Document ID: EPA-HQ-OAR-2003-0210-0004
Agency: epa
Document Type: Supporting & Related Material
Title: 
Posted Date: 2003-07-22T04:00Z

APPENDIX
1
National
Survey
on
Environmental
Management
of
Asthma
Survey
Instructions
and
Questionnaire
1­
1
Revised:
6/
20/
02
Draft
Asthma
Screening
Questions
Sample
script:
Hello,
my
name
is
xxx,
with
xxx.
I'm
calling
on
behalf
of
the
U.
S.
Environmental
Protection
Agency.
EPA
is
putting
together
information
on
things
in
the
indoor
air
which
may
cause
breathing
problems.

[
If
person
answering
phone
is
not
an
adult.]

May
I
please
speak
to
an
adult
in
your
household?

[
If
no
adult
is
present,
then
call
back
later.]

Thank
you
very
much,
we'd
like
to
speak
to
an
adult.
We
will
call
back
another
time.

[
If
a
new
person
is
put
on
the
phone,
then
restate
the
2
sentences
below,
then
continue:
]

Hello,
my
name
is
xxx,
with
xxx.
I'm
calling
on
behalf
of
the
U.
S.
Environmental
Protection
Agency.
EPA
is
putting
together
information
on
things
in
the
indoor
air
which
may
cause
breathing
problems.

I'd
like
to
ask
you
a
few
questions
about
indoor
air
and
breathing
problems
in
your
household.

This
questionnaire
should
take
no
more
than
4
minutes
of
your
time,
and
it
would
help
the
EPA
better
serve
the
public.
Your
responses
will
always
be
kept
confidential.

1.
Including
yourself,
has
anyone
living
in
your
household
ever
been
told
by
a
doctor
or
other
health
professional
that
they
have
asthma?

_____
YES
____
NO
______
DON'T
KNOW
_____
REFUSED
[
If
answer
is
`
No'
or
`
Don't
know',
read
following
statement
and
proceed
to
question
8.]

Since
no
one
in
your
household
has
asthma,
I
have
just
a
few
more
questions
about
the
members
of
your
household
so
we
may
compare
people
who
do
and
do
not
not
have
asthma.

[
If
answer
is
`
Yes',
continue
below.]

2.
How
many
people
in
your
household
have
asthma?

___
(
enter
number)
1­
2
Revised:
6/
20/
02
[
Note:
If
there
is
more
than
1
asthmatic
in
the
household,
obtain
this
screening
information
separately
for
each
one.
Run
through
the
series
of
questions
separately
for
each
asthmatic.
e.
g.,

if
there
is
more
than
one
person
with
asthma,
then
say
`
Person
1
with
Asthma'
and
ask
questions
3­
7.
Then
ask
questions
3­
7
about
`
Person
2
with
Asthma,'
etc.]

3.
Is
the
person
under
18
years
old?

[
Check
appropriate
box.]

___
Under
18
years
___
18
years
or
older
4.
[
Do
you/
does
the
person
in
your
home
diagnosed
with
asthma]
still
have
asthma?

[
Answer
`
Yes'
or
`
No.']

___
Yes
___
No
___
(
Don't
know)
_____
Refused
5.
How
long
has
it
been
since
[
you/
the
person
with
asthma]
last
talked
to
a
doctor
or
other
health
professional
about
[
your/
his/
her]
asthma?

[
Answer
`
Yes'
or
`
No.']

___
Never
____
Within
the
past
yr
____
1
yr
to
less
than
3
yrs
ago
____
3
years
to
5
yrs
ago
____
More
than
5
years
ago
____
Don't
know
____
Refused
6.
How
long
has
it
been
since
[
you/
the
person
with
asthma]
last
took
asthma
medication?

____
Never
____
Less
than
1
day
ago
____
1­
6
days
ago
____
1
week
to
less
than
3
mos.
ago
____
3
mo.
s
to
less
than
1
yr
ago
____
1
yr
to
less
than
3
yrs.
ago
1­
3
Revised:
6/
20/
02
____
3­
5
yrs.
ago
____
More
than
5
yrs
ago
____
Don't
know
____
Refused
Read:
Symptoms
of
asthma
include
coughing,
wheezing,
shortness
of
breath,
chest
tightness
or
phlegm
production
when
[
you/
the
person
with
asthma]
do/
does
not
have
a
cold
or
respiratory
infection.

