CDE Detailed Report
Disease: content
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 50 of 63
Subdomain Name: General Health History
CRF: welcome
Displaying 1 - 50 of 63
| CDE ID | CDE Name | Variable Name | Definition | Short Description | 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 / Guidance) | Subdomain Name | Domain Name | Size | Input Restrictions | Min Value | Max Value | Measurement Type | External Id Loinc | External Id Snomed | External Id caDSR | External Id CDISC |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| C58250 | Pesticide spray area live within 300 meter type | PstcdSpryAreaLvWin300MTyp | Type of pesticide spray area (e.g., farm, orchard, golf course) that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of pesticide spray area (e.g., farm, orchard, golf course) that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Areas sprayed with pesticides, e.g., farms, orchards, golf course (please specify type): | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:16:27.0 | Exposure History | General Health History | Participant History and Family History | 32 |
Free-Form Entry |
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| C58293 | Residence renovation year number | ResidenceRenovationYearNum | Number of the year in which renovations were done to the subject/participant's residence | Number of the year in which renovations were done to the subject/participant's residence | If yes, specify when: | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:21:36.0 | Exposure History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C58264 | Cell tower live within 300 meter indicator | CellTwrLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a cell tower | Indicator of whether the subject/participant currently lives within 300 meters of a cell tower | Cellphone towers: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:27:35.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58307 | Pesticide use pet indicator | PesticideUsePetIndicator | Indicator of whether pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) | Indicator of whether pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) | Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets on your pets? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:39:27.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58279 | Residence current occupy duration text | RsdncCrrntOccpyDuratnTxt | Text field for indicating the duration for which the subject/participant has occupied his/her current residence | Text field for indicating the duration for which the subject/participant has occupied his/her current residence | How long have you lived in your present residence? | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:49:00.0 | Exposure History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C58220 | Heavy traffic ever live within 300 meter year range | HvyTrfcEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of heavy traffic | Range of years during which the subject/participant lived within 300 meters of heavy traffic | Heavy traffic: | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-06 16:10:03.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58252 | Industrial plant live within 300 meter indicator | IndustPlntLivWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of an industrial plant | Indicator of whether the subject/participant currently lives within 300 meters of an industrial plant | Industrial plant(s): | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:17:46.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58294 | Residence renovation text | ResidenceRenovationTxt | The free-text field for describing the renovations done to the subject/participant's residence | The free-text field for describing the renovations done to the subject/participant's residence | What was renovated: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:22:57.0 | Exposure History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C58266 | Cell tower ever live within 300 meter year range | CellTwrEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a cell tower | Range of years during which the subject/participant lived within 300 meters of a cell tower | Cellphone towers: | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:32:10.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58308 | Pesticide pet type | PesticidePetTyp | The type of pesticide used on the subject/participant's pets (as sprays, collars, powders, etc.) | The type of pesticide used on the subject/participant's pets (as sprays, collars, powders, etc.) | Please specify type: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:41:02.0 | Exposure History | General Health History | Participant History and Family History | 128 |
Free-Form Entry |
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| C58280 | Residence current age value | RsdncCrrntAgeVal | Value for the age of the subject/participant's current residence | Value for the age of the subject/participant's current residence | How old is it? | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:51:04.0 | Exposure History | General Health History | Participant History and Family History |
Free-Form Entry |
Years | |||||||||||
