CDE Detailed Report

Disease: Myalgic Encephalomyelitis/Chronic Fatigue Syndrome
Sub-Domain: General Health History
CRF: Exposure History

Displaying 1 - 50 of 63
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (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
C58315 Chemical biological exposure reaction grade ChemBioExposurReactnGrade Grade of subject/participant's reaction to the chemical or biological substance selected in 'Chemical biological exposure substance type' Grade of subject/participant's reaction to the chemical or biological substance selected in 'Chemical biological exposure substance type' Reaction to exposure None, Unknown;Mild;Moderate;Severe None, Unknown;Mild;Moderate;Severe Alphanumeric

Please choose 'None, Unknown' if the participant does not know if there has been an exposure

Adult;Pediatric Exploratory 1.00 2018-02-07 12:06:23.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58273 Insect borne pathogen endemic area live within 300 meter indicator InsBrnPthEndArLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) Indicator of whether the subject/participant currently lives within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) Area where Lyme Disease, Zika virus or other insect borne pathogens are endemic: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:37:27.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58290 Residence heat fuel type ResidenceHeatFuelTyp Type of fuel used to heat the subject/participant's residence Type of fuel used to heat the subject/participant's residence What type of fuel is used for heating? Propane;Electricity;Wood;Oil;Natural gas Propane;Electricity;Wood;Oil;Natural gas Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:10:08.0 Exposure History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58247 Dump site live within 300 meter type DmpSitLivWin300MTyp Type of dump site that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of dump site that the subject/participant within 300 meters of which the subject/participant lives now or has lived Dump site (please specify type) Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:09:57.0 Exposure History General Health History Participant History and Family History 128

Free-Form Entry

C58304 Pesticide use residence indicator PestcidUseResdncInd Indicator of whether pesticides are used in the subject/participant's residence Indicator of whether pesticides are used in the subject/participant's residence Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets in your home/apartment/building? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:35:26.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58259 Nuclear power plant ever live within 300 meter year range NucPwrPlntEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a nuclear power plant Range of years during which the subject/participant lived within 300 meters of a nuclear power plant Nuclear power plant: Alphanumeric

If you ever lived nearby, please write the years:

Adult;Pediatric Exploratory 1.00 2018-02-07 10:24:41.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58274 Insect borne pathogen endemic area ever live within 300 meter year range InsBrnPthEndArEvLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) Range of years during which the subject/participant lived within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) Area where Lyme Disease, Zika virus or other insect borne pathogens are endemic Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:39:32.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58291 Residence test radon indicator ResidenceTestRadonInd Indicator of whether the subject/participant's residence has been tested for radon Indicator of whether the subject/participant's residence has been tested for radon Has your home or apartment building been tested for radon? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:13:19.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58248 Pesticide spray area live within 300 meter indicator PstcdSpryAreaLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Indicator of whether the subject/participant currently lives within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Areas sprayed with pesticides, e.g., farms, orchards, golf course: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:12:31.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58305 Pesticide residence type PesticideResidenceTyp Type(s) of pesticide(s) used in the subject/participant's residence Type(s) of pesticide(s) used in the subject/participant's residence Please specify type: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:36:46.0 Exposure History General Health History Participant History and Family History 128

Free-Form Entry

C58261 Electrical tower live within 300 meter indicator ElectrcTwrLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of an electrical tower Indicator of whether the subject/participant currently lives within 300 meters of an electrical tower Electricity towers: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:25:24.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C04814 Residence type ResdncTyp Type of residence where the participant/subject is currently living Type of residence where the participant/subject is currently living Is your residence: Apartment;House, detached;House, semi-detached;Mobile home Apartment;House, detached;House, semi-detached;Mobile home Alphanumeric Adult;Pediatric Exploratory 3.00 2013-07-20 10:21:25.65 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58276 Sun exposure excess protect self frequency category SunExpExcssPrtctSlfFrqCat Category for the frequency with which the subject/participant protects him/herself from excess sun exposure Category for the frequency with which the subject/participant protects him/herself from excess sun exposure Do you protect yourself from excess sun exposure? Rarely;Occasionally;Often;Always Rarely;Occasionally;Often;Always Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:42:07.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58292 Residence renovation indicator ResidenceRenovationInd Indicator of whether any renovation has been done to the subject/participant's residence Indicator of whether any renovation has been done to the subject/participant's residence Have any renovations been done? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:14:20.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58249 Pesticide spray area ever live within 300 meter year range PstcdSpryAreaEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Range of years during which the subject/participant lived within 300 meters of a pesticide spray area (e.g., farm, orchard, golf course) Areas sprayed with pesticides, e.g., farms, orchards, golf course: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:14:55.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58306 Pesticide residence use frequency text PestcidRsdncUsFrqTxt Text specifying the frequency with which pesticide is used in the subject/participant's residence Text specifying the frequency with which pesticide is used in the subject/participant's residence Please specify how often: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:37:54.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58263 Electrical tower ever live within 300 meter year range ElectrcTwrEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of an electrical tower Range of years during which the subject/participant lived within 300 meters of an electrical tower Electricity towers: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:26:45.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58277 Tanning bed use indicator TanningBedUseInd Indicator of whether the subject/participant uses tanning beds Indicator of whether the subject/participant uses tanning beds Do you use a tanning bed? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:45:16.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58219 Heavy traffic live within 300 meter indicator HvyTrfcLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of heavy traffic Indicator of whether the subject/participant currently lives within 300 meters of heavy traffic Heavy traffic: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-06 16:07:48.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58293 Residence renovation year number ResidenceRenovationYearNum Number of the year in which renovations were done to the subject/participant's residence Number of the year in which renovations were done to the subject/participant's residence If yes, specify when: Numeric Values Adult;Pediatric Exploratory 1.00 2018-02-07 11:21:36.0 Exposure History General Health History Participant History and Family History

