Community Noise and Health Study
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For Information onlyThis is an electronic survey example for information purposes only. This is not a working questionnaire.
Table of Contents
- Language of Preference (LP)
- Age without Date of Birth (ANDB)
- Sex (SEX)
- Marital Status Without Confirmation (De-facto) (MSNC)
- Aboriginal Minimum (AMB)
- Population group (PG)
- Education Highest Degree (EHG1)
- Specific health questions (SHQ)
- Chronic conditions (CCC)
- Height and weight - Self-reported (HWT)
- Smoking Status (SS)
- Alcohol use (ALC)
- Caffeine consumption (CAF)
- Quality of life (WHO)
- Perceived Stress Scale (PSS)
- Pittsburgh Sleep Quality (PSQ)
- Perception of outdoor noise sources (PNS)
- Housing Environmental Characteristics (HEC)
- Labour (LABR)
- Total Household Income (THI)
- Administration information (ADM)
- Possible future contact (PFC)
- Sleep Watch (SW)
- Blood Pressure Measurement (BPM)
- Hair Cortisol Sample (HCS)
- GPS (GPS)
Language of Preference (LP)
Language of Preference (LP) - Question identifier:LP_Q01
Would you prefer that I speak in English or in French?
- 1: English
- 2: French
- 3: Other
Age without Date of Birth (ANDB)
Age without Date of Birth (ANDB) - Question identifier:ANDB_Q01
What is [specific respondent]'s age?
- Minimum: 0
- Maximum: 121
Sex (SEX)
Sex (SEX) - Question identifier:SEX_Q01
INTERVIEWER: Enter [specific respondent]'s sex.
If necessary, ask: (Is [specific respondent] male or female?)
- 1: Male
- 2: Female
Marital Status Without Confirmation (De-facto) (MSNC)
Marital Status Without Confirmation (De-facto) (MSNC) - Question identifier:MSNC_Q01
What is your marital status?
Are you... ?
- 1: Married
- 2: Living common-law
- 3: Widowed
- 4: Separated
- 5: Divorced
- 6: Single, never married
- 98: Refusal
- 99: Don't know
Aboriginal Minimum (AMB)
Aboriginal Minimum (AMB) - Question identifier:AMB_Q01
Are you an Aboriginal person, that is, First Nations, Métis or Inuk (Inuit)? First Nations includes Status and Non-Status Indians.
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Aboriginal Minimum (AMB) - Question identifier:AMB_Q02
Are you First Nations, Métis or Inuk (Inuit)?
- 1: First Nations (North American Indian)
- 2: Métis
- 3: Inuk (Inuit)
- 98: Refusal
- 99: Don't know
Population group (PG)
Population group (PG) - Question identifier:PG_Q01
You may belong to one or more racial or cultural groups on the following list.
Are you... ?
- 01: White
- 02: South Asian (e.g., East Indian, Pakistani, Sri Lankan)
- 03: Chinese
- 04: Black
- 05: Filipino
- 06: Latin American
- 07: Arab
- 08: Southeast Asian (e.g., Vietnamese, Cambodian,
Malaysian, Laotian) - 09: West Asian (e.g., Iranian, Afghan)
- 10: Korean
- 11: Japanese
- 12: Other - Specify
- 98: Refusal
- 99: Don't know
Education Highest Degree (EHG1)
Education Highest Degree (EHG1) - Question identifier:EHG1_Q01
What is the highest certificate, diploma or degree that you have completed?
- 1: Less than high school diploma or its equivalent
- 2: High school diploma or a high school equivalency certificate
- 3: Trade certificate or diploma
- 4: College, CEGEP or other non-university certificate or diploma (other than trades certificates or diplomas)
- 5: University certificate or diploma below the bachelor's level
- 6: Bachelor's degree (e.g. B.A., B.Sc., LL.B.)
- 7: University certificate, diploma, degree above the bachelor's level
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ)
Specific health questions (SHQ) - Question identifier:SHQ_R01
This study has been developed to look at how community noise may affect the health of individuals. You will be asked a variety of general and specific questions about different areas of your life such as stress, sleep quality, living environment, physical and mental health.
Specific health questions (SHQ) - Question identifier:SHQ_Q01
Compared to one year ago, how would you say your health is now? Is it...?
- 1: Much better now than 1 year ago
- 2: Somewhat better now (than 1 year ago)
- 3: About the same as 1 year ago
- 4: Somewhat worse now (than 1 year ago)
- 5: Much worse now (than 1 year ago)
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q02
In general, how sensitive would you say you are to noise?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q20A
In the last 12 months, have you experienced frequent migraines or headaches (includes nausea, vomiting, sensitivity to light and sound)?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q20C
Have you consulted a health professional regarding this problem?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q70A
In the last 12 months, have you experienced dizziness?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q70C
Have you consulted a health professional regarding this problem?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q100A
In the last 12 months, have you experienced ringing, buzzing or whistling sounds in your ears for no reason?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Specific health questions (SHQ) - Question identifier:SHQ_Q100C
Have you consulted a health professional regarding this problem?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC)
Chronic conditions (CCC) - Question identifier:CCC_R011
Now I would like to ask about certain long-term health conditions which you may have. We are interested in "long-term conditions" which are expected to last or have already lasted 6 months or more and that have been diagnosed by a health professional.
Chronic conditions (CCC) - Question identifier:CCC_Q021
Do you suffer from chronic pain?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q031
Do you have asthma?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q051
Do you have arthritis?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q071
Do you have high blood pressure?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q072
In the past month, have you taken any medicine for high blood pressure?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q073
Is there a history of high blood pressure in your family?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q091
Do you have chronic bronchitis, emphysema or chronic obstructive pulmonary disease (COPD)?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q101
Remember, we're interested in conditions diagnosed by a health professional.
