
Very warm
2
Warm
3
About right
4
Cold
5
Very cold
Does your home have the following? kitchen where there is space to sit and eat
1
Yes sole use
2
Yes shared with other household(s)
3
No
Does your home have the following? kitchen for cooking only
1
Yes sole use
2
Yes shared with other household(s)
3
No
Does your home have the following? indoor flushing toilet
1
Yes sole use
2
Yes shared with other household(s)
3
No
Apart from the kitchen, how many rooms do you have for living and/or sleeping ?
How many

Do you have sole use of the following amenities or are they shared with other household(s)?

-

1 - Yes sole use

2 - Yes shared

3 - No, don't have at all

running hot water
bath
shower
garden or yard
balcony
Is there a working telephone in your home (include mobiles)?
1
No
2
Yes, but for incoming calls only
3
Yes, a fully working phone or mobile phone
If yes, go to B12a on page 9
Where is the nearest working telephone that you can use in an emergency?
1
pay phone in the building
2
pay phone in the street
3
neighbour's phone
4
none within 5 minutes walk
5
other (please tick describe)
Other
Is there ever any damp, condensation or mould in your home?
1
Yes
2
No
If no, go to B13a on page 10
How much of a problem is damp or condensation?
1
no damp or condensation
2
not serious
3
fairly serious
4
very serious
How much of a problem is mould?
1
no mould
2
not serious
3
fairly serious
4
very serious
Does your roof leak at all? (If you have another flat above yours, please tick 'does not apply')
7
does not apply
1
no leak
2
yes, slight leak
3
yes, serious leak
In wet weather, does water get in from anywhere else, such as through badly fitting windows or doors?
1
no leaks
2
yes, slight leaks
3
yes, serious leaks
Taking everything into account, which of the following best describes your feeling about your home?
1
satisfied
2
fairly satisfied
3
dissatisfied
4
very dissatisfied
In the past year have you done any of the following: sanded floors
1
Yes, in own home
2
Yes, elsewhere
3
Yes, both home and elsewhere
4
No, not at all
In the past year have you done any of the following: stripped wallpaper
1
Yes, in own home
2
Yes, elsewhere
3
Yes, both home and elsewhere
4
No, not at all
In the past year have you done any of the following: removed paint or varnish
1
Yes, in own home
2
Yes, elsewhere
3
Yes, both home and elsewhere
4
No, not at all

In the past year have any of the following rooms been decorated or had any brand new furniture?

-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture

In the past year have any of the following rooms been decorated or had any brand new furniture?

-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture

In the past year have any of the following rooms been decorated or had any brand new furniture?

-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture

In the past year have any of the following rooms been decorated or had any brand new furniture?

-

1 - Yes

2 - No

9 - Don't know

painted
wallpapered
new carpet
new furniture
which room (s)?
Generic text
How would you rate your home in relation to that of other homes with children?
1
much cleaner
2
a bit cleaner
3
about the same
4
less clean
5
much less clean
9
don't know
How would you rate your home in relation to that of other homes with children?
1
much tidier
2
a bit tidier
3
about the same
4
less tidy
5
much less tidy
9
don't know

Here is a list of some things that can be a problem in people's homes or in the neighbourhood. How much of a problem are the following for you and your family:

-

1 - Serious problem

2 - Minor problem

3 - Not a problem

4 - No opinion

Badly fitted doors and windows
Poor ventilation
Noise travelling between the rooms of your home
Noise from other homes
Noise from outside in the street
Rubbish or litter dumped around your neighbourhood
Dog dirt on pavement/walkways
Worry about vandalism
Worry about burglaries
Worry about muggings or attacks
Disturbance from teenagers or youths
Here is a list of some things that can be a problem in people's homes or in the neighbourhood. How much of a problem are the following for you and your family: Other problems (please tick & describe)
1
Serious problem
2
Minor problem
3
Not a problem
4
No opinion
Other
Do the other people in your neighbourhood: visit your home
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do the other people in your neighbourhood: argue with you
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do the other people in your neighbourhood: look after your children
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do the other people in your neighbourhood: keep to themselves
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: visit the home of your neighbours
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: argue with your neighbours
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: look after your neighbour's children
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
Do you: keep to yourself
1
No, never
2
Rarely
3
Sometimes
4
Often
5
Always
What do you think of your neighbourhood as a place to live?
1
a very good place to live
2
a fairly good place to live
3
not a very good place to live
4
not at all a good place to live
How heavy is the traffic on the street where you live?
1
very heavy
2
quite heavy
3
not very heavy
4
hardly any traffic

