CDE Detailed Report

Disease: Parkinson's Disease
Sub-Domain: Epidemiology/Environmental History
CRF: Risk Factor Questionnaire (RFQ) - Toxicants

Displaying 1 - 50 of 106
CDE ID CDE Name Variable Name Definition Short Description Additional Notes (Question Text) Permissible Values Description Data Type Disease Specific Instructions Disease Specific Reference Population Classification (e.g., Core) Version Number Version Date CRF Name (CRF Module / Guideline) Sub Domain Name Domain Name Size Input Restrictions Min Value Max Value Measurement Type External Id Loinc External Id Snomed External Id caDSR External Id CDISC
C17721 Risk Factor Questionnaire (RFQ) - age started regularly using solvents or degreasers period 3 value RFQAgStrtRgUseSlvntDgrsrPr3Val Age when the participant started regularly using solvents or degreasers period 3 as part of the Risk Factor Questionnaire for Toxicants Age when the participant started regularly using solvents or degreasers period 3 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT use solvents or degreasers? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08763 Risk Factor Questionnaire (RFQ) - use kerosene indicator RFQUseKeroseneInd Ever use kerosene as part of the Risk Factor Questionnaire for Toxicants Ever use kerosene as part of the Risk Factor Questionnaire for Toxicants Did or do you use kerosene? No;Yes No;Yes Alphanumeric

If 'No' skip to Q21

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08795 Risk Factor Questionnaire (RFQ) - First soldered value RFQ1stSolderedVal Age/year the participant first soldered as part of the Risk Factor Questionnaire for Toxicants Age/year the participant first soldered as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you first solder? Numeric Values

Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08742 Risk Factor Questionnaire (RFQ) - use Elmer carpenter or wood glue indicator RFQUseElmerCarpntrWoodGlueInd Ever use Elmer's, carpenter's, or wood glue as part of the Risk Factor Questionnaire for Toxicants Ever use Elmer's, carpenter's, or wood glue as part of the Risk Factor Questionnaire for Toxicants Did or do you use Elmer's, carpenter's, or wood glue? No;Yes No;Yes Alphanumeric

If 'No' skip to Q6

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C17732 Risk Factor Questionnaire (RFQ) - age started regularly working around metal dust or metal fumes period 3 value RFQAgStrtRgWrkArdMtlDtFmPr3Val Age when the participant started regularly working around metal dust or metal fumes period 3 as part of the Risk Factor Questionnaire for Toxicants Age when the participant started regularly working around metal dust or metal fumes period 3 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT solder? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08774 Risk Factor Questionnaire (RFQ) - ever flame cut metals indicator RFQEvrFlameCutMetalInd Has the participant ever flame cut metals as part of the Risk Factor Questionnaire for Toxicants Has the participant ever flame cut metals as part of the Risk Factor Questionnaire for Toxicants Have you flame cut metal? No;Yes No;Yes Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08806 Risk Factor Questionnaire (RFQ) - First worked around metal dust or fumes value RFQ1stWrkdArndMtlDstFmVal Age/year the participant first worked around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants Age/year the participant first worked around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you first work around metal dust or metal fumes? Numeric Values

Answer for age OR year, not both Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C10468 Risk Factor Questionnaire (RFQ) - currently using adhesives indicator RFQCrrntlyUsingAdhesivesInd Currently using adhesives as part of the Risk Factor Questionnaire for Toxicants Currently using adhesives as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop using glues or adhesives? Currently Use selected/checked;"Currently Use" NOT selected/checked Currently Use selected/checked;"Currently Use" NOT selected/checked Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08753 Risk Factor Questionnaire (RFQ) - age stopped regularly using solvents or degreasers period 3 value RFQAgStpRgUseSlvntDgrsrPer3Val Age when the participant stopped regularly using solvents or degreasers period 3 as part of the Risk Factor Questionnaire for Toxicants Age when the participant stopped regularly using solvents or degreasers period 3 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT use solvents or degreasers? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08785 Risk Factor Questionnaire (RFQ) - ever weld cut braze lead-plated or leaded steel indicator RFQEvrWldCtBrzLdPltdLdSteelInd Has the participant ever weld, cut, braze lead-plated or leaded steel as part of the Risk Factor Questionnaire for Toxicants Has the participant ever weld, cut, braze lead-plated or leaded steel as part of the Risk Factor Questionnaire for Toxicants Did or do you weld, cut, or braze lead-plated or leaded steel? No;Yes No;Yes Alphanumeric