Do you have diabetes?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q121
Do you have heart disease?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q175
Have you ever been diagnosed with a sleep disorder including sleep apnea or insomnia?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Chronic conditions (CCC) - Question identifier:CCC_Q200
Do you have restless legs syndrome?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT)
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q1
It is important to know when analyzing health whether or not the person is pregnant. Are you pregnant?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q1A
In what week are you?
- Minimum: 1
- Maximum: 45
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q2
The next questions are about height and weight. How tall are you without shoes on?
- 0: Less than 1' / 12" (less than 29.2 cm.)
- 1: 1'0" to 1'11" / 12" to 23" (29.2 to 59.6 cm.)
- 2: 2'0" to 2'11" / 24" to 35" (59.7 to 90.1 cm.)
- 3: 3'0" to 3'11" / 36" to 47" (90.2 to 120.6 cm.)
- 4: 4'0" to 4'11" / 48" to 59" (120.7 to 151.0 cm.)
- 5: 5'0" to 5'11" (151.1 to 181.5 cm.)
- 6: 6'0" to 6'11" (181.6 to 212.0 cm.)
- 7: 7'0" and over (212.1 cm. and over)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2A
INTERVIEWER: Select the exact height.
- 00: 1'0" / 12" (29.2 to 31.7 cm.)
- 01: 1'1" / 13" (31.8 to 34.2 cm.)
- 02: 1'2" / 14" (34.3 to 36.7 cm.)
- 03: 1'3" / 15" (36.8 to 39.3 cm.)
- 04: 1'4" / 16" (39.4 to 41.8 cm.)
- 05: 1'5" / 17" (41.9 to 44.4 cm.)
- 06: 1'6" / 18" (44.5 to 46.9 cm.)
- 07: 1'7" / 19" (47.0 to 49.4 cm.)
- 08: 1'8" / 20" (49.5 to 52.0 cm.)
- 09: 1'9" / 21" (52.1 to 54.5 cm.)
- 10: 1'10" / 22" (54.6 to 57.1 cm.)
- 11: 1'11" / 23" (57.2 to 59.6 cm.)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2B
INTERVIEWER: Select the exact height.
- 00: 2'0" / 24" (59.7 to 62.1 cm.)
- 01: 2'1" / 25" (62.2 to 64.7 cm.)
- 02: 2'2" / 26" (64.8 to 67.2 cm.)
- 03: 2'3" / 27" (67.3 to 69.8 cm.)
- 04: 2'4" / 28" (69.9 to 72.3 cm.)
- 05: 2'5" / 29" (72.4 to 74.8 cm.)
- 06: 2'6" / 30" (74.9 to 77.4 cm.)
- 07: 2'7" / 31" (77.5 to 79.9 cm.)
- 08: 2'8" / 32" (80.0 to 82.5 cm.)
- 09: 2'9" / 33" (82.6 to 85.0 cm.)
- 10: 2'10" / 34" (85.1 to 87.5 cm.)
- 11: 2'11" / 35" (87.6 to 90.1 cm.)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2C
INTERVIEWER: Select the exact height.
- 00: 3'0" / 36" (90.2 to 92.6 cm.)
- 01: 3'1" / 37" (92.7 to 95.2 cm.)
- 02: 3'2" / 38" (95.3 to 97.7 cm.)
- 03: 3'3" / 39" (97.8 to 100.2 cm.)
- 04: 3'4" / 40" (100.3 to 102.8 cm.)
- 05: 3'5" / 41" (102.9 to 105.3 cm.)
- 06: 3'6" / 42" (105.4 to 107.9 cm.)
- 07: 3'7" / 43" (108.0 to 110.4 cm.)
- 08: 3'8" / 44" (110.5 to 112.9 cm.)
- 09: 3'9" / 45" (113.0 to 115.5 cm.)
- 10: 3'10" / 46" (115.6 to 118.0 cm.)
- 11: 3'11" / 47" (118.1 to 120.6 cm.)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2D
INTERVIEWER: Select the exact height.
- 00: 4'0" / 48" (120.7 to 123.1 cm.)
- 01: 4'1" / 49" (123.2 to 125.6 cm.)
- 02: 4'2" / 50" (125.7 to 128.2 cm.)
- 03: 4'3" / 51" (128.3 to 130.7 cm.)
- 04: 4'4" / 52" (130.8 to 133.3 cm.)
- 05: 4'5" / 53" (133.4 to 135.8 cm.)
- 06: 4'6" / 54" (135.9 to 138.3 cm.)
- 07: 4'7" / 55" (138.4 to 140.9 cm.)
- 08: 4'8" / 56" (141.0 to 143.4 cm.)
- 09: 4'9" / 57" (143.5 to 146.0 cm.)
- 10: 4'10" / 58" (146.1 to 148.5 cm.)
- 11: 4'11" / 59" (148.6 to 151.0 cm.)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2E
INTERVIEWER: Select the exact height.
- 00: 5'0" (151.1 to 153.6 cm.)
- 01: 5'1" (153.7 to 156.1 cm.)
- 02: 5'2" (156.2 to 158.7 cm.)
- 03: 5'3" (158.8 to 161.2 cm.)
- 04: 5'4" (161.3 to 163.7 cm.)
- 05: 5'5" (163.8 to 166.3 cm.)
- 06: 5'6" (166.4 to 168.8 cm.)
- 07: 5'7" (168.9 to 171.4 cm.)
- 08: 5'8" (171.5 to 173.9 cm.)
- 09: 5'9" (174.0 to 176.4 cm.)
- 10: 5'10" (176.5 to 179.0 cm.)
- 11: 5'11" (179.1 to 181.5 cm.)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N2F
INTERVIEWER: Select the exact height.
- 00: 6'0" (181.6 to 184.1 cm.)
- 01: 6'1" (184.2 to 186.6 cm.)
