**[EDITORIAL NOTE]{.underline}: There are 31 job-associated modules. The
modules for chemical industry worker, engineer, and painter are given as
examples. The other job modules are available from P. Stewart.**

CHEMICAL INDUSTRY (CHI) JOB MODULE

**Lead-in.** I am going to ask about your work as (a/an) (JOB TITLE) at
(EMPLOYER) \[from (YEAR STARTED) to (YEAR STOPPED)/in (YEAR)\].

+-------------------+--------------------------+-----------------------+
| PRODUCT           | **Made.**                | > IF YES TO **Made**, |
|                   |                          | > ASK                 |
|                   | Did (EMPLOYER) make      | >                     |
|                   | (PRODUCT)?               |  **ProductSpecifics** |
|                   |                          | > (IF\*).             |
|                   |                          |                       |
|                   |                          | **ProductSpecifics.** |
+-------------------+--------------------------+-----------------------+
| **Paint.**        | > YES 1                  |                       |
|                   | >                        |                       |
| Paints            | > NO 2                   |                       |
+-------------------+--------------------------+-----------------------+
| **Pesticides.**   | > YES 1                  |                       |
|                   | >                        |                       |
| Pesticides        | > NO 2                   |                       |
+-------------------+--------------------------+-----------------------+
| **Drugs.**        | > YES 1                  |                       |
|                   | >                        |                       |
| Drugs or          | > NO 2                   |                       |
| pharmaceuticals   |                          |                       |
+-------------------+--------------------------+-----------------------+
| **Plastics.**     | > YES 1                  |                       |
|                   | >                        |                       |
| Plastics or       | > NO 2                   |                       |
| resins            |                          |                       |
+-------------------+--------------------------+-----------------------+
| **                | > YES 1                  |                       |
| OtherChemicals.** | >                        |                       |
|                   | > **ChemicalSpecify**    |                       |
| Other chemicals   | >                        |                       |
| (SPECIFY)         | > NO 2                   |                       |
+-------------------+--------------------------+-----------------------+

BOX CHI-1

IF **Made** ALL = NO, DK, OR REFUSED (RF), that is none of the answers
is one, END MODULE.

> IF \>1 \"YES\" IN **Made**, ASK **MakeProduct**. ASK **MakeProduct**
> SEPARATELY ABOUT EACH YES (1) IN **Made.**

IF EXACTLY ONE \"YES\" IN **Made**, GO TO **InOrOutdoors**.

**MakeProduct.** Were [you]{.underline} involved in making (PRODUCT FROM
**Made**)?

YES 1

NO 2

BOX CHI-2

IF **MakeProduct** ALL = NO, DK, OR RF (≠ 1), END MODULE.

**InOrOutdoors.** Was the part of the plant where you worked primarily
indoors, primarily outdoors, or did you work the same amount of time
both indoors and outdoors?

INDOORS 1

OUTDOORS 2

BOTH 3

**Job.** ASK JOB MINI-MODULE.

Now I'm going to ask you about specific activities you may have done
while working at this job.