7.
How
long
has
it
been
since
[
you/
the
person
with
asthma]
last
had
any
symptoms
of
asthma?

____
Never
____
Less
than
1
day
ago
____
1­
6
days
ago
____
1
week
to
less
than
3
mos.
ago
____
3
mo.
s
to
less
than
1
yr
ago
____
1
yr
to
less
than
3
yrs.
ago
____
3­
5
yrs.
ago
____
More
than
5
yrs
ago
____
Don't
know
____
Refused
8.
How
many
children
six
years
old
and
younger
live
in
your
home?

___
(
enter
number)

9.
Does
anyone
living
with
you
in
the
home
smoke
cigarettes,
cigars,
or
a
pipe?

[
Answer
`
Yes'
or
`
No.']

___
Yes
___
No
10.
Does
anyone
smoke
inside
your
home
on
a
regular
basis?

[
Answer
`
Yes'
or
`
No.']
1­
4
Revised:
6/
20/
02
___
Yes
___
No
11.
What
is
the
zip
code
where
your
home
is
located?

_________
(
enter
zip
code)

12.
Would
you
please
tell
me
the
age
of
each
person
in
your
household
starting
with
you
and
then
followed
by
the
oldest
member
and
ending
with
the
youngest
member?

[
For
this
question
insert
grid
that
will
allow
interviewer
to
enter
ages
for
all
household
members.]

[
If
more
than
one
child/
person
is
the
same
age
in
years
go
to
question
13,
otherwise
go
to
question
14]

13.
Since
more
than
one
child/
person
is
[
age
id],
I
need
a
way
to
refer
to
each
of
them
during
the
interview.
Could
you
please
tell
me
their
first
name
or
initials?

____
Yes
_____
No
____
Don't
Know
____
Refused
[
If
yes
skip
to
age
grid
and
enter
name/
initials,
then
proceed
to
question
14]

14.
Are
you
of
Hispanic
or
Latino
origin?

[
STARTING
WITH
SECOND
PERSON:
And
how
about
[
the
[
AGE]
year
old]?
[
LOOP
FOR
EACH
HH
MEMBER]

______
YES
_______
NO
_______
DON'T
KNOW
________
REFUSED
15.
Now,
I'm
going
to
read
a
list
of
categories.
Please
choose
one
or
more
of
the
following
categories
to
describe
yourself.
Are
you
White,
Black
or
African­
American,
American
Indian,

Alaska
Native,
Asian,
or
Native
Hawaiian
or
other
Pacific
Islander?

[
STARTING
WITH
SECOND
PERSON:
And
how
about
[
the
[
AGE]
year
old]?
[
LOOP
FOR
EACH
HH
MEMBER]

[
MARK
ALL
THAT
APPLY]
1­
5
Revised:
6/
20/
02
_____
WHITE
______
BLACK/
AFRICAN­
AMERICAN
______
AMERICAN
INDIAN
______
ALASKA
NATIVE
______
ASIAN
______
NATIVE
HAWAIIAN
______
PACIFIC
ISLANDER
______
DON'T
KNOW
______
REFUSED
16.
What
is
the
highest
level
of
school
that
the
primary
breadwinner
in
the
household
has
completed?

_____
Enter
highest
grade
completed
(
1­
12)

_____
Graduated
High
School
_____
Some
post­
high
school,
but
not
a
Bachelor's
degree
(
B.
A.)

_____
College
Graduate
­
Bachelor's
degree
or
B.
A.

_____
Some
Graduate
or
Professional
School
(
with
or
without
degree)

_____
No
formal
schooling
_____
Don't
know
_____
Refused
If
the
caller
answered
`
No'
to
Question
1
(
i.
e.,
no
one
in
his
or
her
household
has
asthma),
or
all
identified
asthmatics
have
not
had
a
doctors
visit
for
asthma,
used
asthma
medication
or
had
asthma
symptoms
in
over
5
years,
end
the
interview
with
the
following
statement:

This
concludes
the
interview.
Thank
you
for
your
time.
Goodbye.