- 02: 6'2" (186.7 to 189.1 cm.)
- 03: 6'3" (189.2 to 191.7 cm.)
- 04: 6'4" (191.8 to 194.2 cm.)
- 05: 6'5" (194.3 to 196.8 cm.)
- 06: 6'6" (196.9 to 199.3 cm.)
- 07: 6'7" (199.4 to 201.8 cm.)
- 08: 6'8" (201.9 to 204.4 cm.)
- 09: 6'9" (204.5 to 206.9 cm.)
- 10: 6'10" (207.0 to 209.5 cm.)
- 11: 6'11" (209.6 to 212.0 cm.)
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q3
How much do you weigh?
- Minimum: 1
- Maximum: 575
- 98: Refusal
- 99: Don't know
Height and weight - Self-reported (HWT) - Question identifier:HWT_N4
INTERVIEWER: Was that in pounds or kilograms?
- 1: Pounds
- 2: Kilograms
Height and weight - Self-reported (HWT) - Question identifier:HWT_Q4
Do you consider yourself...?
- 1: Overweight
- 2: Underweight
- 3: Just about right
- 98: Refusal
- 99: Don't know
Smoking Status (SS)
Smoking Status (SS) - Question identifier:SS_R10
The next questions are about cigarette smoking. Include cigarettes that are bought ready-made as well as cigarettes that you make yourself.
Smoking Status (SS) - Question identifier:SS_Q10
At the present time, do you smoke cigarettes every day, occasionally or not at all?
- 1: Every day
- 2: Occasionally
- 3: Not at all
- 98: Refusal
- 99: Don't know
Smoking Status (SS) - Question identifier:SS_Q20
In the past 30 days, did you smoke any cigarettes?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Smoking Status (SS) - Question identifier:SS_Q30
During the past 30 days, did you smoke every day?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Smoking Status (SS) - Question identifier:SS_Q40
Have you smoked at least 100 cigarettes in your life?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Alcohol use (ALC)
Alcohol use (ALC) - Question identifier:ALC_R1
Now, some questions about your alcohol consumption.
When we use the word 'drink' it means:
- one bottle or can of beer or a glass of draft
- one glass of wine or a wine cooler
- one drink or cocktail with one and a half ounces of liquor
Alcohol use (ALC) - Question identifier:ALC_Q1
In the past 12 months, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Alcohol use (ALC) - Question identifier:ALC_Q2
In the past 12 months, how often did you drink alcoholic beverages?
- 1: Less than once a month
- 2: Once a month
- 3: 2 to 3 times a month
- 4: Once a week
- 5: 2 to 3 times a week
- 6: 4 to 6 times a week
- 7: Every day
- 98: Refusal
- 99: Don't know
Alcohol use (ALC) - Question identifier:ALC_Q3
How often in the past 12 months have you had 5 or more drinks on one occasion?
- 1: Never
- 2: Less than once a month
- 3: Once a month
- 4: 2 to 3 times a month
- 5: Once a week
- 6: More than once a week
- 98: Refusal
- 99: Don't know
Alcohol use (ALC) - Question identifier:ALC_Q4
In the past 7 days, have you had a drink of beer, wine, liquor or any other alcoholic beverage?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Caffeine consumption (CAF)
Caffeine consumption (CAF) - Question identifier:CAF_R1
Now, some questions about your caffeine consumption.
When we use the word 'caffeinated beverage' it means:
- one regular cup of caffeinated coffee
- one cup of caffeinated tea
- one caffeinated soft drink or energy drink
Caffeine consumption (CAF) - Question identifier:CAF_Q1
On an average day, how many caffeinated beverages do you consume?
- 1: None
- 2: 1 or 2
- 3: 3 or 4
- 4: 5 or more
- 98: Refusal
- 99: Don't know
Caffeine consumption (CAF) - Question identifier:CAF_Q2
During which period of the day do you consume the majority of your caffeinated beverages?
- 1: Between midnight and 8 am
- 2: Between 8 am and 4 pm
- 3: Between 4 pm and midnight
- 98: Refusal
- 99: Don't know
Quality of life (WHO)
Quality of life (WHO) - Question identifier:WHO_R01
The following questions ask how you feel about your quality of life, health, or other areas of your life in the past month. Please choose the answer that appears most appropriate. If you are unsure about which response to give to a question, the first response you think of is often the best one.
Quality of life (WHO) - Question identifier:WHO_Q01
In the past month, how would you rate your quality of life?
- 1: Very poor
- 2: Poor
- 3: Neither poor nor good
- 4: Good
- 5: Very good
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q02
(In the past month,) how satisfied were you with your health?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_R03
The following questions ask about how much you have experienced certain things in the last month.
Quality of life (WHO) - Question identifier:WHO_Q03
In the past month, to what extent did you feel that physical pain prevented you from doing what you needed to do?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q04
In the past month, how much did you need any medical treatment to function in your daily life?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q05
(In the past month,) how much did you enjoy life?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q06
(In the past month,) to what extent did you feel your life was meaningful?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q07
(In the past month,) how well were you able to concentrate?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q08
(In the past month,) how safe did you feel in your daily life?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q09
(In the past month,) how healthy was your physical environment?
- 1: Not at all
- 2: A little
- 3: A moderate amount
- 4: Very much
- 5: An extreme amount
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q10
In the past month, did you have enough energy for everyday life?
- 1: Not at all
- 2: A little
- 3: Moderately
- 4: Mostly
- 5: Completely
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q11
(In the past month,) were you able to accept your bodily appearance?
- 1: Not at all
- 2: A little
- 3: Moderately
- 4: Mostly
- 5: Completely
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q12
(In the past month,) did you have enough money to meet your needs?
- 1: Not at all
- 2: A little
- 3: Moderately
- 4: Mostly
- 5: Completely
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q13
(In the past month,) how available to you was the information that you needed in your day-to-day life?