+------------------------------+-------------------+------------------+
| ACTIVITY                     | > ASK **DidTask** | > IF YES TO      |
|                              | > FOR EACH        | > **DidTask**,   |
|                              | > ACTIVITY        | > ASK            |
|                              | > (**Ventilated   | > *              |
|                              | > Room** THROUGH  | *TaskSpecifics** |
|                              | >                 | > IF (\*).       |
|                              | **LoadOrUnload)** |                  |
|                              | > BEFORE GOING TO | **               |
|                              | > *               | TaskSpecifics.** |
|                              | *TaskSpecifics.** |                  |
|                              | >                 | You said that,   |
|                              | > **DidTask.**    | at this job, you |
|                              | >                 | had to           |
|                              | > Did you ever    | (ACTIVITY).      |
|                              | > (ACTIVITY)?     |                  |
+==============================+===================+==================+
| > ONLY ASK                   | > YES 1           | > \* ASK PERCENT |
| > **VentilatedRoom** THROUGH | >                 | > SUBROUTINE     |
| > **NonControlRoom** IF      | > NO 2            | > (ACTIVITY =    |
| > **TypeOfWork** = 03        |                   | > "doing this"). |
| > (PRODUCTION).              |                   |                  |
| >                            |                   |                  |
| > **VentilatedRoom.**        |                   |                  |
|                              |                   |                  |
| Work in a room where the air |                   |                  |
| was removed to outside the   |                   |                  |
| control room by a fan or     |                   |                  |
| exhaust system               |                   |                  |
+------------------------------+-------------------+------------------+
| **UnventilatedRoom**         | > YES 1           | > \* ASK PERCENT |
|                              | >                 | > SUBROUTINE     |
| Work in a control room where | > NO 2            | > (ACTIVITY =    |
| the inside air was not       |                   | > "doing this"). |
| removed from the control     |                   |                  |
| room                         |                   |                  |
+------------------------------+-------------------+------------------+
| **NonControl Room.**         | > YES 1           | > \* ASK PERCENT |
|                              | >                 | > SUBROUTINE     |
| Work in an area where the    | > NO 2            | > (ACTIVITY =    |
| (PRODUCTS FOR WHICH          |                   | > "doing this"). |
| **MakeProduct** = YES OR     |                   |                  |
| SINGLE PRODUCT IN **Made**)  |                   |                  |
| were being made              |                   |                  |
| [other]{.underline} than in  |                   |                  |
| a control room               |                   |                  |
+------------------------------+-------------------+------------------+
| > ONLY ASK **QualitySample** | > YES 1           | > \* ASK         |
| > IF **TypeOfWork** = 02,    | >                 | > NumTime2       |
| > 03, 05, OR 08 (QC,         | > NO 2            | > SUBROUTINE     |
| > PRODUCTION, ENGINEERING,   |                   | > (ACTIVITY =    |
| > OR RESEARCH)               |                   | > "taking a      |
| >                            |                   | > sample").      |
| > **QualitySample.**         |                   | >                |
|                              |                   | > \* IF          |
| Take a sample from the       |                   | > *              |
| process equipment for        |                   | *QualitySample** |
| quality control, quality     |                   | > \> PER DAY,    |
| assurance, QC, or QA         |                   | > ASK **TAKING   |
| purposes                     |                   | > SAMPLES        |
|                              |                   | > QUESTIONS.**   |
+------------------------------+-------------------+------------------+
| > ONLY ASK                   | > YES 1           | > \* ASK         |
| > **CleanEquipment** IF      | >                 | > Timespent1     |
| > **TypeOfWork** = 01 OR 03  | > NO 2            | > SUBROUTINE     |
| > (MAINTENANCE OR            |                   | > (ACTIVITY =    |
| > PRODUCTION).               |                   | > "did you clean |
| >                            |                   | > equipment").   |
| > **CleanEquipment.**        |                   | >                |
|                              |                   | > \* IF          |
| Clean reactors, kettles,     |                   | > **             |
| filters, molding machines,   |                   | CleanEquipment** |
| or other equipment used to   |                   | > \> 1 HR/WK,    |
| make the (PRODUCTS FOR WHICH |                   | > ASK **CLEAN    |
| **MakeProduct** = YES OR     |                   | > EQUIPMENT      |
| SINGLE PRODUCT IN **Made**)  |                   | > QUESTIONS.**   |
+------------------------------+-------------------+------------------+
| > ONLY ASK **PackMaterials** | > YES 1           | > \* ASK         |
| > IF **TypeOfWork** = 01 OR  | >                 | > Timespent1     |
| > 07 (MAINTENANCE OR         | > NO 2            | > SUBROUTINE     |
| > SHIPPING).                 |                   | > (ACTIVITY =    |
| >                            |                   | > "did you do    |
| > **PackMaterials.**         |                   | > this").        |
| >                            |                   | >                |
| > Pack or package materials  |                   | > \* IF          |
|                              |                   | > *              |
|                              |                   | *PackMaterials** |
|                              |                   | > \> 1 HR/WK,    |
|                              |                   | > ASK **PACKING  |
|                              |                   | > MATERIALS      |
|                              |                   | > QUESTIONS.**   |
+------------------------------+-------------------+------------------+

+------------------------------+-------------------+------------------+
| > ONLY ASK **LoadOrUnload**  | > YES 1           | > \* ASK         |
| > IF **TypeOfWork** = 03,    | >                 | > NumTimes2      |
| > 04, OR 07 (PRODUCTION,     | > NO 2            | > SUBROUTINE     |
| > UTILITIES, OR SHIPPING).   |                   | > (ACTIVITY =    |
| >                            |                   | > "did you load  |
| > **LoadOrUnload.**          |                   | > or unload      |
| >                            |                   | >                |
| > Unload from or load into   |                   | > chemicals").   |
| > tank trucks, tank cars, or |                   | >                |
| > rail cars the (PRODUCTS    |                   | > \* ASK         |
| > FOR WHICH **MakeProduct**  |                   | > **LOADING/     |
| > = YES OR SINGLE PRODUCT IN |                   | > UNLOADING      |
| > **Made**)                  |                   | > QUESTIONS.**   |
+------------------------------+-------------------+------------------+

BOX CHI-3

ASK **ChemicalsInArea** THROUGH **OtherChemicalsAdded** IF
**TypeOfWork** = 03 (PRODUCTION.)