To heat your home in winter what methods do you mainly use?

central heating or storage heaters wood stoves or wood fires coal fires paraffin heaters gas fires (mains gas) gas fires (bottled gas) other type of heating (please tick describe) other type of heating (please tick describe) no heating in this room

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

OtherOther

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

Other

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

1 - Yes

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1 - Yes

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1 - Yes

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1 - Yes

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1 - Yes

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1 - Yes

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In main living room
In study child's bedroom
In other rooms
If your home is centrally heated in winter, please describe:
7
no central heating
If your home is centrally heated in winter, please describe: type:
1
solid fuel
2
oil
3
gas
4
electricity
5
other (please tick describe)
Other
How is heating distributed?
1
Radiators
2
warm air
3
storage heaters
4
under floor heating
5
other please describe
Other
Where is the boiler?
1
kitchen
2
living room
3
no boiler
4
other (please tick describe)
Other
Do you use gas for cooking?
1
Yes, ring(s) only
2
yes, oven only
3
yes, rings and oven
4
no, not at all
Do you use the cooker (whether gas or electric) for any other purpose than cooking (e.g. drying clothes, heating the room)?
1
Yes
2
No
7
Don't have a cooker
please describe:
Generic text
How old is your cooker?
1
more than 20 years
2
10-19 years old
3
5-9 years old
4
2-4 years old
5
less than 2 years old
6
don't know
When you first got your present cooker - was it:
1
brand new
2
second hand
When someone is cooking, how often do they get rid of the smells and steam in the kitchen using the following:
7
Never cook

When someone is cooking, how often do they get rid of the smells and steam in the kitchen using the following:

-

1 - Usually

2 - Sometimes

3 - Not at all

open windows
ventaxia/air extractor
extractor hood which vents to outside
extractor hood that doesn't vent to outside
When someone is cooking, how often do they get rid of the smells and steam in the kitchen using the following: other (please tick and describe)
1
Usually
2
Sometimes
3
Not at all
Other
How often do you have any windows open in your home: In summer: day
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
How often do you have any windows open in your home: In summer: night
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
How often do you have any windows open in your home: In winter: day
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
How often do you have any windows open in your home: In winter: night
1
Windows almost always open
2
Windows open only when weather is good
3
Windows open occasionally
4
Windows almost never open
Are any of your windows double glazed? (including secondary double glazing)
1
yes, all of them
2
yes, some of them
3
no, none of them
9
don't know
Does your home have chimneys?
1
Yes
2
No
have they been blocked up?
1
yes, all of them
2
yes, some of them
3
no
9
don't know
Do you use a thermometer or thermostat to help keep the temperature at the level you want in winter? In main living room:
1
thermostat on radiators
2
room thermostat
3
room thermometer
4
none of these
5
other (please describe)
Other
Do you use a thermometer or thermostat to help keep the temperature at the level you want in winter? In your study child's bedroom:
1
thermostat on radiators
2
room thermostat
3
room thermometer
4
none of these
5
other (please describe)
Other

What temperature do you try to maintain in winter? (If you don't try to maintain any particular temperature put 97)

day night
TemperatureTemperatureTemperatureTemperature TemperatureTemperatureTemperatureTemperature
in living rooms
in room where your study child sleeps

This question is about whether various appliances in your home were fitted by professionals or by you, your family or friends.

Fitted by professionals

1 - Yes

2 - No

3 - Don't know

7 - Don't have this

central heating boiler
gas fires
cooker
Do you have these appliances regularly serviced? central heating boiler
1
Regularly serviced
2
Serviced occasionally
3
Not serviced
7
Don't have this
Do you have these appliances regularly serviced? gas fires
1
Regularly serviced
2
Serviced occasionally
3
Not serviced
7
Don't have this
Do you have these appliances regularly serviced? cooker
1
Regularly serviced
2
Serviced occasionally
3
Not serviced
7
Don't have this
Do you have a tumble dryer?
1
yes, gas
2
yes, electric
3
no, don't have
How often do you drive a car, van or lorry ?
1
almost every day
2
2-5 times a week
3
once a week
4
rarely
5
never
What type of fuel is used?
1
diesel
2
lead free petrol
3
other petrol