- 1: Not at all
- 2: A little
- 3: Moderately
- 4: Mostly
- 5: Completely
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q14
(In the past month,) to what extent did you have the opportunity for leisure activities?
- 1: Not at all
- 2: A little
- 3: Moderately
- 4: Mostly
- 5: Completely
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q15
(In the past month,) how well were you able to get around?
- 1: Very poorly
- 2: Poorly
- 3: Neither poorly nor good
- 4: Good
- 5: Very good
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q16
In the past month, how satisfied were you with your sleep?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q17
(In the past month,) how satisfied were you with your ability to perform your daily living activities?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q18
(In the past month,) how satisfied were you with your capacity for work?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q19
(In the past month,) how satisfied were you with yourself?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q20
(In the past month,) how satisfied were you with your personal relationships?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q21
(In the past month,) how satisfied were you with your sex life?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q22
(In the past month,) how satisfied were you with the support you got from your friends?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q23
(In the past month,) how satisfied were you with the conditions of your living place?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q24
(In the past month,) how satisfied were you with your access to health services?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q25
(In the past month,) how satisfied were you with your transport?
- 1: Very dissatisfied
- 2: Dissatisfied
- 3: Neither satisfied nor dissatisfied
- 4: Satisfied
- 5: Very satisfied
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q26
(In the past month,) how often did you have negative feelings such as blue mood, despair, anxiety, depression?
- 1: Never
- 2: Seldom
- 3: Quite often
- 4: Very often
- 5: Always
- 98: Refusal
- 99: Don't know
Quality of life (WHO) - Question identifier:WHO_Q30
In the past month, did you take any medication for anxiety or depression?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS)
Perceived Stress Scale (PSS) - Question identifier:PSS_R01
The next set of questions is about your feelings and thoughts during the last month. For each question, you will be asked to indicate how often you felt or thought a certain way.
Perceived Stress Scale (PSS) - Question identifier:PSS_Q01
In the last month, how often have you been upset because of something that happened unexpectedly?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q02
(In the last month,) how often have you felt that you were unable to control the important things in your life?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q03
(In the last month,) how often have you felt nervous and stressed?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q04
(In the last month,) how often have you felt confident about your ability to handle your personal problems?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q05
(In the last month,) how often have you felt that things were going your way?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q06
In the last month, how often have you found that you could not cope with all the things that you had to do?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q07
(In the last month,) how often have you been able to control irritations in your life?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q08
(In the last month,) how often have you felt that you were on top of things?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q09
(In the last month,) how often have you been angered because of things that were outside of your control?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Perceived Stress Scale (PSS) - Question identifier:PSS_Q10
(In the last month,) how often have you felt difficulties were piling up so high that you could not overcome them?
- 1: Never
- 2: Almost never
- 3: Sometimes
- 4: Fairly often
- 5: Very often
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ)
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_R01
The next set of questions relate to your usual sleep habits during the past month only. Your answers should indicate the most accurate reply for the majority of days and nights in the past month.
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q01A
In the past month, what time have you usually gone to bed at night?
- Minimum: 1
- Maximum: 12
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_N01B
INTERVIEWER: Enter the minutes.
- Minimum: 0
- Maximum: 59
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_N01C
INTERVIEWER: Is it...?
- 1: AM
- 2: PM
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q02
(In the past month,) how long, in minutes, has it usually taken you to fall asleep each night?
- Minimum: 1
- Maximum: 180
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q03A
(In the past month,) what time have you usually gotten up in the morning?
- Minimum: 1
- Maximum: 12
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_N03B
INTERVIEWER: Enter the minutes.
- Minimum: 0
- Maximum: 59
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_N03C
INTERVIEWER: Is it...?
- 1: AM
- 2: PM
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q04
In the past month, how many hours of actual sleep did you get each night? This may be different than the number of hours you spent in bed.
- 1: Under 5 hours
- 2: 5 hours to less than 6 hours
- 3: 6 hours to less than 7 hours
- 4: 7 hours or more
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05A
In the past month, how often have you had trouble sleeping because you:
... cannot get to sleep within 30 minutes?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05B
(In the past month, how often have you had trouble sleeping because you:)
... wake up in the middle of the night or early morning?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05C
(In the past month, how often have you had trouble sleeping because you:)
... have to get up to use the bathroom?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05D
(In the past month, how often have you had trouble sleeping because you:)
... cannot breathe comfortably?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05E
In the past month, how often have you had trouble sleeping because you:
... cough or snore loudly?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05F
(In the past month, how often have you had trouble sleeping because you:)
... feel too cold?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05G
(In the past month, how often have you had trouble sleeping because you:)
... feel too hot?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05H
(In the past month, how often have you had trouble sleeping because you:)
... have bad dreams?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05I
(In the past month, how often have you had trouble sleeping because you:)
... have pain?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q05J
In the past month, how often have you had trouble sleeping for other reasons?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q06
In the past month, how often have you taken medicine to help you sleep (prescribed or "over the counter")?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q07
(In the past month,) how often have you had trouble staying awake while driving, eating meals, or engaging in social activity?
- 1: Not during the past month
- 2: Less than once a week
- 3: Once or twice a week
- 4: Three or more times a week
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q08
(In the past month,) how much of a problem has it been for you to keep up enough enthusiasm to get things done?
- 1: No problem at all
- 2: Only a very slight problem
- 3: Somewhat of a problem
- 4: A very big problem
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q09
In the past month, how would you rate your sleep quality overall?
- 1: Very good
- 2: Fairly good
- 3: Fairly bad
- 4: Very bad
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q11A
To what extent does your snoring or snoring from anyone else in your household disturb your sleep?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 6: N/A - lives alone
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_R13
The next question asks about sleeping problems in the past 12 months.