If
the
caller
answered
`
Yes'
to
Question
1
(
i.
e.,
someone
in
his
or
her
household
has
asthma),

and
the
identified
asthmatic(
s)
has/
have
had
a
doctors
visit
for
asthma,
used
asthma
medication
or
had
asthma
symptoms
within
the
last
5
years,
end
the
interview
with
the
following
and
then
proceed
to
question
17:

This
concludes
the
screening
interview.
Thank
you
for
your
time.
Since
you
have
a
person
with
asthma
in
the
home,
we
would
like
to
ask
some
additional
questions
about
how
the
asthma
is
managed.
1­
6
Revised:
6/
20/
02
18.
Our
survey
method
requires
that
if
the
person
with
asthma
is
an
adult
[
age
18
or
older]
,
that
person
must
be
the
one
who
is
interviewed
(
someone
else
cannot
answer
for
him/
her).
If
the
person
with
asthma
is
a
child,
then
a
parent
or
caregiver
must
answer
for
him/
her.
Okay?

Are
you
the
person
with
asthma
or
is
your
child
the
asthmatic?

___
Self
___
Child
___
Both
self
and
child
have
asthma
___
Not
asthmatic
or
parent/
caregiver
of
asthmatic
child
[
If
they
answer
that
they
are
not
the
asthmatic
or
parent
of
the
asthmatic,
proceed
to
Ques.
19.]

[
If
they
answer
that
they
or
their
child
has
asthma,
and
staffing
is
available
to
administer
the
complete
questionnaire
proceed
to
Question
20.]

[
If
they
answer
that
they
or
their
child
has
asthma,
but
staffing
is
not
available
to
administer
the
complete
questionnaire,
proceed
to
Question
22.]

19.
Since
you
have
a
person
with
asthma
in
the
home,
we
would
like
to
call
back
soon
to
hear
more
about
how
it
is
managed.
When
we
call
again,
we
would
like
to
talk
to
the
person
with
asthma
(
or
the
parent
or
caregiver
of
the
child
with
asthma).
When
would
be
a
good
time
to
call
back
to
talk
to
that
person?

___
Day(
s)
of
week
___
Time
of
day
________________________
First
Name
of
Person
to
Ask
For
Thank
you,
and
goodbye.

20.
You
may
choose
to
continue
now
with
the
set
of
questions
about
how
the
asthma
is
being
managed.
The
questions
will
take
about
15
minutes.
Would
that
be
okay?

___
Yes___
No
1­
7
Revised:
6/
20/
02
[
If
answer
is
`
Yes',
proceed
to
the
instructions
on
the
Asthma
Survey
Questionnaire
immediately
following
the
`***']

[
If
answer
is
`
No'
proceed
to
Question
21.]

21.
When
would
be
a
good
time
to
call
back
to
talk
to
you?

___
Day(
s)
of
week
___
Time
of
day
______________________
First
Name
of
Person
Talking
To
Thank
you,
and
goodbye.

22.
Since
you
have
asthma
(
or
are
the
parent
or
caregiver
of
the
child
with
asthma),
we
would
like
to
call
back
soon
to
hear
more
about
how
it
is
managed.
When
we
call
again,
we
would
like
to
talk
to
you.

When
would
be
a
good
time
to
call
back
to
talk
to
you?

___
Day(
s)
of
week
___
Time
of
day
______________________
First
Name
Person
Talking
To
Thank
you,
and
goodbye.
1­
8
Revised:
6/
20/
02
Draft
Asthma
Survey
Questions
Sample
Script:

[
The
computer
should
adjust
wording
to
fit
the
subject
(
child
or
adult)
throughout
the
survey.

Introduction:
Hello,
my
name
is
xxx,
with
xxx.
I'm
calling
on
behalf
of
the
United
States
Environmental
Protection
Agency.
EPA
is
putting
information
together
to
help
people
with
asthma.

[
If
person
answering
phone
is
not
an
adult.]

May
I
please
speak
to
an
adult
in
your
household?

[
If
no
adult
is
present,
END
interview,
then
call
back
later.]

Thank
you
very
much,
we'd
like
to
speak
to
an
adult.
We
will
call
back
another
time.
Goodbye.

We
understand
from
a
previous
call
that
an
adult/
child
[
identify
which]
in
your
household
has
asthma.
May
I
speak
with
[
Name
(
if
known)/
that
person
(
or
the
parent
or
caretaker
if
the
asthmatic
is
a
child)]?

Repeat
Introduction
if
this
is
a
new
person
on
the
phone.

I
have
a
set
of
questions
about
how
the
asthma
is
being
managed.
The
questions
will
take
about
15
minutes.
Would
that
be
okay?

[
State
`
respondent
rules'
up
front.]

Our
survey
method
requires
that
if
the
person
with
asthma
is
an
adult,
that
person
must
be
the
one
who
is
interviewed
(
someone
else
cannot
answer
for
him/
her).
If
the
person
with
asthma
is
a
child,
then
a
parent
or
caregiver
must
answer
for
him/
her.
Okay?
Are
you
the
person
with
asthma
or
is
your
child
the
asthmatic?