If 'No' skip to Q34

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C17722 Risk Factor Questionnaire (RFQ) - age started regularly weld braze or flame cut metals period 1 value RFQAgStrtRgWldBrzFmCtMtlPr1Val Age when the participant started regularly weld, braze, or flame cut metals period 1 as part of the Risk Factor Questionnaire for Toxicants Age when the participant started regularly weld, braze, or flame cut metals period 1 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08764 Risk Factor Questionnaire (RFQ) - use mineral spirits naptha or paint thinner indicator RFQUseMinSprtsNapthaPntThnrInd Ever use mineral spirits, naptha, or paint thinner as part of the Risk Factor Questionnaire for Toxicants Ever use mineral spirits, naptha, or paint thinner as part of the Risk Factor Questionnaire for Toxicants Did or do you use mineral spirits, naptha, paint thinner? No;Yes No;Yes Alphanumeric

If 'No' skip to Q22

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08796 Risk Factor Questionnaire (RFQ) - Stopped soldering value RFQAgeYrStpSolderingVal Age/year the participant stopped soldering as part of the Risk Factor Questionnaire for Toxicants Age/year the participant stopped soldering as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop soldering? Numeric Values

Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08743 Risk Factor Questionnaire (RFQ) - use superglue indicator RFQUseSuperglueInd Ever use Superglue as part of the Risk Factor Questionnaire for Toxicants Ever use Superglue as part of the Risk Factor Questionnaire for Toxicants Did or do you use Superglue (cyanoacrylate)? No;Yes No;Yes Alphanumeric

If 'No' skip to Q7

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08775 Risk Factor Questionnaire (RFQ) - first weld braze or flame cut metals value RFQ1stWldBrzdFlmCtMtlVal Age/year the participant first welded, brazed, or flame cut metals as part of the Risk Factor Questionnaire for Toxicants Age/year the participant first welded, brazed, or flame cut metals as part of the Risk Factor Questionnaire for Toxicants If Yes answered for 27a - 27c, at what age or year did you first weld, braze, or flame cut metal? Numeric Values

Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08807 Risk Factor Questionnaire (RFQ) - Stopped working around metal dust or fumes value RFQStpWrkgArndMtlDstFmVal Age/year the participant stopped working around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants Age/year the participant stopped working around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop working around metal dust or metal fumes? Numeric Values

Answer for age OR year, not both Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C10469 Risk Factor Questionnaire (RFQ) - currently using solvents degreasers indicator RFQCrrntlyUsingSlvntsDgrsrsInd Currently using solvents or degreasers as part of the Risk Factor Questionnaire for Toxicants Currently using solvents or degreasers as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop using solvents or degreasers? Currently Use selected/checked;"Currently Use" NOT selected/checked Currently Use selected/checked;"Currently Use" NOT selected/checked Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08754 Risk Factor Questionnaire (RFQ) - use carbon tetrachloride indicator RFQUseCarbonTetrachlorideInd Ever use carbon tetrachloride as part of the Risk Factor Questionnaire for Toxicants Ever use carbon tetracholride as part of the Risk Factor Questionnaire for Toxicants Did or do you use carbon tetrachloride? No;Yes No;Yes Alphanumeric

If 'No' skip to Q12

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08786 Risk Factor Questionnaire (RFQ) - ever weld cu, braze chromium plated steel indicator RFQEvrWldCtBrzChrmumPltdStlInd Has the participant ever weld, cut, braze chromium plated steel as part of the Risk Factor Questionnaire for Toxicants Has the participant ever weld, cut, braze chromium plated steel as part of the Risk Factor Questionnaire for Toxicants Did or do you weld, cut, or braze chromium plated steel? No;Yes No;Yes Alphanumeric

If 'No' skip to Q35

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08733 Risk Factor Questionnaire (RFQ) - used adhesives 100 days indicator RFQUsedAdhesives100DaysInd Has the participant ever used adhesives at least 100 days at work or home as part of the Risk Factor Questionnaire for Toxicants Has the participant ever used adhesives at least 100 days at work or home as part of the Risk Factor Questionnaire for Toxicants In your lifetime, have you used glues or adhesives 100 or more days at work or at home? No;Yes No;Yes Alphanumeric