Free-Form Entry

C58250 Pesticide spray area live within 300 meter type PstcdSpryAreaLvWin300MTyp Type of pesticide spray area (e.g., farm, orchard, golf course) that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of pesticide spray area (e.g., farm, orchard, golf course) that the subject/participant within 300 meters of which the subject/participant lives now or has lived Areas sprayed with pesticides, e.g., farms, orchards, golf course (please specify type): Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:16:27.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58307 Pesticide use pet indicator PesticideUsePetIndicator Indicator of whether pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) Indicator of whether pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets on your pets? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:39:27.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58264 Cell tower live within 300 meter indicator CellTwrLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a cell tower Indicator of whether the subject/participant currently lives within 300 meters of a cell tower Cellphone towers: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:27:35.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58279 Residence current occupy duration text RsdncCrrntOccpyDuratnTxt Text field for indicating the duration for which the subject/participant has occupied his/her current residence Text field for indicating the duration for which the subject/participant has occupied his/her current residence How long have you lived in your present residence? Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:49:00.0 Exposure History General Health History Participant History and Family History 16

Free-Form Entry

C58220 Heavy traffic ever live within 300 meter year range HvyTrfcEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of heavy traffic Range of years during which the subject/participant lived within 300 meters of heavy traffic Heavy traffic: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-06 16:10:03.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58294 Residence renovation text ResidenceRenovationTxt The free-text field for describing the renovations done to the subject/participant's residence The free-text field for describing the renovations done to the subject/participant's residence What was renovated: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:22:57.0 Exposure History General Health History Participant History and Family History 255

Free-Form Entry

C58252 Industrial plant live within 300 meter indicator IndustPlntLivWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of an industrial plant Indicator of whether the subject/participant currently lives within 300 meters of an industrial plant Industrial plant(s): No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:17:46.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58308 Pesticide pet type PesticidePetTyp The type of pesticide used on the subject/participant's pets (as sprays, collars, powders, etc.) The type of pesticide used on the subject/participant's pets (as sprays, collars, powders, etc.) Please specify type: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:41:02.0 Exposure History General Health History Participant History and Family History 128

Free-Form Entry

C58266 Cell tower ever live within 300 meter year range CellTwrEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a cell tower Range of years during which the subject/participant lived within 300 meters of a cell tower Cellphone towers: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:32:10.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58280 Residence current age value RsdncCrrntAgeVal Value for the age of the subject/participant's current residence Value for the age of the subject/participant's current residence How old is it? Numeric Values Adult;Pediatric Exploratory 1.00 2018-02-07 10:51:04.0 Exposure History General Health History Participant History and Family History

Free-Form Entry

Years
C58221 Heavy traffic live within 300 meter type HvyTrfcLvWin300MTyp Type of heavy traffic that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of heavy traffic that the subject/participant within 300 meters of which the subject/participant lives now or has lived Heavy traffic (please specify) Busy street;Highway Busy street;Highway Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-06 16:13:02.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58295 Residential vacuum equipment type ResidentialVacuumEquipTyp Type of vacuum equipment (if any) used in the subject/participant's residence Type of vacuum equipment (if any) used in the subject/participant's residence Do you use: Central vacuum;HEPA filter vacuum;Other, specify Central vacuum;HEPA filter vacuum;Other, specify Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:24:17.0 Exposure History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58253 Industrial plant ever live within 300 meter year range IndustPlntEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of an industrial plant Range of years during which the subject/participant lived within 300 meters of an industrial plant Industrial plant(s) Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:18:56.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58309 Pesticide pet use frequency text PestcidUsPetFrqTxt Text field for specifying the frequency with which pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) Text field for specifying the frequency with which pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) Please specify how often: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:42:06.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58267 Windmill live within 300 meter indicator WndmllLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a windmill Indicator of whether the subject/participant currently lives within 300 meters of a windmill Windmills No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:33:05.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58281 Apartment residence location ApartmentResidenceLoc Location of apartment residence in the building Location of apartment residence in the building If apartment: Above store;Basement Above store;Basement Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:58:10.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58242 Vehicle idle area live within 300 meter indicator VehIdlAreaLvWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a vehicle idling area Indicator of whether the subject/participant currently lives within 300 meters of a vehicle idling area Vehicle idling area: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 09:51:36.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58296 Residential vacuum equipment other text RsdntlVcuumEquipOthTxt The free-text field related to 'Residential vacuum equipment type' specifying other text The free-text field related to 'Residential vacuum equipment type' specifying other text Other, specify: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:27:12.0 Exposure History General Health History Participant History and Family History 64