SECTION C: YOUR HOUSEHOLD

How many people live in your household now? (including yourself) adults (over 18 years)
How many
How many people live in your household now? (including yourself) young adults (16-18 years)
How many
How many people live in your household now? (including yourself) children (less than 16 years)
How many
Please indicate who the adults over 18 are: yourself
1
Yes
Please indicate who the adults over 18 are: your husband/partner
1
Yes
Please indicate who the adults over 18 are: your parent(s)
1
Yes
Please indicate who the adults over 18 are: your husband's/partner's parent(s)
1
Yes
Please indicate who the adults over 18 are: other relation(s) of yourself
1
Yes
Please indicate who the adults over 18 are: other relation(s) of your husband/partner
1
Yes
Please indicate who the adults over 18 are: friend(s)
1
Yes
Please indicate who the adults over 18 are: lodger
1
Yes
Please indicate who the adults over 18 are: other (please tick and describe)
1
Yes
Other
Do you have a rule that smoking never happens in particular rooms?
1
no smoking in house at all
2
smoking only allowed in some rooms
3
smoking allowed anywhere
How many people living in your household (including yourself) are smokers?
How many
What is your present marital status?
1
never married
2
widowed
3
divorced
4
separated
5
married (once only)
6
married for second or third time
what was the date of the most recent marriage?
Generic date
Does the biological (natural) father of the 10 year old study child live with the study child?
1
No
2
Yes
If yes, go to C4c on page 23
How old was the child when the natural father stopped living with the child? ... months
Age in months
How often does the natural father see the study child?
1
not at all
2
less than once a month
3
about once a month
4
about once a fortnight
5
once or twice a week
6
nearly every day
7
child's father is dead
Does he help support the child financially?
1
yes, on a regular basis
2
yes, occasionally
3
no
Does the biological (natural) mother of the 10 year old study child live with the study child?
1
No
2
Yes
If yes, go to C5 on page 24
How old was the child when the natural mother stopped living with the child? ... months
Age in months
How often does the natural mother see the study child?
1
not at all
2
less than once a month
3
about once a month
4
about once a fortnight
5
once or twice a week
6
nearly every day
7
child's mother is dead
Does she help support the child financially ?
1
yes, on a regular basis
2
yes, occasionally
3
no
To make the questions less complicated, for the rest of this section, for partner we mean husband or partner.

Please indicate how many of the children living in your household have:

Number of children
How many
you and your partner as their natural parents
their natural mother present (but their natural father is not present)
the natural father present (but not their natural mother)
Please indicate how many of the children living in your household have: neither natural parent present (please describe whether you have adopted, fostered etc.) Number of children
How many
Generic text

Are there other children of yourself or your partner who visit (whether to play or to stay)?

- Number of children

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many

1 - No

2 - Yes

How many
Children of my partner but not me
Children of myself but not my partner
Children of me and my partner
Do any of the people living in your household, including yourself and your study child, have a chronic illness or disabling condition (for example asthma, arthritis, epilepsy, depression)
1
Yes
2
No
If no, go to C8 on page 25

please describe:

Nature of condition(s) Person(s) involved (state relationship to you - husband/ partner, child, mother, etc.)
Generic textGeneric textGeneric textGeneric text Generic textGeneric textGeneric textGeneric text
1
2
3
4
Do you have any pets in the household?
1
Yes
2
No
If no, go to C9 below
How many of the following pets do you have? Number cats
How many
How many of the following pets do you have? Number dogs
How many
How many of the following pets do you have? Number rabbits
How many
How many of the following pets do you have? Number rodents (mice, hamster, gerbil etc.)
How many
How many of the following pets do you have? Number birds (budgerigar, parrot, etc.)
How many
How many of the following pets do you have? Number fish
How many
How many of the following pets do you have? Number turtles/tortoises/terrapins
How many
How many of the following pets do you have? Number other pets (please say how many and describe)
How many
Other
The other children in the household:

How many brothers and sisters does your 10 year old study child have that live with you or visit at least 1 day a week? (include half-brothers and half sisters, step-brothers and stepsisters, fostered or adopted children.)

younger same age (e.g. twin of the study child) older
How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many How manyHow manyHow manyHow manyHow manyHow manyHow manyHow manyHow many
Brothers
Sisters

How would you describe the noise level in your home?

-

1 - Yes

2 - No

there is usually music or television on in our home
the noises from outside our home are disturbing (neighbours, traffic, factory)
it is often so noisy at home it is difficult to hold a conversation

SECTION D: PILLS AND POTIONS

Please indicate below if you have used any medicines (pills, syrups, inhalers, drops, sprays, suppositories, pessaries, ointments etc including homeopathic and herbal remedies) in the last 12 months.

Yes in past 12 months If yes, give name of substance 1 If yes, give name of substance 2 How often did you take/use this? 1 How often did you take/use this? 2
Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

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1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic textGeneric textGeneric text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Generic text

1 - Yes

Generic text

1 - Every day

2 - Most da