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q13
How much was your sleep disturbed in any way in the past 12 months when you are at home?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q14
What do you think is contributing to your sleep disturbance?
- 1: Wind turbines
- 2: Children
- 3: Pets
- 4: Neighbours
- 5: Other - Specify
- 98: Refusal
- 99: Don't know
Pittsburgh Sleep Quality (PSQ) - Question identifier:PSQ_Q15
Thinking of the past 12 months, which of the following would you say best describes your sleeping difficulties related to disruption from wind turbines. Do they... ?
- 1: Keep you from falling asleep at night
- 2: Wake you up during the night
- 3: Keep you from falling back to sleep after waking during the night
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS)
Perception of outdoor noise sources (PNS) - Question identifier:PNS_R01
Now I would like to ask you about different noises you may be hearing when you are at home. "At home" means inside your home or outdoors.
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q01
When at home, what are some of the different types of noise you hear coming from outside?
- 1: Road traffic
- 2: Aircraft
- 3: Railway/Trains
- 4: Wind turbines
- 5: Other
- 6: None
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q05A
Do you ever hear noise from road traffic when you are at home?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q05B
Do you ever hear noise from aircraft when you are at home?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q05C
Do you ever hear noise from railways or trains when you are at home?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q05D
Do you ever hear noise from wind turbines when you are at home?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q30A
Thinking about the last 12 months, when you are at home, how much does noise from road traffic bother, disturb or annoy you?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q30B
Thinking about the last 12 months, when you are at home, how much does noise from aircrafts bother, disturb or annoy you ?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q30C
Thinking about the last 12 months, when you are at home, how much does noise from railways or trains bother, disturb or annoy you ?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q100
How long have you been hearing noises coming from wind turbines?
- 1: Less than 1 month
- 2: 1 month to less than 6 months
- 3: 6 months to less than a year
- 4: 1 year to less than 2 years ago
- 5: More than 2 years
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q102
How would you best describe the sound of wind turbines?
- 1: Swishing
- 2: Whistling
- 3: Rustling
- 4: Thumping or throbbing
- 5: Modulating
- 6: Other - Specify
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q105
Thinking about the last 12 months, when you are at home, how much does noise from wind turbines bother, disturb or annoy you?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q110
Thinking about the last 12 months, when you are at home, how much does noise from wind turbines bother, disturb or annoy you...?
when standing inside your home.
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q120
Thinking about the last 12 months, when you are at home, how much does noise from wind turbines bother, disturb or annoy you...?
when standing outside your home.
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q130
When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?
during the morning (6AM until 12 noon).
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q131
(When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?)
during the afternoon (12 noon until 6PM).
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q132
(When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?)
during the evening (6PM to 10PM).
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q133
(When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise..?)
during the night (10PM until 6AM).
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_R140
Next, we want to rate how annoying the wind turbine noise is at different times of the year.
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q140
When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?
during the spring.
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q141
(When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?)
during the fall.
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q142
(When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?)
during the summer.
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q143
(When you are at home, how bothered, disturbed or annoyed are you by the wind turbine noise...?)
during the winter.
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q170
Are there one or more wind turbines located on the property where you live?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q175
How many wind turbines are located on the property where you live?
- Minimum: 1
- Maximum: 10
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q180
Do you benefit in any way (rent, payments or other indirect benefits such as a hall or community center) for having wind turbines in your area?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q185
Does your community benefit in any way (rent, payments or other indirect benefits such as a hall or community center) for having wind turbines in your area?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q205
When you are at home, can you see any wind turbines from anywhere on your property?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q210
When you are at home, how much does the visual appearance of wind turbines bother, disturb or annoy you?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q220
Thinking about the last 12 months, when you are at home, how much do the blinking lights on the wind turbines bother, disturb or annoy you?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q225
Thinking about the last 12 months, when you are at home, how much do the shadows or flickers of light from the wind turbines bother, disturb or annoy you?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_R230
Now I would like to ask you a few questions about vibrations and rattling.
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q230
When wind turbines are operating, have you noticed any vibrations or rattling inside your home?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q240
How much do vibrations or rattling bother, disturb or annoy you?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q250
Has anyone in your household ever lodged a formal complaint (including signing a petition) regarding noise from wind turbines?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q255
How many formal complaints in total has your household lodged?
- Minimum: 1
- Maximum: 100
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q256
To whom were these formal complaints lodged?
- 1: Municipal authorities
- 2: Provincial government
- 3: Federal government
- 4: Wind turbine operator
- 5: Other
- 98: Refusal
- 99: Don't know
Perception of outdoor noise sources (PNS) - Question identifier:PNS_Q260
How concerned are you for your physical safety due to the presence of wind turbines in your area?
- 1: Not at all
- 2: Slightly
- 3: Moderately
- 4: Very
- 5: Extremely
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC)
Housing Environmental Characteristics (HEC) - Question identifier:HEC_R01
The next set of questions is about the dwelling in which you currently reside.
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q01A
What type of dwelling do you live in? Is it a...?
- 1: Single-detached house
- 2: Semi-detached house
- 3: Row house
- 4: Duplex
- 5: Apartment in a building that has five or more storeys
- 6: Apartment in a building that has fewer than five storeys
- 7: Mobile home
- 8: Other
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q01B
Which of the following best describes the exterior of your dwelling?
- 1: Fully bricked
- 2: Partially bricked
- 3: No brick
- 4: Other
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q02
How long have you lived in your current dwelling?
- Minimum: 1
- Maximum: 95
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_N2
INTERVIEWER: Ask if necessary: (Is this in months or years?)
- 1: Months
- 2: Years
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q03
Is this dwelling... ?
- 1: Owned by you or a member of this household, even if it is still being paid for
- 2: Rented, even if no cash rent is paid
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_R04
The next set of questions is about your bedroom or the room you typically sleep in.