Free-Form Entry

C58254 Industrial plant live within 300 meter type IndustPlntLivWin300MTyp Type of industrial plant that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of industrial plant that the subject/participant within 300 meters of which the subject/participant lives now or has lived Industrial plant(s) (please specify type): Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:19:49.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58310 Pesticide use lawn garden indicator PestcidUsLawnGardnInd Indicator of whether pesticide is used on the subject/particpant's lawn or garden Indicator of whether pesticide is used on the subject/particpant's lawn or garden Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets on your lawn or garden? No;Yes No;Yes Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:43:37.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58268 Windmill ever live within 300 meter year range WndmllEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a windmill Range of years during which the subject/participant lived within 300 meters of a windmill Windmills: Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 10:34:04.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58283 Apartment building floor count ApartmentBldgFloorCt Count of floors in the building containing the apartment residence Count of floors in the building containing the apartment residence # of floors Numeric Values Adult;Pediatric Exploratory 1.00 2018-02-07 11:00:59.0 Exposure History General Health History Participant History and Family History

Free-Form Entry

C58243 Vehicle idle area ever live within 300 meter year range VehIdlAreaEvrLvWin300MYrRng Range of years during which the subject/participant lived within 300 meters of a vehicle idling area Range of years during which the subject/participant lived within 300 meters of a vehicle idling area Vehicle idling area Alphanumeric

If you ever lived nearby, please write the years.

Adult;Pediatric Exploratory 1.00 2018-02-07 09:53:45.0 Exposure History General Health History Participant History and Family History 25

Free-Form Entry

C58298 Smoke permit domestic location SmokPermtDomestcLoc Location(s) in which smoking is permitted in the subject/participant's domestic life Location(s) in which smoking is permitted in the subject/participant's domestic life Is smoking permitted: In your car;In your home In your car;In your home Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:29:05.0 Exposure History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58255 Polluted waterway live within 300 meter indicator PlltdWtrwyLivWin300MInd Indicator of whether the subject/participant currently lives within 300 meters of a polluted waterway Indicator of whether the subject/participant currently lives within 300 meters of a polluted waterway Polluted lake/stream: No;Yes No;Yes Alphanumeric

Do you presently live nearby? (within 300 m—about 3 midsized city blocks)

Adult;Pediatric Exploratory 1.00 2018-02-07 10:20:47.0 Exposure History General Health History Participant History and Family History

Single Pre-Defined Value Selected

C58311 Pesticide lawn garden type PestcidLawnGardnTyp Type of pesticide(s) used on the subject/participant's lawn or garden Type of pesticide(s) used on the subject/participant's lawn or garden Please specify type: Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:44:32.0 Exposure History General Health History Participant History and Family History 128

Free-Form Entry

C58269 Windmill live within 300 meter type WndmllLvWin300MTyp Type of windmill that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type of windmill that the subject/participant within 300 meters of which the subject/participant lives now or has lived Windmills (please specify type): Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 10:34:47.0 Exposure History General Health History Participant History and Family History 32

Free-Form Entry

C58285 Apartment residence building floor number AptRsdncBldgFlrNum Number of the building floor on which the apartment residence is located Number of the building floor on which the apartment residence is located your floor: Numeric Values Adult;Pediatric Exploratory 1.00 2018-02-07 11:02:17.0 Exposure History General Health History Participant History and Family History

Free-Form Entry

C58244 Idling area live within 300 meter vehicle type IdlAreaLvWin300MVehTyp Type(s) of vehicle(s) that use(d) the idling area that the subject/participant within 300 meters of which the subject/participant lives now or has lived Type(s) of vehicle(s) that use(d) the idling area that the subject/participant within 300 meters of which the subject/participant lives now or has lived Vehicle idling area (please specify type) Bus/truck;Auto Bus/truck;Auto Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 09:55:07.0 Exposure History General Health History Participant History and Family History

Multiple Pre-Defined Values Selected

C58299 Smoker person domestic text SmokerPersonDomesticTxt Text identifying the person or people in the subject/participant's domestic life who smoke Text identifying the person or people in the subject/participant's domestic life who smoke Who smokes? Alphanumeric Adult;Pediatric Exploratory 1.00 2018-02-07 11:31:12.0 Exposure History General Health History Participant History and Family History 255

Free-Form Entry

CSV