| C58221 | Heavy traffic live within 300 meter type | HvyTrfcLvWin300MTyp | Type of heavy traffic that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of heavy traffic that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Heavy traffic (please specify) | Busy street;Highway | Busy street;Highway | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-06 16:13:02.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58253 | Industrial plant ever live within 300 meter year range | IndustPlntEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of an industrial plant | Range of years during which the subject/participant lived within 300 meters of an industrial plant | Industrial plant(s) | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:18:56.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58295 | Residential vacuum equipment type | ResidentialVacuumEquipTyp | Type of vacuum equipment (if any) used in the subject/participant's residence | Type of vacuum equipment (if any) used in the subject/participant's residence | Do you use: | Central vacuum;HEPA filter vacuum;Other, specify | Central vacuum;HEPA filter vacuum;Other, specify | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:24:17.0 | Exposure History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58267 | Windmill live within 300 meter indicator | WndmllLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a windmill | Indicator of whether the subject/participant currently lives within 300 meters of a windmill | Windmills | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:33:05.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58309 | Pesticide pet use frequency text | PestcidUsPetFrqTxt | Text field for specifying the frequency with which pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) | Text field for specifying the frequency with which pesticides are used on the subject/participant's pets (as sprays, collars, powders, etc.) | Please specify how often: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:42:06.0 | Exposure History | General Health History | Participant History and Family History | 32 |
Free-Form Entry |
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| C58281 | Apartment residence location | ApartmentResidenceLoc | Location of apartment residence in the building | Location of apartment residence in the building | If apartment: | Above store;Basement | Above store;Basement | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:58:10.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58242 | Vehicle idle area live within 300 meter indicator | VehIdlAreaLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a vehicle idling area | Indicator of whether the subject/participant currently lives within 300 meters of a vehicle idling area | Vehicle idling area: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 09:51:36.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58254 | Industrial plant live within 300 meter type | IndustPlntLivWin300MTyp | Type of industrial plant that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of industrial plant that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Industrial plant(s) (please specify type): | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:19:49.0 | Exposure History | General Health History | Participant History and Family History | 32 |
Free-Form Entry |
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| C58296 | Residential vacuum equipment other text | RsdntlVcuumEquipOthTxt | The free-text field related to 'Residential vacuum equipment type' specifying other text | The free-text field related to 'Residential vacuum equipment type' specifying other text | Other, specify: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:27:12.0 | Exposure History | General Health History | Participant History and Family History | 64 |
Free-Form Entry |
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| C58268 | Windmill ever live within 300 meter year range | WndmllEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a windmill | Range of years during which the subject/participant lived within 300 meters of a windmill | Windmills: | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:34:04.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58310 | Pesticide use lawn garden indicator | PestcidUsLawnGardnInd | Indicator of whether pesticide is used on the subject/particpant's lawn or garden | Indicator of whether pesticide is used on the subject/particpant's lawn or garden | Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets on your lawn or garden? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:43:37.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58283 | Apartment building floor count | ApartmentBldgFloorCt | Count of floors in the building containing the apartment residence | Count of floors in the building containing the apartment residence | # of floors | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:00:59.0 | Exposure History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C58243 | Vehicle idle area ever live within 300 meter year range | VehIdlAreaEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a vehicle idling area | Range of years during which the subject/participant lived within 300 meters of a vehicle idling area | Vehicle idling area | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 09:53:45.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58255 | Polluted waterway live within 300 meter indicator | PlltdWtrwyLivWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a polluted waterway | Indicator of whether the subject/participant currently lives within 300 meters of a polluted waterway | Polluted lake/stream: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:20:47.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58298 | Smoke permit domestic location | SmokPermtDomestcLoc | Location(s) in which smoking is permitted in the subject/participant's domestic life | Location(s) in which smoking is permitted in the subject/participant's domestic life | Is smoking permitted: | In your car;In your home | In your car;In your home | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:29:05.0 | Exposure History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58269 | Windmill live within 300 meter type | WndmllLvWin300MTyp | Type of windmill that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of windmill that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Windmills (please specify type): | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:34:47.0 | Exposure History | General Health History | Participant History and Family History | 32 |
Free-Form Entry |