If 'No' skip to Question 3

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C17723 Risk Factor Questionnaire (RFQ) - age started regularly weld braze or flame cut metals period 2 value RFQAgStrtRgWldBrzFmCtMtlPr2Val Age when the participant started regularly weld, braze, or flame cut metals period 2 as part of the Risk Factor Questionnaire for Toxicants Age when the participant started regularly weld, braze, or flame cut metals period 2 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08765 Risk Factor Questionnaire (RFQ) - use n-hexane indicator RFQUseNHexaneInd Ever use n-hexane as part of the Risk Factor Questionnaire for Toxicants Ever use n-hexane as part of the Risk Factor Questionnaire for Toxicants Did or do you use n-hexane? No;Yes No;Yes Alphanumeric

If 'No' skip to Q23

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08797 Risk Factor Questionnaire (RFQ) - year not regularly solder indicator RFQYrNtRegSolderInd Periods of a year or more when the participant did not regularly solder as part of the Risk Factor Questionnaire for Toxicants Periods of a year or more when the participant did not regularly solder as part of the Risk Factor Questionnaire for Toxicants Were there periods of a year or more when you did NOT regularly solder? No;Yes No;Yes Alphanumeric

If 'No' skip to Q43

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08744 Risk Factor Questionnaire (RFQ) - use contact adhesives indicator RFQUseContactAdhesivesInd Ever use contact adhesives as part of the Risk Factor Questionnaire for Toxicants Ever use contact adhesives as part of the Risk Factor Questionnaire for Toxicants Did or do you use contact adhesives (rubber cement)? No;Yes No;Yes Alphanumeric

If 'No' skip to Q8

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08776 Risk Factor Questionnaire (RFQ) - stopped weld braze or flame cut metals value RFQStpWldBrzdFlmCtMtlVal Age/year the participant stopped welding, brazing, or flame cutting metals as part of the Risk Factor Questionnaire for Toxicants Age/year the participant stopped welding, brazing, or flame cutting metals as part of the Risk Factor Questionnaire for Toxicants If Yes answered for 27a- 27c, at what age or year did you stop welding, brazing, or flame cutting metals? Numeric Values

Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C08808 Risk Factor Questionnaire (RFQ) - year not regularly working around metal dust or metal fumes indicator RFQYrNtRegWrkArndMtlDstFmInd Periods of a year or more when the participant did not regularly working around metal dust or metal fumes as part of the Risk Factor Questionnaire for Toxicants Periods of a year or more when the participant did not regularly working around metal dust or metal fumes as part of the Risk Factor Questionnaire for Toxicants Were there periods of a year or more when you did NOT regularly work around metal dust or metal fumes? No;Yes No;Yes Alphanumeric

If 'No' skip to Question 48

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C10470 Risk Factor Questionnaire (RFQ) - current weld braze flame cut metals indicator RFQCrrntlyWldBrzdFlmCtMtlInd Currently welding, brazing, or flame cutting metals as part of the Risk Factor Questionnaire for Toxicants Currently welding, brazing, or flame cutting metals as part of the Risk Factor Questionnaire for Toxicants If Yes answered for 27a- 27c, at what age or year did you stop welding, brazing, or flame cutting metals? Currently Weld, Braze, or Flame Cut Metal selected/checked;"Currently Weld, Braze, or Flame Cut Metal" NOT selected/checked Currently Weld, Braze, or Flame Cut Metal selected/checked;"Currently Weld, Braze, or Flame Cut Metal" NOT selected/checked Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08755 Risk Factor Questionnaire (RFQ) - use chloroform indicator RFQUseChloroformInd Ever use chloroform as part of the Risk Factor Questionnaire for Toxicants Ever use chloroform as part of the Risk Factor Questionnaire for Toxicants Did or do you use chloroform? No;Yes No;Yes Alphanumeric

If 'No' skip to Q13

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08787 Risk Factor Questionnaire (RFQ) - ever weld cut braze titanium based alloy indicator RFQEvrWldCtBrzTitnmBsdAlloyInd Has the participant ever weld, cut, braze titanium based alloy as part of the Risk Factor Questionnaire for Toxicants Has the participant ever weld, cut, braze titanium based alloy as part of the Risk Factor Questionnaire for Toxicants Did or do you weld, cut, or braze titanium based alloy? No;Yes No;Yes Alphanumeric

If 'No' skip to Q36

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08734 Risk Factor Questionnaire (RFQ) - started using adhesives value RFQStrtUseAdhesivesVal Age/year the participant started using adhesives as part of the Risk Factor Questionnaire for Toxicants Age/year the participant started using adhesives as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you first use glues or adhesives? Numeric Values

Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C17724 Risk Factor Questionnaire (RFQ) - age started regularly weld braze or flame cut metals period 3 value RFQAgStrtRgWldBrzFmCtMtlPr3Val Age when the participant started regularly weld, braze, or flame cut metals period 3 as part of the Risk Factor Questionnaire for Toxicants Age when the participant started regularly weld, braze, or flame cut metals period 3 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08766 Risk Factor Questionnaire (RFQ) - use Stoddard solvent indicator RFQUseStoddardSolventInd Ever use Stoddard solvent as part of the Risk Factor Questionnaire for Toxicants Ever use Stoddard solvent as part of the Risk Factor Questionnaire for Toxicants Did or do you use Stoddard solvent? No;Yes No;Yes Alphanumeric

If 'No' skip to Q24

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08798 Risk Factor Questionnaire (RFQ) - age stopped regularly soldering period 1 value RFQAgStpRgSolderingPr1Val Age when the participant stopped regularly soldering period 1 as part of the Risk Factor Questionnaire for Toxicants Age when the participant stopped regularly soldering period 1 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT solder? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08745 Risk Factor Questionnaire (RFQ) - use other solvent-based adhesives indicator RFQUseOthrSlvntBsdAdhesivesInd Ever use other solvent-based adhesives as part of the Risk Factor Questionnaire for Toxicants Ever use other solvent-based adhesives as part of the Risk Factor Questionnaire for Toxicants Did or do you use other solvent-based adhesives? No;Yes No;Yes Alphanumeric

If 'No' skip to Q9

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08777 Risk Factor Questionnaire (RFQ) - year not regularly weld braze or flame cut metals indicator RFQYrNtRegWldBrzFlmCtMtlInd Periods of a year or more when the participant did not regularly weld, braze, or flame cut metals as part of the Risk Factor Questionnaire for Toxicants Periods of a year or more when the participant did not regularly weld, braze, or flame cut metals as part of the Risk Factor Questionnaire for Toxicants Were there periods of a year or more when you did NOT regularly weld, braze, or flame cut metals? No;Yes No;Yes Alphanumeric

If 'No' skip to Q29

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08809 Risk Factor Questionnaire (RFQ) - age stopped regularly working around metal dust or metal fumes period 1 value RFQAgStpRgWrkArdMtlDstFmPr1Val Age when the participant stopped regularly working around metal dust or metal fumes period 1 as part of the Risk Factor Questionnaire for Toxicants Age when the participant stopped regularly working around metal dust or metal fumes period 1 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT solder? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C10471 Risk Factor Questionnaire (RFQ) - currently soldering indicator RFQCrrntlySolderInd Currently soldering as part of the Risk Factor Questionnaire for Toxicants Currently soldering as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop soldering? Current Solder selected/checked;"Current Solder" NOT selected/checked Current Solder selected/checked;"Current Solder" NOT selected/checked Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08756 Risk Factor Questionnaire (RFQ) - use methylene chloride indicator RFQUseMethyleneChlorideInd Ever use methylene chloride as part of the Risk Factor Questionnaire for Toxicants Ever use methylene chloride as part of the Risk Factor Questionnaire for Toxicants Did or do you use methylene chloride? No;Yes No;Yes Alphanumeric

If 'No' skip to Q14

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08788 Risk Factor Questionnaire (RFQ) - ever weld cut braze brass or bronze indicator RFQEvrWldCtBrzBrassBronzeInd Has the participant ever weld, cut, braze brass or bronze as part of the Risk Factor Questionnaire for Toxicants Has the participant ever weld, cut, braze brass or bronze as part of the Risk Factor Questionnaire for Toxicants Did or do you weld, cut, or braze brass or bronze? No;Yes No;Yes Alphanumeric

If 'No' skip to Q37

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08735 Risk Factor Questionnaire (RFQ) - stopped using adhesives value RFQStpUseAdhesivesVal Age/year the participant stopped using adhesives as part of the Risk Factor Questionnaire for Toxicants Age/year the participant stopped using adhesives as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop using glues or adhesives? Numeric Values

Only answer for Age or Year; not both. Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

C17725 Risk Factor Questionnaire (RFQ) - age started regularly soldering period 1 value RFQAgStrtRgSolderingPr1Val Age when the participant started regularly soldering period 1 as part of the Risk Factor Questionnaire for Toxicants Age when the participant started regularly soldering period 1 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT solder? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-08-30 17:06:52.8 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08767 Risk Factor Questionnaire (RFQ) - use toluol xylol xylene indicator RFQUseToluolXylolXyleneInd Ever use toluol/xylol/xylene as part of the Risk Factor Questionnaire for Toxicants Ever use toluol/xylol/xylene as part of the Risk Factor Questionnaire for Toxicants Did or do you use toluol/xylol/xylene? No;Yes No;Yes Alphanumeric

