CDE Detailed Report
Disease: Huntington's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ) - Toxicants
Displaying 1 - 50 of 106
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ) - Toxicants
Displaying 1 - 50 of 106
| CDE ID | CDE Name | Variable Name | Definition | Short Description | Question Text | Permissible Values | Description | Data Type | Disease Specific Instructions | Disease Specific Reference | Population | Classification (e.g., Core) | Version Number | Version Date | CRF Name (CRF Module / Guideline) | Sub Domain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C08777 | Risk Factor Questionnaire (RFQ) - year not regularly weld braze or flame cut metals indicator | RFQYrNtRegWldBrzFlmCtMtlInd | Periods of a year or more when the participant did not regularly weld, braze, or flame cut metals as part of the Risk Factor Questionnaire for Toxicants | Periods of a year or more when the participant did not regularly weld, braze, or flame cut metals as part of the Risk Factor Questionnaire for Toxicants | Were there periods of a year or more when you did NOT regularly weld, braze, or flame cut metals? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q29 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08809 | Risk Factor Questionnaire (RFQ) - age stopped regularly working around metal dust or metal fumes period 1 value | RFQAgStpRgWrkArdMtlDstFmPr1Val | Age when the participant stopped regularly working around metal dust or metal fumes period 1 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly working around metal dust or metal fumes period 1 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08745 | Risk Factor Questionnaire (RFQ) - use other solvent-based adhesives indicator | RFQUseOthrSlvntBsdAdhesivesInd | Ever use other solvent-based adhesives as part of the Risk Factor Questionnaire for Toxicants | Ever use other solvent-based adhesives as part of the Risk Factor Questionnaire for Toxicants | Did or do you use other solvent-based adhesives? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q9 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08756 | Risk Factor Questionnaire (RFQ) - use methylene chloride indicator | RFQUseMethyleneChlorideInd | Ever use methylene chloride as part of the Risk Factor Questionnaire for Toxicants | Ever use methylene chloride as part of the Risk Factor Questionnaire for Toxicants | Did or do you use methylene chloride? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q14 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08788 | Risk Factor Questionnaire (RFQ) - ever weld cut braze brass or bronze indicator | RFQEvrWldCtBrzBrassBronzeInd | Has the participant ever weld, cut, braze brass or bronze as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever weld, cut, braze brass or bronze as part of the Risk Factor Questionnaire for Toxicants | Did or do you weld, cut, or braze brass or bronze? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q37 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10471 | Risk Factor Questionnaire (RFQ) - currently soldering indicator | RFQCrrntlySolderInd | Currently soldering as part of the Risk Factor Questionnaire for Toxicants | Currently soldering as part of the Risk Factor Questionnaire for Toxicants | If Yes, at what age or year did you stop soldering? | Current Solder selected/checked;"Current Solder" NOT selected/checked | Current Solder selected/checked;"Current Solder" NOT selected/checked | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17725 | Risk Factor Questionnaire (RFQ) - age started regularly soldering period 1 value | RFQAgStrtRgSolderingPr1Val | Age when the participant started regularly soldering period 1 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly soldering period 1 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08767 | Risk Factor Questionnaire (RFQ) - use toluol xylol xylene indicator | RFQUseToluolXylolXyleneInd | Ever use toluol/xylol/xylene as part of the Risk Factor Questionnaire for Toxicants | Ever use toluol/xylol/xylene as part of the Risk Factor Questionnaire for Toxicants | Did or do you use toluol/xylol/xylene? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q25 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08799 | Risk Factor Questionnaire (RFQ) - age stopped regularly soldering period 2 value | RFQAgStpRgSolderingPr2Val | Age when the participant stopped regularly soldering period 2 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly soldering period 2 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08735 | Risk Factor Questionnaire (RFQ) - stopped using adhesives value | RFQStpUseAdhesivesVal | Age/year the participant stopped using adhesives as part of the Risk Factor Questionnaire for Toxicants | Age/year the participant stopped using adhesives as part of the Risk Factor Questionnaire for Toxicants | If Yes, at what age or year did you stop using glues or adhesives? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C08778 | Risk Factor Questionnaire (RFQ) - age stopped regularly weld braze or flame cut metals period 1 value | RFQAgStpRgWldBrzFlmCtMtlPr1Val | Age when the participant stopped regularly weld, braze, or flame cut metals period 1 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly weld, braze, or flame cut metals period 1 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08812 | Risk Factor Questionnaire (RFQ) - metal dust or fume 1 worked around text | RFQMetalDustFume1WrkArndTxt | Text description of first metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants | Text description of first metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants | What specific types of metal dust or metal fumes did you work around? | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08746 | Risk Factor Questionnaire (RFQ) - use other solvent-based adhesives text | RFQUseOthrSlvntBsdAdhsvesTxt | Text description of which other solvent-based adhesives used as part of the Risk Factor Questionnaire for Toxicants | Text description of which other solvent-based adhesives used as part of the Risk Factor Questionnaire for Toxicants | If Yes, specify other solvent-based adhesives used | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08757 | Risk Factor Questionnaire (RFQ) - use trichloroethane indicator | RFQUseTrichloroethaneInd | Ever use trichloroethane as part of the Risk Factor Questionnaire for Toxicants | Ever use trichloroethylene or PERC (perchloroethylene) as part of the Risk Factor Questionnaire for Toxicants | Did or do you use trichloroethane? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q15 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08789 | Risk Factor Questionnaire (RFQ) - ever weld cut braze cast iron indicator | RFQEvrWldCtBrzCastIronInd | Has the participant ever weld, cut, braze cast iron as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever weld, cut, braze cast iron as part of the Risk Factor Questionnaire for Toxicants | Did or do you weld, cut, or braze cast iron? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q38 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C10472 | Risk Factor Questionnaire (RFQ) - currently working around metal dust fumes indicator | RFQCrrntlyWrkgArndMtlDstFmInd | Currently working around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants | Currently working around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants | If Yes, at what age or year did you stop working around metal dust or metal fumes? | Currently work around metal dust or metal fumes checked/selected;"Currently work around metal dust or metal fumes" NOT checked/selected | Currently work around metal dust or metal fumes checked/selected;"Currently work around metal dust or metal fumes" NOT checked/selected | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17726 | Risk Factor Questionnaire (RFQ) - age started regularly soldering period 2 value | RFQAgStrtRgSolderingPr2Val | Age when the participant started regularly soldering period 2 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly soldering period 2 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08768 | Risk Factor Questionnaire (RFQ) - use turpentine indicator | RFQUseTurpentineInd | Ever use turpentine as part of the Risk Factor Questionnaire for Toxicants | Ever use turpentine as part of the Risk Factor Questionnaire for Toxicants | Did or do you use turpentine? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q26 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08800 | Risk Factor Questionnaire (RFQ) - age stopped regularly soldering period 3 value | RFQAgStpRgSolderingPr3Val | Age when the participant stopped regularly soldering period 3 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly soldering period 3 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08736 | Risk Factor Questionnaire (RFQ) - year not regularly using adhesives indicator | RFQYrNtRegUseAdhesivesInd | Periods of a year or more when the participant did not regularly use adhesives as part of the Risk Factor Questionnaire for Toxicants | Periods of a year or more when the participant did not regularly use adhesives as part of the Risk Factor Questionnaire for Toxicants | Were there periods of a year or more when you did NOT regularly use glues or adhesives? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Question 3 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08747 | Risk Factor Questionnaire (RFQ) - used solvents or degreasers 100 days indicator | RFQUsedSlvntsDgrsrs100DaysInd | Has the participant ever used solvents or degreasers for at least 100 days at work or home as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever used solvents or degreasers for at least 100 days at work or home as part of the Risk Factor Questionnaire for Toxicants | In your lifetime, have you used solvents or degreasers 100 or more days at work or at home? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Question 10 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08779 | Risk Factor Questionnaire (RFQ) - age stopped regularly weld braze or flame cut metals period 2 value | RFQAgStpRgWldBrzFlmCtMtlPr2Val | Age when the participant stopped regularly weld, braze, or flame cut metals period 2 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly weld, braze, or flame cut metals period 2 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08813 | Risk Factor Questionnaire (RFQ) - metal dust or fume 2 worked around text | RFQMetalDustFume2WrkArndTxt | Text description of second metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants | Text description of second metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants | What specific types of metal dust or metal fumes did you work around? | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08758 | Risk Factor Questionnaire (RFQ) - use trichloroethylene or PERC indicator | RFQUseTrichloroethylenePERCInd | Ever use trichloroethylene or PERC (perchloroethylene) as part of the Risk Factor Questionnaire for Toxicants | Ever use trichloroethane as part of the Risk Factor Questionnaire for Toxicants | Did or do you use trichloroethylene or PERC (perchloroethylene)? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q16 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08790 | Risk Factor Questionnaire (RFQ) - ever weld cut braze copper indicator | RFQEvrWldCtBrzCopperInd | Has the participant ever weld, cut, braze copper as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever weld, cut, braze copper as part of the Risk Factor Questionnaire for Toxicants | Did or do you weld, cut, or braze copper? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q39 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17716 | Risk Factor Questionnaire (RFQ) - age started regularly using adhesives period 1 value | RFQAgeStrtRegUseAdhesvePer1Val | Age when the participant started regularly using adhesives period 1 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly using adhesives period 1 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT use glues or adhesives? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C17727 | Risk Factor Questionnaire (RFQ) - age started regularly soldering period 3 value | RFQAgStrtRgSolderingPr3Val | Age when the participant started regularly soldering period 3 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly soldering period 3 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08769 | Risk Factor Questionnaire (RFQ) - use other solvent indicator | RFQUseOthrSolventInd | Ever use another solvent as part of the Risk Factor Questionnaire for Toxicants | Ever use another solvent as part of the Risk Factor Questionnaire for Toxicants | Did or do you use another solvent? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Question 27 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08801 | Risk Factor Questionnaire (RFQ) - ever used tin-lead indicator | RFQEvrUseTinLeadInd | Has the participant ever used tin-lead as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever used tin-lead as part of the Risk Factor Questionnaire for Toxicants | Did or do you use tin-lead? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q44 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08737 | Risk Factor Questionnaire (RFQ) - age stopped regularly using adhesives period 1 value | RFQPer1AgeStpRegUseAdhesiveVal | Age when the participant stopped regularly using adhesives period 1 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly using adhesives period 1 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT use glues or adhesives? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08748 | Risk Factor Questionnaire (RFQ) - started using solvents or degreasers value | RFQStrtUseSlvntsDgrsrsVal | Age/year the participant started using solvents or degreasers as part of the Risk Factor Questionnaire for Toxicants | Age/year the participant started using solvents or degreasers as part of the Risk Factor Questionnaire for Toxicants | If Yes, at what age or year did you first use solvents or degreasers? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C08780 | Risk Factor Questionnaire (RFQ) - age stopped regularly weld braze or flame cut metals period 3 value | RFQAgStpRgWldBrzFlmCtMtlPr3Val | Age when the participant stopped regularly weld, braze, or flame cut metals period 3 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly weld, braze, or flame cut metals period 3 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08814 | Risk Factor Questionnaire (RFQ) - metal dust or fume 3 worked around text | RFQMetalDustFume3WrkArndTxt | Text description of third metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants | Text description of third metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants | What specific types of metal dust or metal fumes did you work around? | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08759 | Risk Factor Questionnaire (RFQ) - use acids alkalis or alcohols indicator | RFQUseAcidsAlkalisAlcInd | Ever use acids, alkalis or alcohols as part of the Risk Factor Questionnaire for Toxicants | Ever use acids, alkalis or alcohols as part of the Risk Factor Questionnaire for Toxicants | Did or do you use acids, alkalis or alcohols? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q17 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08791 | Risk Factor Questionnaire (RFQ) - ever weld cut braze aluminum indicator | RFQEvrWldCtBrzAluminumInd | Has the participant ever weld, cut, braze aluminum as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever weld, cut, braze aluminum as part of the Risk Factor Questionnaire for Toxicants | Did or do you weld, cut, or braze aluminum? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q40 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17717 | Risk Factor Questionnaire (RFQ) - age started regularly using adhesives period 2 value | RFQAgeStrtRegUseAdhesvePr2Val | Age when the participant started regularly using adhesives period 2 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly using adhesives period 2 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT use glues or adhesives? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C17728 | Risk Factor Questionnaire (RFQ) - age started regularly working around metal dust or metal fumes period 1 value | RFQAgStrtRgWrkArdMtlDtFmPr1Val | Age when the participant started regularly working around metal dust or metal fumes period 1 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly working around metal dust or metal fumes period 1 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08770 | Risk Factor Questionnaire (RFQ) - use other solvent text | RFQUseOthrSolventTxt | Text description of which solvent was used as part of the Risk Factor Questionnaire for Toxicants | Text description of which solvent was used as part of the Risk Factor Questionnaire for Toxicants | If Yes, specify other solvent used | Alphanumeric |
No instructions available |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History | 255 |
Free-Form Entry |