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| C58311 | Pesticide lawn garden type | PestcidLawnGardnTyp | Type of pesticide(s) used on the subject/participant's lawn or garden | Type of pesticide(s) used on the subject/participant's lawn or garden | Please specify type: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:44:32.0 | Exposure History | General Health History | Participant History and Family History | 128 |
Free-Form Entry |
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| C58285 | Apartment residence building floor number | AptRsdncBldgFlrNum | Number of the building floor on which the apartment residence is located | Number of the building floor on which the apartment residence is located | your floor: | Numeric Values | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:02:17.0 | Exposure History | General Health History | Participant History and Family History |
Free-Form Entry |
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| C58244 | Idling area live within 300 meter vehicle type | IdlAreaLvWin300MVehTyp | Type(s) of vehicle(s) that use(d) the idling area that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type(s) of vehicle(s) that use(d) the idling area that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Vehicle idling area (please specify type) | Bus/truck;Auto | Bus/truck;Auto | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 09:55:07.0 | Exposure History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58256 | Polluted waterway ever live within 300 meter year range | PlltdWtrwyEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a polluted waterway | Range of years during which the subject/participant lived within 300 meters of a polluted waterway | Polluted lake/stream: | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:21:41.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58299 | Smoker person domestic text | SmokerPersonDomesticTxt | Text identifying the person or people in the subject/participant's domestic life who smoke | Text identifying the person or people in the subject/participant's domestic life who smoke | Who smokes? | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:31:12.0 | Exposure History | General Health History | Participant History and Family History | 255 |
Free-Form Entry |
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| C58270 | Moldy building live within 300 meter indicator | MldyBldgLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a moldy building | Indicator of whether the subject/participant currently lives within 300 meters of a moldy building | Moldy buildings: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:35:34.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58312 | Pesticide lawn garden use frequency text | PestcidLawnGardnUsFrqTxt | Text field for specifying the frequency with which pesticide is used on the subject/participant's lawn or garden | Text field for specifying the frequency with which pesticide is used on the subject/participant's lawn or garden | Please specify how often: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:45:43.0 | Exposure History | General Health History | Participant History and Family History | 32 |
Free-Form Entry |
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| C58286 | Residence ownership type | ResidenceOwnershipTyp | Type of ownership of the subject/participant's residence | Type of ownership of the subject/participant's residence | Ownership: | Public housing;Co-op;Rental;Owner occupied | Public housing;Co-op;Rental;Owner occupied | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:03:18.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58245 | Dump site live within 300 meter indicator | DmpSitLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a dump site | Indicator of whether the subject/participant currently lives within 300 meters of a dump site | Dump site: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:02:46.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58257 | Polluted waterway live within 300 meter type | PlltdWtrwyLvWin300MTyp | Type of polluted waterway that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of polluted waterway that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Polluted lake/stream (please specify type) | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:22:33.0 | Exposure History | General Health History | Participant History and Family History | 32 |
Free-Form Entry |
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| C58300 | Bath water source | BathWaterSource | Source of the water used by the subject/participant for bathing | Source of the water used by the subject/participant for bathing | What is your water source for bathing? | Well;City;Other, specify | Well;City;Other, specify | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:32:27.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58272 | Moldy building ever live within 300 meter year range | MldyBldgEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a moldy building | Range of years during which the subject/participant lived within 300 meters of a moldy building | Moldy buildings: | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:36:45.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58313 | Chemical biological exposure substance type | ChemBioExposurSubstncTyp | Type of chemical or biological substance to which the subject/participant has ever been exposed | Type of chemical or biological substance to which the subject/participant has ever been exposed | Exposure | Mold;Diesel or gas engine exhaust;Tobacco smoke;Pesticides/Herbicides;Gasoline;Paint or paint thinner;Cleaning products;Certain perfumes, air fresheners, or other fragrances;Fresh tar or asphalt;Nail polish, nail polish remover, or hairspray;New furnishings such as new carpeting, a new soft plastic shower curtain or the interior of a new car | Mold;Diesel or gas engine exhaust;Tobacco smoke;Pesticides/Herbicides;Gasoline, for example at a service station while filling the gas tank;Paint or paint thinner;Cleaning products, such as disinfectants, bleach, bathroom cleansers or floor cleaners;Certain perfumes, air fresheners, or other fragrances;Fresh tar or asphalt;Nail polish, nail polish remover, or hairspray;New furnishings such as new carpeting, a new soft plastic shower curtain or the interior of a new car | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:57:34.