___
Self
___
Child
___
Both
self
and
child
have
asthma
1­
9
Revised:
6/
20/
02
***

[
The
appropriate
interview
subject
should
be
identified
before
the
interview
begins.

If
there
is
only
one
asthmatic
questions
will
be
asked
about
that
individual.
If
both
an
adult
and
a
child
have
asthma,
questions
will
be
asked
about
the
child.
If
more
than
one
child
in
the
household
has
asthma,
a
random
determination
will
be
made
as
to
which
child
the
questions
will
be
asked
about.
If
more
than
one
adult
in
the
household
has
asthma,
but
there
are
no
asthmatic
children
in
the
household,
a
random
determination
will
be
made
as
to
which
adult
the
questions
will
be
asked
of.]

[
If
there
is
more
than
one
asthmatic
in
the
home
(
if
answered
`
Both'
above),
identify
which
one
is
the
subject
before
starting.]

I
understand
you
have
more
than
one
[
child/
adult]
with
asthma
in
your
home.
We
can
only
talk
about
one
of
them
today.
We
have
determined
that
we
will
ask
the
questions
about
the
X
year
old
[
child/
adult].
All
the
questions
we
ask
will
be
about
that
one
person.
Okay,
do
you
have
that
person
in
mind?
Good,

let's
begin
the
interview.

[
Note
if
subject
is
self
or
child
and
what
age]

Interview:

A.
Demographic
information
Let's
start
with
a
basic
question.

1.
What
is
your/
your
child's
sex:

____
M
_____
F
B.
Asthma
questions
The
following
questions
are
about
your/
your
child's
asthma.
1­
10
Revised:
6/
20/
02
1.
Do
you
think
any
of
the
following
things
commonly
affect
asthma
symptoms
in
asthmatics
generally,
not
just
in
you/
your
child?

[
For
each
of
the
options
below,
ask
for
`
Yes'
or
`
No'
answers.
Check
`
Don't
know'
only
if
this
answer
is
volunteered,
but
don't
mention
`
Don't
know'
as
an
option.]

pollen
___
Yes
___
No
___
(
Don't
know)

molds
___
Yes
___
No
___
(
Don't
know)

dust
mites
___
Yes
___
No
___
(
Don't
know)

cats
___
Yes
___
No
___
(
Don't
know)

dogs
___
Yes
___
No
___
(
Don't
know)

cockroaches
___
Yes
___
No
___
(
Don't
know)

High
ozone
outside
___
Yes
___
No
___
(
Don't
know)

secondhand
tobacco
smoke___
Yes
___
No
___
(
Don't
know)

2a.
Next,
I
will
ask
you
about
things
that
may
trigger
your/
your
child's
asthma.
Please
answer
`
Yes'
if
the
thing
I
mention
triggers
your/
your
child's
asthma
attacks
or
`
No'
if
it
does
not.

[
Read
all
options,
and
answer
`
Yes'
or
`
No'
to
each.
May
answer
`
Don't
know'
if
volunteered.]
[
The
responses
to
this
question
will
determine
which
of
the
response
options
will
be
asked
in
question
3.
The
computer
program
should
be
designed
to
automatically
bring
up
the
appropriate
options
in
question
3.]

Do
molds
trigger
the
asthma?___
Yes___
No___
(
Don't
know)

Do
cockroaches
trigger
it?___
Yes___
No___
(
Don't
know)
1­
11
Revised:
6/
20/
02
Do
dust
mites?___
Yes___
No___
(
Don't
know)

Do
cats?
___
Yes___
No___
(
Don't
know)

Do
dogs?___
Yes___
No___
(
Don't
know)

Does
anything
else
trigger
the
asthma?

Specify:______________________________________

2b.
Have
you/
has
your
child
seen
a
doctor
to
diagnose
what
things
may
trigger
your/
your
child's
asthma?
[
Check
`
Yes'
or
`
No.']

___
Yes___
No___
(
Don't
know)

2c.
Are
you/
Is
your
child
susceptible
to
having
an
asthma
attack
from
exercising
or
from
something
else
that's
not
in
the
environment?
[
Check
`
Yes'
or
`
No.']