**ChemicalsInArea.** What specific chemicals were being made in the area
where you worked?

**Ran.** Did you run:

[YES]{.underline} [NO]{.underline}

**Reactor.** Reactors? 1 2

**Kettle.** Kettles? 1 2

**Distillation Tower.** Distillation towers? 1 2

**Quencher.** Quenchers? 1 2

**OtherEquipment.** Some other equipment? (SPECIFY) 1 2

**EquipmentSpecify**

BOX CHI-4

> IF **Ran (Reactor** THROUGH **OtherEquipment)** ALL = NO, DK, OR RF,
> ASK **InArea**. OTHERWISE, GO TO **OpenOrClosed.**

**InArea.** Were any of the following types of equipment in the area
where you worked:

[YES]{.underline} [NO]{.underline}

**Reactor.** Reactors? 1 2

**Kettle.** Kettles? 1 2

**Distillation Tower.** Distillation towers? 1 2

**Quencher.** Quenchers? 1 2

**OtherEquipment.** Some other equipment? (SPECIFY) 1 2

**EquipmentSpecify**

BOX CHI-5

IF **InArea (Reactor** THROUGH **OtherEquipment)** ALL = NO, GO TO
**AddChemicals.**

**OpenOrClosed.** Which best describes the equipment where you worked:
closed or open? "Closed" means that the equipment had covers on them and
pipes were used to transport most of the material from any piece of
equipment to another. "Open" means there were no covers on the
equipment, and pipes were not used to transport most of the material.

CLOSED 1

OPEN 2

BOTH 3

NEITHER (SPECIFY) 4

**OpenOrClosedSpec**

**AddChemicals.** Did you add chemicals into the equipment, either
manually or automatically?

YES 1

NO 2 (END MODULE)

**ChemicalsAdded.** What chemicals were these?

**OtherChemicalsAdded.** What other chemicals, if any, were added by
other workers, using either method?

\[INTERVIEWER: ENTER \"NONE\" IF NO OTHER CHEMICALS WERE ADDED.}

**Protective.** ASK PROTECTIVE MINI-MODULE (ACTIVITY = "chemicals were
added").

BOX CHI-6

ASK **ProtectedTasks** OR **DidProtectedTask** FOR TYPE OF EACH
PROTECTIVE EQUIPMENT SUBJECT REPORTED WEARING IN **RespiratorType.**

ONLY ASK **TakeSamples** IF **QualitySample** = 1 (YES).

ONLY ASK **CleanEquipment** IF **CleanEquipment** =1 (YES).

ONLY ASK **LoadOrUnload** IF **LoadOrUnload** = 1 (YES).

ONLY ASK **Pack** IF **PackMaterials** = 1 (YES).

ONLY ASK **OtherTask** IF AT LEAST ONE OTHER TYPE OF TASK WAS ASKED
ABOUT IN **ProtectedTasks.**

IF NO TYPE OF TASK WOULD BE ASKED ABOUT IN **ProtectedTasks**, DO NOT
ASK **ProtectedTasks** AND GO TO **DidProtectedTask**.

**ProtectedTasks.** What tasks did you do while you were wearing
(PROTECTIVE EQUIPMENT IN **RespiratorType**)? Did you wear it while you:

[YES]{.underline} [NO]{.underline}

**TakeSamples.** Took samples? 1 2

**CleanEquipment.** Cleaned equipment? 1 2

**LoadOrUnload.** Loaded or unloaded on top of a car or truck? 1 2

**Pack.** Packed? 1 2

**OtherTask.** Did anything else? (SPECIFY) 1 2

**TaskSpecify**

GO TO BOX CHI-7.

**DidProtectedTask.** What tasks did you do while you were wearing
(PROTECTIVE EQUIPMENT IN **RespiratorType)**?

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

BOX CHI-7

IF **TypeOfWork** ≠ 03 (NOT PRODUCTION), ASK NON-PRODUCTON WORKERS
MINI-MODULE.

