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alspac_01_fas
FATHER AND SURROUNDINGS
This questionnaire is for the study child’s father or the person taking the role of father
All answers are confidential
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 - Once or twice 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

1
Every day
2
Most days
3
Once or twice 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 - Once or twice a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - Once or twice a week

4 - Less than once a week

5 - Not at all

gardening
hairdressing
farm work
hospital work
shift work
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)
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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.
In the past year have you done any of the following:
-

1 - Yes, in own home

2 - Yes, elsewhere

3 - Yes,both home and elsewhere

4 - No, not at all

sanded floors
stripped wallpaper
removed paint or vanish

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
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

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
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:
-

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: 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 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
Go to Section B on page 11
qc_A11_a == 5
Else

What type of fuel is used?

1
diesel
2
lead free petrol
3
other petrol
SECTION B: 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

1 - Yes

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

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2 - Most days

3 - Sometimes

4 - Once or twice

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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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

Headache or or migraine
Backache
Groin 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
Diabetes
Epilepsy
High blood pressure
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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)

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 no medicines, pills, drops or ointment

1
Yes
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 14.
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 the last 12 month

1 - Regularly

2 - Occasionally

3 - Not at all

1 - Regularly

2 - Occasionally

3 - Not at all

1 - Regularly

2 - Occasionally

3 - Not at all

1 - Regularly

2 - Occasionally

3 - Not at all

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
- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

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
- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

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
- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

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
- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1
2
3
Some of these questions may seem familiar
Please bear with us- but we need to ask them again
SECTION C: 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 C8 on page 22
qc_C1_a_i == 7
Else
Since the study child was 5 years old have you worked at all? (please tick all that apply).
-

1 - Yes

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 C1b or no, do not work now to question C1b
qc_C1_b_i == 3 || qc_C1_b_i == 4

when did you last stop?

Generic date
If do not work now go to C7 on page 22
qc_C1_b_ii == 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_C1_c_i == 2 || qc_C1_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

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 C6a Go to C7 on page 22
qc_C6_a == 7
Else
How do you usually travel to work? (Tick all that apply)
-

1 - Yes

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
AgeHours in weekGeneric textAgeGeneric textHours in weekHours in weekAgeAgeGeneric textHours in weekGeneric textHours in weekGeneric textHours in weekAgeAgeGeneric text AgeHours in weekGeneric textAgeGeneric textHours in weekHours in weekAgeAgeGeneric textHours in weekGeneric textHours in weekGeneric textHours in weekAgeAgeGeneric text AgeHours in weekGeneric textAgeGeneric textHours in weekHours in weekAgeAgeGeneric textHours in weekGeneric textHours in weekGeneric textHours in weekAgeAgeGeneric text
1
2
3
4
5
If you are working now please go to Question C9 on page 23
now go to C9 on page 23
If you are not working now:
qc_C1_a_ii == 7 || qc_C1_b_ii == 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 C9 on page 23
If no,
qc_C8 == 1

Have you been looking for work?

1
Yes
2
No
If no, go to C8c on page 23
If yes
qc_C8_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

1 - Yes

do not want to work
looking after family
retired
not well enough

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

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

1 - Yes

2 - No

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

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?
THANK YOU VERY MUCH FOR YOUR HELP
SECTION D:

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

1
Yes

This questionnaire was completed by: (Please tick all that apply) mother's husband/male partner

1
Yes

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

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

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_fas

FATHER AND SURROUNDINGS
This questionnaire is for the study child’s father or the person taking the role of father
All answers are confidential
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 - Once or twice 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
1
Every day
2
Most days
3
Once or twice 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 - Once or twice a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - Once or twice a week

4 - Less than once a week

5 - Not at all

gardening
hairdressing
farm work
hospital work
shift work

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.

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

-

1 - Yes, in own home

2 - Yes, elsewhere

3 - Yes,both home and elsewhere

4 - No, not at all

sanded floors
stripped wallpaper
removed paint or vanish
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

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
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

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:

-

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: 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 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 B: 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

1 - Yes

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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 textGeneric 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

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 textGeneric text

1 - Yes

Generic textGeneric text

1 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

1 - Every day

2 - Most days

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Headache or or migraine
Backache
Groin 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
Diabetes
Epilepsy
High blood pressure

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 - Yes

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1 - Every day

2 - Most days

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4 - Once or twice

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1 - Yes

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2 - Most days

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4 - Once or twice

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2 - Most days

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4 - Once or twice

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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 - 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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - 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 - Yes

Generic text

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 - Every day

2 - Most days

3 - Sometimes

4 - Once or twice

Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)
Other condition (please tick & describe)
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 no medicines, pills, drops or ointment
1
Yes
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 14.

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 the last 12 month

1 - Regularly

2 - Occasionally

3 - Not at all

1 - Regularly

2 - Occasionally

3 - Not at all

1 - Regularly

2 - Occasionally

3 - Not at all

1 - Regularly

2 - Occasionally

3 - Not at all

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

- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

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

- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

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

- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

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

- -
Generic textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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 textGeneric text

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1 - Every day

2 - Most days

3 - About 1-2 times a week

4 - Less than once a week

5 - Not at all

Generic textGeneric 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

1
2
3
Some of these questions may seem familiar
Please bear with us- but we need to ask them again

SECTION C: 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

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

-

1 - Yes

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
when did you last stop?
Generic date
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
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

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

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

-

1 - Yes

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
AgeHours in weekGeneric textAgeGeneric textHours in weekHours in weekAgeAgeGeneric textHours in weekGeneric textHours in weekGeneric textHours in weekAgeAgeGeneric text AgeHours in weekGeneric textAgeGeneric textHours in weekHours in weekAgeAgeGeneric textHours in weekGeneric textHours in weekGeneric textHours in weekAgeAgeGeneric text AgeHours in weekGeneric textAgeGeneric textHours in weekHours in weekAgeAgeGeneric textHours in weekGeneric textHours in weekGeneric textHours in weekAgeAgeGeneric text
1
2
3
4
5
If you are working now please go to Question C9 on page 23
now go to C9 on page 23
Have you chosen not to work so that you can stay at home with your children?
1
No
2
Yes
If yes, go to C9 on page 23
Have you been looking for work?
1
Yes
2
No
If no, go to C8c on page 23
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

1 - Yes

do not want to work
looking after family
retired
not well enough
If you have not been looking for work, please give reasons (tick all that apply): other (please tick describe)
1
Yes

In the past 2 years have you taken any courses or educational training?

-

1 - Yes

2 - No

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

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?
THANK YOU VERY MUCH FOR YOUR HELP

SECTION D:

This questionnaire was completed by: (Please tick all that apply) child's biological father
1
Yes
This questionnaire was completed by: (Please tick all that apply) mother's husband/male partner
1
Yes
This questionnaire was completed by: (Please tick all that apply) mother's female partner
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
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
Name

Father and Surroundings