___
Yes___
No___
(
Don't
know)

3.
Is
smoking
ever
allowed
in
your
home?
[
Answer
`
Yes'
or
`
No.']

___
Yes___
No___
(
Don't
know)

4.
Next,
I
want
to
ask
about
managing
your
home
environment.
Please
answer
`
Yes'
or
`
No'
to
any
of
the
following
actions
that
may
or
may
not
be
taken
in
your
home.

[
Read
through
the
response
options
and
answer
`
Yes'
or
`
No'
to
each.]

[
If
respondent
answered
`
No'
to
all
options
in
2a
and
`
Yes'
to
2c
then
ask
respondent
about
all
the
options
in
4.]
1­
12
Revised:
6/
20/
02
If
the
person
answered
`
Yes'
or
`
Don't
know'
to
the
`
molds'
option
in
2a:

4a.
Do
you
ever
notice
mold
in
your
home?

___
Yes___
No___
(
Don't
know)

If
`
Yes,'
proceed
to
4b
4b.
Do
you
clean
mold
as
soon
as
it
is
noticed
in
the
home?

___
Yes___
No___
(
Don't
know)

If
respondent
answered
`
Yes'
or
`
Don't
know'
to
the
mold
and/
or
dust
mite
option
in
2a,
proceed
to
4c
&
4d:

4c.
Do
you
use
an
air
conditioner
or
dehumidifier
to
reduce
excess
humidity
in
your
home?

___
Yes___
No___
(
Don't
know)

4d.
Do
you
regularly
use
exhaust
fans
or
open
windows
in
the
kitchen
or
bathroom
to
reduce
humidity
from
showering,
cooking,
or
dishwashing?

___
Yes___
No___
(
Don't
know)

If
the
respondent
answered
`
Yes'
or
`
Don't
know'
to
the
`
cockroaches'

option
in
2a,
proceed
to
4e
&
4f:

4e.
Do
you
keep
indoor
areas
clean
and
store
food
in
tight
containers
to
discourage
cockroaches?

___
Yes___
No___
(
Don't
know)

4f.
If
you
ever
discover
cockroaches,
which
of
the
following
is
the
main
method
you
use
to
control
them?
1­
13
Revised:
6/
20/
02
___
do
nothing
to
control
roaches
___
use
roach
pesticidal
spray
(
like
Raid)

____
use
roach
traps
___
use
boric
acid
___
Other
Specify______________________________________________

If
the
respondent
answered
`
Yes'
or
`
Don't
know'
to
the
`
dust
mites'

option
in
2a,
proceed
to
4g,
4h,
&
4i:

4g.
Do
you
use
allergen­
impermeable
mattress
and
pillow
covers?

___
Yes___
No___
(
Don't
know)

4h.
Do
you
regularly
wash
the
sheets
and
pillow
cases
of
the
person
with
asthma
in
hot
water?

___
Yes___
No___
(
Don't
know)

4i.
Have
you
taken
actions
to
reduce
the
use
of
upholstered
furniture
in
the
home?

___
Yes___
No___
(
Don't
know)

If
the
respondent
answered
`
Yes'
or
`
Don't
know'
to
the
`
cats'
option
in
2a,
proceed
to
4j:

4j.
Do
you
have
a
cat
in
the
house
or
do
you
choose
not
to
have
a
cat
in
the
house?

___
Have
a
cat
___
Choose
not
to
have
a
cat
1­
14
Revised:
6/
20/
02
If
have
a
cat,
proceed
to
4k:

4k.
Is
the
cat
ever
allowed
inside
the
house?

___
Yes___
No
If
yes,
proceed
to
4l:

4l.
Is
the
cat
ever
allowed
to
come
into
the
bedroom
of
the
person
with
asthma?

___
Yes___
No
If
the
respondent
answered
`
Yes'
or
`
Don't
know'
to
the
`
dogs'
option
in
2a,
proceed
to
4m:

4m.
Do
you
have
a
dog
in
the
house
or
do
you
choose
not
to
have
a
dog
in
the
house?

___
Have
a
dog
___
Choose
not
to
have
a
dog
If
have
a
dog,
proceed
to
4n:

4n.
Is
the
dog
ever
allowed
inside
the
house?

___
Yes___
No
If
yes,
proceed
to
4o:

4o.
Is
the
dog
ever
allowed
to
come
into
the
bedroom
of
the
person
with
asthma?

___
Yes___
No
1­
15
Revised:
6/
20/
02
5.
The
next
question
is
about
reasons
that
might
prevent
you
from
reducing
exposures
to
indoor
asthma
triggers.
[
The
computer
will
list
items
that
should
be
asked
about,
based
on
what
the
subject
is
allergic
to
and
what
actions
have
not
been
taken.]