[\* TAKING SAMPLES QUESTIONS]{.underline} (**ChemCollect** THROUGH
**HowCollected)**

**ChemCollect.** What chemicals did you collect?

**WhereCollected.** Where in the process did you collect the samples?

**HowCollected.** How did you usually collect the samples? \[SHOW CARD
CHI-1.\]

PLACING A SAMPLE CONTAINER INSIDE A VENTILATED

BOX AND FILLING THE CONTAINER 10

POKING THE RUBBER OR PLASTIC MEMBRANE OF A

SAMPLE CONTAINER WITH A NEEDLE, TURNING A

VALVE AND FILLING THE CONTAINER 11

TURNING A VALVE, SPIGOT, OR SIMILAR DEVICE AND

FILLING A SAMPLE CONTAINER OUT IN THE OPEN AIR 12

CONNECTING A SAMPLE CONTAINER TO THE PROCESS

LINE SO THAT THE PROCESS CHEMICAL FLOWED

THROUGH THE CONTAINER 13

USING SOME OTHER METHOD (SPECIFY) 96

**MehodSpecify**

**END OF JOB MODULE**

[\* CLEAN EQUIPMENT QUESTIONS]{.underline} (**TypeOfEquipment** THROUGH
**CleaningChem**)

**TypeOfEquipment.** What equipment did you clean?

**ChemicalsRemoved.** What chemicals were in the equipment when you
cleaned it?

**CleaningChem** What chemicals did you use to clean it? \[LIST ALL THAT
APPLY.\]

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

SOAP 1

WATER 2

[\* PACKING MATERIALS QUESTIONS]{.underline} (**FormOfMaterials**
THROUGH **ChemPack**)

**FormOfMaterial.** Was the material you packed a dust, a liquid, or a
gas?

DUST 1 (END MODULE)

LIQUID 2

GAS 3 (END MODULE)

OTHER (SPECIFY) 4

**FormSpecify**

**Ventilated.** Was there ventilation at the packing machine that
removed vapors from where you worked?

YES 1

NO 2

IF **ChemicalsInArea** ALREADY ASKED, END SERIES.

**ChemPack.** What specific chemicals did you pack?

[\* LOADING/UNLOADING QUESTIONS]{.underline} (**HowLoaded** THROUGH
**LoadUnloadChems**)

**HowLoaded.** Did you pump the chemicals from a truck or railcar into a
storage tank or bin, or were the chemicals in containers?

> MATERIALS WERE IN CONTAINERS 1 (END SERIES)
>
> PUMPED MATERIALS TO OR FROM A STORAGE TANK 2
>
> BOTH (SPECIFY WHAT WAS PUMPED) 3

**MaterialPumped**

> NEITHER 4 (END SERIES)
>
> RF **(RecoverySystem)**
>
> DK **(RecoverySystem)**

**TopOrBottom.** Did you load or unload chemicals from the top of the
truck or car or from the bottom?

TOP 1

BOTTOM 2 **(RecoverySystem)**

SOME TOP, SOME BOTTOM 3

NEITHER 4 **(RecoverySystem)**

DK **(RecoverySystem)**

**Opening.** Was there a cover over the opening on top when you loaded
or unloaded to keep fumes to a minimum, or was the truck or car opening
uncovered?

COVERED 1

UNCOVERED 2 (BOX CHI-8)

SOMETIMES COVERED, SOMETIMES UNCOVERED 3

DK (BOX CHI-8)

**RecoverySystem.** Was there a vapor recovery system on the pumping
equipment when you loaded or unloaded chemicals?

YES 1

NO 2

SOMETIMES 3

BOX CHI-8

IF **TopOrBottom** = 1 OR 3, ASK **TimeOnRailCar**.

**TimeOnRailCar.** ASK MinHrs SUBROUTINE (ACTIVITY = "did you spend time
on tope of the truck or rail car").

**LoadUnloadChems.** What chemicals did you handle during loading or
unloading?

Protective mini-module

**WoreProtectiveItems**. While working at this job, did you wear any
protective clothing or equipment?

YES 1

NO 2 (END MINI-MODULE)

**ProtectiveItems**. What protective equipment did you use? Did you use:

YES NO

**Gloves**. Gloves? 1 2

**ApronOrOtherClothing**. An apron or special clothing? 1 2

**RespiratorOrMask**. A respirator or mask? 1 2

IF **RespiratorOrMask** = YES, ASK **RespiratorType**.

**RespiratorType**. What type of respirator or mask did you wear? (MARK
ALL THAT APPLY.)

+---------------+------------------------------------------------------+
| SHOW CARD     | An air-supplied respirator that looks like a scuba   |
|               | respirator? 1                                        |
+---------------+------------------------------------------------------+
|               | A paper mask? 2                                      |
+---------------+------------------------------------------------------+
|               | A chemical cartridge respirator? 3                   |
+---------------+------------------------------------------------------+
|               | Another type of respirator? (SPECIFY) 6              |
|               |                                                      |
|               | > **SpecifyRespirator**                              |
+---------------+------------------------------------------------------+