If 'No' skip to Q25

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08799 Risk Factor Questionnaire (RFQ) - age stopped regularly soldering period 2 value RFQAgStpRgSolderingPr2Val Age when the participant stopped regularly soldering period 2 as part of the Risk Factor Questionnaire for Toxicants Age when the participant stopped regularly soldering period 2 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT solder? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08746 Risk Factor Questionnaire (RFQ) - use other solvent-based adhesives text RFQUseOthrSlvntBsdAdhsvesTxt Text description of which other solvent-based adhesives used as part of the Risk Factor Questionnaire for Toxicants Text description of which other solvent-based adhesives used as part of the Risk Factor Questionnaire for Toxicants If Yes, specify other solvent-based adhesives used Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C08778 Risk Factor Questionnaire (RFQ) - age stopped regularly weld braze or flame cut metals period 1 value RFQAgStpRgWldBrzFlmCtMtlPr1Val Age when the participant stopped regularly weld, braze, or flame cut metals period 1 as part of the Risk Factor Questionnaire for Toxicants Age when the participant stopped regularly weld, braze, or flame cut metals period 1 as part of the Risk Factor Questionnaire for Toxicants If Yes, what ages were you when you did NOT weld, braze, or flame cut metals? Numeric Values

Age should be answered in years Year should be answered in the 4-digit format

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Free-Form Entry

year
C08812 Risk Factor Questionnaire (RFQ) - metal dust or fume 1 worked around text RFQMetalDustFume1WrkArndTxt Text description of first metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants Text description of first metal dust or metal fume was worked around as part of the Risk Factor Questionnaire for Toxicants What specific types of metal dust or metal fumes did you work around? Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History 255

Free-Form Entry

C10472 Risk Factor Questionnaire (RFQ) - currently working around metal dust fumes indicator RFQCrrntlyWrkgArndMtlDstFmInd Currently working around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants Currently working around metal dust or fumes as part of the Risk Factor Questionnaire for Toxicants If Yes, at what age or year did you stop working around metal dust or metal fumes? Currently work around metal dust or metal fumes checked/selected;"Currently work around metal dust or metal fumes" NOT checked/selected Currently work around metal dust or metal fumes checked/selected;"Currently work around metal dust or metal fumes" NOT checked/selected Alphanumeric

No instructions available

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08757 Risk Factor Questionnaire (RFQ) - use trichloroethane indicator RFQUseTrichloroethaneInd Ever use trichloroethane as part of the Risk Factor Questionnaire for Toxicants Ever use trichloroethylene or PERC (perchloroethylene) as part of the Risk Factor Questionnaire for Toxicants Did or do you use trichloroethane? No;Yes No;Yes Alphanumeric

If 'No' skip to Q15

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08789 Risk Factor Questionnaire (RFQ) - ever weld cut braze cast iron indicator RFQEvrWldCtBrzCastIronInd Has the participant ever weld, cut, braze cast iron as part of the Risk Factor Questionnaire for Toxicants Has the participant ever weld, cut, braze cast iron as part of the Risk Factor Questionnaire for Toxicants Did or do you weld, cut, or braze cast iron? No;Yes No;Yes Alphanumeric

If 'No' skip to Q38

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

C08736 Risk Factor Questionnaire (RFQ) - year not regularly using adhesives indicator RFQYrNtRegUseAdhesivesInd Periods of a year or more when the participant did not regularly use adhesives as part of the Risk Factor Questionnaire for Toxicants Periods of a year or more when the participant did not regularly use adhesives as part of the Risk Factor Questionnaire for Toxicants Were there periods of a year or more when you did NOT regularly use glues or adhesives? No;Yes No;Yes Alphanumeric

If 'No' skip to Question 3

Epi Info: http://wwwn.cdc.gov/epiinfo/index.htm RFQ-U CRFs, Version 1.0 developed by the Epidemiology Working Group of the collaborative centers for PD. Adult Supplemental 3.00 2013-07-18 09:11:50.26 Risk Factor Questionnaire (RFQ) - Toxicants Epidemiology/Environmental History Participant History and Family History

Single Pre-Defined Value Selected

CSV