[
e.
g.,
You
said
you
are/
your
child
is
sensitive
to
cockroaches
and
you
indicated
that
you
do
not
use
roach
traps,
roach
sprays,
or
boric
acid
to
kill
cockroaches.
Which
of
the
following
best
explain
why
you
do
not?]

___
I
wasn't
sure
what
actions
to
take
___
I
don't
have
time
___
Too
expensive
___
Actions
are
beyond
my
control
___
I
know
what
actions
to
take,
but
I
don't
know
how
to
do
it
___
I
don't
want
to
take
actions
___
Actions
don't
work
___
I
can't
find
right
equipment
___
I
take
different
actions
to
address
the
problem
___
Medications
are
all
I/
my
child
needs
___
Other
Specify:______________________________________________

The
following
questions
relate
to
medical
treatment
for
asthma.
1­
16
Revised:
6/
20/
02
6.
Do
you/
Does
your
child
regularly
take
prescription
long­
term
or
everyday
medication
for
your/
his/
her
asthma?
[
Answer
`
Yes'
or
`
No.']

___
Yes___
No
7.
Do
you/
Does
your
child
take
quick­
acting,
"
rescue"
prescription
medication
for
asthma­
related
emergencies?
[
Answer
`
Yes'
or
`
No.']

___
Yes___
No
8.
Do
you/
Does
your
child
regularly
monitor
your
/
his/
her
lung
function
using
a
peak
flow
meter
or
similar
device?
[
Answer
`
Yes'
or
`
No.']

___
Yes___
No
9.
An
asthma
management
plan
is
a
printed
form
that
tells
when
to
change
the
amount
or
type
of
medicine,
when
to
call
a
doctor
for
advice,
and
when
to
go
to
the
emergency
room.
Has
a
doctor
or
other
health
professional
EVER
given
[
you/
the(
age)
year
old/
name
an
asthma
management
plan?[
Answer
`
Yes'
or
`
No.']

___
Yes___
No
C.
Demographic
information
(
continued)

1.
How
many
people
live
in
your
household?
[
Enter
number
below]

___
Number
in
household
1­
17
Revised:
6/
20/
02
2.
What
was
the
total
combined
household
income
of
your
household
in
[
fill
in
the
last
calendar
year],
including
income
from
all
sources
including
wages,
salaries,
unemployment
payments,
public
assistance,
Social
Security
or
retirement
benefits,
help
from
relatives
and
so
forth?
Can
you
tell
me
that
amount
before
taxes?

Record
income
$__________________

Don't
know
[
skip
to
question
3]

Refused
[
skip
to
question
3]

3.
For
the
purposes
of
this
survey,
it
is
important
to
get
at
least
a
range
for
the
total
income
received
by
all
members
of
your
household
in
[
fill
in
the
last
calendar
year].
Would
you
say
that
the
total
combined
income,
before
taxes
was?

[
Ask
one
of
the
following
questions
based
on
number
of
people
in
the
household]

[
Income
thresholds
will
adjust
automatically
by
computer
to
determine
whether
respondent
is
low
income
or
not.
Ask
one
of
the
following.

Answer
`
More'
or
`
Less.']

___
More
or
less
than
$
9,000
[
for
1
person
household]

___
More
or
less
than
$
11,000
[
for
2
person
household]

___
More
or
less
than
$
13,000
[
for
3
person
household]

___
More
or
less
than
$
17,000
[
for
4
person
household]

___
More
or
less
than
$
20,000
[
for
5
person
household]

___
More
or
less
than
$
23,000
[
for
6
person
household]

___
More
or
less
than
$
26,000
[
for
7
person
household]

___
More
or
less
than
$
29,000
[
for
8
person
household]

___
More
or
less
than
$
34,000
[
for
9
or
more
person
household]

This
concludes
the
interview.
Thank
you
very
much
for
your
help.

If
you
would
like
to
receive
free
information
from
the
EPA
about
managing
asthma
in
the
home,
I
can
give
you
a
telephone
number
to
call.
Would
you
like
to
receive
information?
1­
18
Revised:
6/
20/
02
If
yes:
Please
call
EPA's
Indoor
Air
Quality
hotline
at
1­
800­
438­
4318
and
request
the
brochure
called,
"
Clear
Your
Home
of
Asthma
Triggers."