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q04
On which floor is your bedroom (or the room you typically sleep in) located?
- 1: Basement
- 2: First floor
- 3: Second floor
- 4: Third floor or higher
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q05
Is your bedroom (or the room you typically sleep in) located on the quietest side of your dwelling?
- 1: Yes
- 2: No
- 3: Our dwelling does not have a quiet side
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_R06
We are interested in finding out how noise may be affecting sleep. As room size can affect how noise travels, I would like to ask you a few questions on the size of your typical sleeping area.
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q07
What is the approximate length of your bedroom (or your typical sleeping area)?
- Minimum: 1
- Maximum: 65
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_N7
INTERVIEWER: Ask if necessary: (Is this in meters or feet?)
- 1: Meters
- 2: Feet
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q08
What is the approximate width of your bedroom (or the room you typically sleep in)?
- Minimum: 1
- Maximum: 65
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q09
What is the approximate height of your bedroom (or the room you typically sleep in)?
- Minimum: 1
- Maximum: 65
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q10
Do you ever need to close your bedroom windows completely because outside noise is disturbing your sleep?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q15
Which noise sources have led you to close your bedroom windows to reduce the noise levels?
- 1: Road traffic
- 2: Aircraft
- 3: Railway/Trains
- 4: Wind turbines
- 5: Other
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q20
Have you found that closing your windows improves your sleep quality?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q30
What type of windows do you have in your bedroom?
- 1: Single pane
- 2: Double pane
- 3: Triple pane
- 4: Other
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q40
Does your dwelling have an air conditioner?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q45
Is it...?
- 1: A central air system
- 2: A stand-alone unit in a window or elsewhere
- 3: Other
- 98: Refusal
- 99: Don't know
Housing Environmental Characteristics (HEC) - Question identifier:HEC_Q50
Is the stand-alone unit located in your bedroom?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Labour (LABR)
Labour (LABR) - Question identifier:LABR_R01
The next section contains questions about jobs or employment which you have had in the past 30 days. Please include such employment as part-time jobs, contract work, babysitting and any other paid work.
Labour (LABR) - Question identifier:LABR_Q01
In the past 30 days, did you work at a job or business (regardless of the number of hours)?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Labour (LABR) - Question identifier:LABR_Q05
Which of the following best describes the hours you usually worked during those days?
- 1: A regular daytime schedule or shift
- 2: A regular evening shift
- 3: A regular night shift
- 4: A rotating shift
- 5: A split shift
- 6: On-call or casual
- 7: An irregular schedule
- 8: Other
- 98: Refusal
- 99: Don't know
Labour (LABR) - Question identifier:LABR_R07
The next question is about your current or most recent job.
Labour (LABR) - Question identifier:LABR_Q07
What is your work or occupation?
- 98: Refusal
- 99: Don't know
Total Household Income (THI)
Total Household Income (THI) - Question identifier:THI_Q01
Now a question about your total household income.
What is your best estimate of your total household income received by all household members, from all sources, before taxes and deductions, during the year ending December 31, 2012?
Income can come from various sources such as from work, investments, pensions or government. Examples include Employment Insurance, Social Assistance, Child Tax Benefit and other income such as child support, spousal support (alimony) and rental income.
- Minimum: -9000000
- Maximum: 90000000
- 98: Refusal
- 99: Don't know
Total Household Income (THI) - Question identifier:THI_Q02
Can you estimate in which of the following groups your household income falls? Was the total household income during the year ending December 31, 2012... ?
- 1: Less than $50,000, including income loss
- 2: $50,000 and more
- 98: Refusal
- 99: Don't know
Total Household Income (THI) - Question identifier:THI_Q03
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: Less than $5,000
- 2: $5,000 to less than $10,000
- 3: $10,000 to less than $15,000
- 4: $15,000 to less than $20,000
- 5: $20,000 to less than $30,000
- 6: $30,000 to less than $40,000
- 7: $40,000 to less than $50,000
- 98: Refusal
- 99: Don't know
Total Household Income (THI) - Question identifier:THI_Q04
Please stop me when I have read the category which applies to your household.
Was it... ?
- 1: $50,000 to less than $60,000
- 2: $60,000 to less than $70,000
- 3: $70,000 to less than $80,000
- 4: $80,000 to less than $90,000
- 5: $90,000 to less than $100,000
- 6: $100,000 to less than $150,000
- 7: $150,000 and over
- 98: Refusal
- 99: Don't know
Administration information (ADM)
Administration information (ADM) - Question identifier:ADM_R01
Before we finish, I would like to ask you a few other questions.
Statistics Canada will combine your responses collected during the interview and physical measurements, including the sleep log, with information from sound measurement data and your past and continuing use of health services such as visits to hospitals, clinics and doctor's offices. Statistics Canada may also combine the information you provide with other survey or administrative data sources.
Administration information (ADM) - Question identifier:ADM_Q01
This linked information will be kept confidential and used only for statistical purposes. Do we have your permission?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Administration information (ADM) - Question identifier:ADM_Q02
Having a provincial health number will assist us in linking to this other information.
Do you have a [province/territory] health number?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Administration information (ADM) - Question identifier:ADM_Q03
What is your health number?
- 98: Refusal
- 99: Don't know
Possible future contact (PFC)
Possible future contact (PFC) - Question identifier:PFC_R01
As part of this study, we may need to get in touch in the future.
Sleep Watch (SW)
Sleep Watch (SW) - Question identifier:SW_N01A
INTERVIEWER: From looking at the respondent, record if a wrist cannot be used for the sleep watch measurement, for example, due to an amputation or a cast.
- 1: One or both wrist(s) cannot be used
- 2: Both wrists can be used
Sleep Watch (SW) - Question identifier:SW_N01B
INTERVIEWER: Which wrist is affected?