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58289 | Residence heat method type | ResidenceHeatMethodTyp | Type of method use to heat the subject/participant's residence | Type of method use to heat the subject/participant's residence | How is your home heated? | Baseboard heater;Space heater;Hot water radiator;Forced air heating | Baseboard heater;Space heater;Hot water radiator;Forced air heating | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:06:07.0 | Exposure History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58246 | Dump site ever live within 300 meter year range | DmpSitEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a dump site | Range of years during which the subject/participant lived within 300 meters of a dump site | Dump site | Alphanumeric |
If you ever lived nearby, please write the years. |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:08:47.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58258 | Nuclear power plant live within 300 meter indicator | NucPwrPlntLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of a nuclear power plant | Indicator of whether the subject/participant currently lives within 300 meters of a nuclear power plant | Nuclear power plant: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:23:34.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58303 | Bath water source other text | BathWaterSourceOthTxt | The free-text field related to 'Bath water source' specifying other text | The free-text field related to 'Bath water source' specifying other text | Other, specify: | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:34:05.0 | Exposure History | General Health History | Participant History and Family History | 16 |
Free-Form Entry |
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| C58273 | Insect borne pathogen endemic area live within 300 meter indicator | InsBrnPthEndArLvWin300MInd | Indicator of whether the subject/participant currently lives within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) | Indicator of whether the subject/participant currently lives within 300 meters of an area with an endemic insect-borne pathogen (e.g., Lyme disease, Zika virus) | Area where Lyme Disease, Zika virus or other insect borne pathogens are endemic: | No;Yes | No;Yes | Alphanumeric |
Do you presently live nearby? (within 300 m—about 3 midsized city blocks) |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:37:27.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58315 | Chemical biological exposure reaction grade | ChemBioExposurReactnGrade | Grade of subject/participant's reaction to the chemical or biological substance selected in 'Chemical biological exposure substance type' | Grade of subject/participant's reaction to the chemical or biological substance selected in 'Chemical biological exposure substance type' | Reaction to exposure | None, Unknown;Mild;Moderate;Severe | None, Unknown;Mild;Moderate;Severe | Alphanumeric |
Please choose 'None, Unknown' if the participant does not know if there has been an exposure |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 12:06:23.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
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| C58290 | Residence heat fuel type | ResidenceHeatFuelTyp | Type of fuel used to heat the subject/participant's residence | Type of fuel used to heat the subject/participant's residence | What type of fuel is used for heating? | Propane;Electricity;Wood;Oil;Natural gas | Propane;Electricity;Wood;Oil;Natural gas | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:10:08.0 | Exposure History | General Health History | Participant History and Family History |
Multiple Pre-Defined Values Selected |
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| C58247 | Dump site live within 300 meter type | DmpSitLivWin300MTyp | Type of dump site that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Type of dump site that the subject/participant within 300 meters of which the subject/participant lives now or has lived | Dump site (please specify type) | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:09:57.0 | Exposure History | General Health History | Participant History and Family History | 128 |
Free-Form Entry |
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| C58259 | Nuclear power plant ever live within 300 meter year range | NucPwrPlntEvrLvWin300MYrRng | Range of years during which the subject/participant lived within 300 meters of a nuclear power plant | Range of years during which the subject/participant lived within 300 meters of a nuclear power plant | Nuclear power plant: | Alphanumeric |
If you ever lived nearby, please write the years: |
Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 10:24:41.0 | Exposure History | General Health History | Participant History and Family History | 25 |
Free-Form Entry |
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| C58304 | Pesticide use residence indicator | PestcidUseResdncInd | Indicator of whether pesticides are used in the subject/participant's residence | Indicator of whether pesticides are used in the subject/participant's residence | Is there use of pesticides to kill bugs (e.g. bedbugs, spiders, cockroaches, ants, fleas, ticks) as sprays, collars, powders, pellets in your home/apartment/building? | No;Yes | No;Yes | Alphanumeric | Adult;Pediatric | Exploratory | 1.00 | 2018-02-07 11:35:26.0 | Exposure History | General Health History | Participant History and Family History |
Single Pre-Defined Value Selected |