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| C08802 | Risk Factor Questionnaire (RFQ) - ever used silver indicator | RFQEvrUseSilverInd | Has the participant ever used silver as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever used silver as part of the Risk Factor Questionnaire for Toxicants | Did or do you use silver? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q45 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08738 | Risk Factor Questionnaire (RFQ) - age stopped regularly using adhesives period 2 value | RFQPer2AgeStpRegUseAdhesiveVal | Age when the participant stopped regularly using adhesives period 2 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly using adhesives period 2 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT use glues or adhesives? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08749 | Risk Factor Questionnaire (RFQ) - stopped using solvents or degreasers value | RFQStpUseSlvntsDgrsrsVal | Age/year the participant stopped using solvents or degreasers as part of the Risk Factor Questionnaire for Toxicants | Age/year the participant stopped using solvents or degreasers as part of the Risk Factor Questionnaire for Toxicants | If Yes, at what age or year did you stop using solvents or degreasers? | Numeric Values |
Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
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| C08781 | Risk Factor Questionnaire (RFQ) - ever weld cut braze stainless steel indicator | RFQWldCtBrzStainlessSteelInd | Has the participant ever weld, cut, braze stainless steel as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever weld, cut, braze stainless steel as part of the Risk Factor Questionnaire for Toxicants | Did or do you weld, cut, or braze stainless steel? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q30 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08815 | Risk Factor Questionnaire (RFQ) - worked around other chemicals or fumes indicator | RFQWrkdArndOthrChmclsFumeInd | Has the participant ever worked around any other chemicals or fumes not discussed as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever worked around any other chemicals or fumes not discussed as part of the Risk Factor Questionnaire for Toxicants | In your lifetime, have you ever worked around any other chemicals or fumes that we haven't discussed? | No;Yes | No;Yes | Alphanumeric |
If 'No' end questionnaire |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08760 | Risk Factor Questionnaire (RFQ) - use avgas or jet fuel indicator | RFQUseAvgasJetFuelInd | Ever use Freon as part of the Risk Factor Questionnaire for Toxicants | Ever use Freon as part of the Risk Factor Questionnaire for Toxicants | Did or do you use avgas, jet fuel? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q18 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08792 | Risk Factor Questionnaire (RFQ) - ever weld cut braze another metal indicator | RFQEvrWldCtBrzOthrMetalInd | Has the participant ever weld, cut, braze another metal as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever weld, cut, braze another metal as part of the Risk Factor Questionnaire for Toxicants | Did or do you weld, cut, or braze another metal? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q41 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C17718 | Risk Factor Questionnaire (RFQ) - age started regularly using adhesives period 3 value | RFQAgeStrtRegUseAdhesvePr3Val | Age when the participant started regularly using adhesives period 3 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant started regularly using adhesives period 3 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT use glues or adhesives? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C17729 | Risk Factor Questionnaire (RFQ) - age stopped regularly working around metal dust or metal fumes period 2 value | RFQAgStpRgWrkArdMtlDstFmPr2Val | Age when the participant stopped regularly working around metal dust or metal fumes period 2 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly working around metal dust or metal fumes period 2 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT solder? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-08-30 17:06:52.8 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year | |||||||||
| C08771 | Risk Factor Questionnaire (RFQ) - ever weld braze or flame cut metals 100 days indicator | RFQWldedBrzdFlmCtMtl100DaysInd | Has the participant ever welded, brazed, or flame cut metals at least 100 days at work or home as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever welded, brazed, or flame cut metals at least 100 days at work or home as part of the Risk Factor Questionnaire for Toxicants | In your lifetime, have you welded, brazed, or flame cut metals 100 or more days at work or at home? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Question 28 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08803 | Risk Factor Questionnaire (RFQ) - ever used another metal or alloy indicator | RFQEvrUseOthrMetalAlloyInd | Has the participant ever used another metal or alloy as part of the Risk Factor Questionnaire for Toxicants | Has the participant ever used another metal or alloy as part of the Risk Factor Questionnaire for Toxicants | Did or do you use another metal or alloy? | No;Yes | No;Yes | Alphanumeric |
If 'No' skip to Q46 |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C08739 | Risk Factor Questionnaire (RFQ) - age stopped regularly using adhesives period 3 value | RFQPer3AgeStpRegUseAdhesiveVal | Age when the participant stopped regularly using adhesives period 3 as part of the Risk Factor Questionnaire for Toxicants | Age when the participant stopped regularly using adhesives period 3 as part of the Risk Factor Questionnaire for Toxicants | If Yes, what ages were you when you did NOT use glues or adhesives? | Numeric Values |
Age should be answered in years Year should be answered in the 4-digit format |
Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. | Adult | Supplemental | 3.00 | 2013-07-18 09:11:50.26 | Risk Factor Questionnaire (RFQ) - Toxicants | Epidemiology/Environmental History | Participant History and Family History |
Free-Form Entry |
year |