- 1: Right
- 2: Left
- 3: Both
Sleep Watch (SW) - Question identifier:SW_N02
INTERVIEWER: Record whether a sleep watch is available and operational.
- 1: Yes
- 2: No
Sleep Watch (SW) - Question identifier:SW_R12
One of the ways noise can affect health is its effect on sleep. To measure your sleep, I would like you to wear a sleep watch for the next seven days. A sleep watch records your daily sleep patterns based on movement and lighting conditions.
Sleep Watch (SW) - Question identifier:SW_R14
The sleep watch is to be worn for the next seven days and mailed back after the seven day period. To ensure that accurate information is collected and that you are eligible for this measurement, I need to ask you a few questions.
Sleep Watch (SW) - Question identifier:SW_Q20
Over the next seven day period, how many nights do you anticipate sleeping at this address?
- 1: 0-2 nights
- 2: 3-7 nights
- 98: Refusal
- 99: Don't know
Sleep Watch (SW) - Question identifier:SW_Q24
Do you have limited mobility with either arm, for example, due to a physical disability, injury or illness?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Sleep Watch (SW) - Question identifier:SW_Q26
In which arm(s) do you have limited mobility?
- 1: Right
- 2: Left
- 3: Both
- 98: Refusal
- 99: Don't know
Sleep Watch (SW) - Question identifier:SW_Q27
What hand do you typically write with?
- 1: Right
- 2: Left
- 98: Refusal
- 99: Don't know
Sleep Watch (SW) - Question identifier:SW_R28
You will need to start wearing the sleep watch today and continue wearing it for the next seven days. Please wear the watch on the ^DT_HAND, with the 'face' of the watch on the top of your wrist. Try not to cover the watch with clothing, as it collects information on lighting conditions. It is very important that you press the event marker just before you fall asleep and when you wake up to start your day. For example, you would press the event marker after reading or watching television in bed. The watch is waterproof and should be worn at all times. Do not remove the watch when showering, swimming or taking a nap. Since we are interested in your normal sleeping behavior it is very important that you do not alter your typical sleep patterns.
Sleep Watch (SW) - Question identifier:SW_R29
To help interpret the data collected by the sleep watch, I would also like you to complete a sleep log for each night of the study. The sleep log contains only a couple of questions and will not take long to complete.
Sleep Watch (SW) - Question identifier:SW_R30
A full description of how the sleep watch works can be found on the information sheet inside the pre-paid envelope. Should you have any questions or concerns, you will find a toll-free number on this sheet.
Sleep Watch (SW) - Question identifier:SW_Q31
Do you agree to participate in this part of the study and wear a sleep watch for the next seven days?
- 1: Yes
- 2: No
Sleep Watch (SW) - Question identifier:SW_N32
INTERVIEWER: Record the reason why the respondent did not agree to wear a sleep watch.
- 1: Burden (hassle)
- 2: Invasive
- 3: Aesthetics (appearance)
- 4: Anticipating change in normal sleep patterns
- 5: Worried about losing or damaging the device
- 6: Other - Specify
- 99: Don't know
Blood Pressure Measurement (BPM)
Blood Pressure Measurement (BPM) - Question identifier:BPM_N010
INTERVIEWER: From looking at the respondent, record if an arm cannot be used for the blood pressure measurement, for example, due to cast, amputation or paralysis.
- 1: One or both arm(s) cannot be used
- 2: Both arms can be used
Blood Pressure Measurement (BPM) - Question identifier:BPM_N011
INTERVIEWER: Which arm is affected?
- 1: Right
- 2: Left
- 3: Both
Blood Pressure Measurement (BPM) - Question identifier:BPM_R017
A person's blood pressure is important in understanding their overall health. Because of this, I would like to measure your blood pressure using an automated blood pressure machine.
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q018
I will be able to provide you with the results of the measurements at the end of the interview today. Do I have your permission to measure your blood pressure?
- 1: Yes
- 2: No
Blood Pressure Measurement (BPM) - Question identifier:BPM_N019
INTERVIEWER: Is the respondent wearing loose-fitting, short-sleeved clothing?
- 1: Yes
- 2: No
Blood Pressure Measurement (BPM) - Question identifier:BPM_N020
INTERVIEWER: Is the current location of the interview acceptable for completing the blood pressure measurement (for example, a quiet room free of distraction, with a firm chair and table)?
- 1: Yes
- 2: No
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q021
In order to get an accurate blood pressure measurement, it would be best to complete the measurement in a quiet room, with a firm chair and a table for you to rest your arm on. Is there a more suitable room available?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q030
To ensure that the results are accurate, I need to make sure that your clothing does not interfere with the measurement. Could you please change into loose-fitting, short-sleeved clothing? Since the blood pressure measurements will take approximately 10 minutes, if you have to use the washroom, now would be a good time to do so.
- 1: Yes
- 2: No
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q040
To confirm that I am able to take the measurement safely, I will need to look at your arms and ask you a few questions.
- 1: Continue
- 98: Refusal
Blood Pressure Measurement (BPM) - Question identifier:BPM_N050
INTERVIEWER: From looking at the respondent's right and left arms, record if an arm cannot be used to measure the respondent's blood pressure, for example, due to edema, a severe skin condition, open wounds or dressings.
- 1: One or both arm(s) cannot be used
- 2: Both arms can be used
Blood Pressure Measurement (BPM) - Question identifier:BPM_N051
INTERVIEWER: Which arm is affected?
- 1: Right
- 2: Left
- 3: Both
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q070
Are there any reasons why you should not complete the blood pressure measurement, for example, due to the partial paralysis of an arm, an AV shunt (arteriovenous shunt) or a mastectomy?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q071
Which arm is affected?
- 1: Right
- 2: Left
- 3: Both
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q100A
Have you smoked cigarettes or used other tobacco or nicotine products during the past 2 hours?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q100B
Have you consumed any caffeinated products (e.g., coffee, pop, energy drinks, tea or chocolate) during the past 2 hours?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q100C
Have you consumed any alcohol during the past 2 hours?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q100D
Have you exercised today for at least ten minutes at a time (e.g., running, moderate or vigorous walking, swimming, weight training)?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q100E
How long has it been since you last exercised?
- 1: 1 to less than 30 minutes ago
- 2: 30 minutes to less than 1 hour ago
- 3: 1 hour to less than 2 hours ago
- 4: More than 2 hours ago
- 98: Refusal
- 99: Don't know
Blood Pressure Measurement (BPM) - Question identifier:BPM_R101
It will take approximately 10 minutes to set up the equipment and take the measurements. If you have to use the washroom, please do so before we begin.
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q102
I will start by placing a cuff on your arm. I will need you to sit up straight with your feet flat on the floor, your back against the back rest of the chair, and your [right/left] arm on the table.
- 1: Continue
- 98: Refusal
Blood Pressure Measurement (BPM) - Question identifier:BPM_Q103A
When I start the machine, the cuff will inflate automatically once every minute, applying pressure to your arm. A total of 6 measurements will be taken. You should not move or talk during the test, and you need to keep both feet flat on the floor. It is important that you stay relaxed to ensure we get accurate results.
- 1: Continue
- 2: Technical difficulty
- 3: Respondent refuses to continue
Blood Pressure Measurement (BPM) - Question identifier:BPM_N103B
INTERVIEWER: Press the <Start> button on the BpTRU.
- Write down the first result.
- 1: Continue
Blood Pressure Measurement (BPM) - Question identifier:BPM_R104
The measurements are now finished. I need to enter the results into the computer. This will only take a few minutes.
Hair Cortisol Sample (HCS)
Hair Cortisol Sample (HCS) - Question identifier:HCS_N10
INTERVIEWER: From looking at the respondent, are you able to collect a hair sample?
At the crown of their head, the respondent must have:
- At least 2cm of hair; and
- At least 100 strands of hair (approximately half the diameter of a pencil eraser), which can be collected from multiple locations on the back of the head, but each location should not be greater than the area of a dime.
- 1: Yes
- 2: No
- 3: Need to assess
Hair Cortisol Sample (HCS) - Question identifier:HCS_R15
Some studies have shown that people exposed to noise have higher levels of stress. Cortisol is a hormone that accumulates in hair. Studies have shown that a person's level of stress can be measured using the amount of cortisol in their hair.
Hair Cortisol Sample (HCS) - Question identifier:HCS_Q16
In order to measure the amount of cortisol in your hair, I will need to take a small hair sample from the back of your head.
- 1: Continue
- 98: Refusal
Hair Cortisol Sample (HCS) - Question identifier:HCS_Q17
For this study, cortisol cannot be measured from a wig, hairpiece or weave, for example.
Is the hair at the back of your head your own natural hair?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Hair Cortisol Sample (HCS) - Question identifier:HCS_Q20
To ensure that your hair is long and thick enough for me to take a sample, I would like to examine the hair at the back of your head.
This will require that I touch your head. Do I have your permission?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Hair Cortisol Sample (HCS) - Question identifier:HCS_N21
INTERVIEWER: Does the respondent have enough hair for you to take a hair sample?
- 1: Yes
- 2: No
Hair Cortisol Sample (HCS) - Question identifier:HCS_Q30
I will cut the hair sample close to the scalp using clean scissors.
Do I have permission to take a sample of your hair?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
Hair Cortisol Sample (HCS) - Question identifier:HCS_N35
INTERVIEWER: Record the reason why the respondent is not willing to provide a hair sample.
Mark all that apply.
- 1: Invasive
- 2: Aesthetics (appearance)
- 3: Cultural/Religious objections (e.g., turban, hijab, etc.)
- 4: Other - Specify
- 99: Don't know
Hair Cortisol Sample (HCS) - Question identifier:HCS_R40
It will just take me a minute to enter some information into my computer.
GPS (GPS)
GPS (GPS) - Question identifier:GPS_N01
INTERVIEWER: Do you have GPS coordinates to enter?
- 1: Yes
- 2: No
GPS (GPS) - Question identifier:GPS_N02
INTERVIEWER: Are you at the correct address?
- 1: Yes
- 2: No
- 98: Refusal
- 99: Don't know
GPS (GPS) - Question identifier:GPS_N03
INTERVIEWER: Where are you entering the GPS coordinates from?
- 1: Inside the dwelling
- 2: Immediately outside the dwelling
- 3: Street
- 4: Parking lot
- 5: Other - Specify
GPS (GPS) - Question identifier:GPS_N04
INTERVIEWER: Please enter the GPS coordinates for latitude to the fourth decimal place (e.g. 46.1225).
- Minimum: -999.9999
- Maximum: 999.9999
GPS (GPS) - Question identifier:GPS_N05
INTERVIEWER: Please re-enter the GPS coordinates for latitude to the fourth decimal place (e.g. 46.1225).
- Minimum: -999.9999
- Maximum: 999.9999
GPS (GPS) - Question identifier:GPS_N06
INTERVIEWER: Please enter the GPS coordinates for longitude to the fourth decimal place (e.g. -046.1256).
- Minimum: -999.9999
- Maximum: 999.9999
GPS (GPS) - Question identifier:GPS_N07
INTERVIEWER: Please re-enter the GPS coordinates for longitude to the fourth decimal place (e.g. -046.1256).
- Minimum: -999.9999
- Maximum: 999.9999
GPS (GPS) - Question identifier:GPS_N08
INTERVIEWER: Why could you not enter the GPS coordinates?
Mark all that apply.
- 1: Weather conditions
- 2: Equipment failure
- 3: Wrong address
- 4: Other - Specify
- 98: Refusal
- 99: Don't know
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