From: Self-reported acute pesticide intoxications in Ethiopia
Section | Items in the interview guide | |
---|---|---|
Socio-demographic information | Identification: House Number: _______; Village: ___________ | |
Gender: 1. Male 2. Female | ||
Age in years: __________ | ||
Are you head of the household? (yes/no) | ||
How many people live in the family? 1. Male: _____ 2. Female: ____3. Total: ______ | ||
What is the level of your education in school years? ________________ | ||
Current job | What is your current job? | |
1. Farmer-own land | ||
2. Flower farm worker (greenhouse, pack-house, sprayer, other) | ||
3. Other (Office worker, small private business, housewife) | ||
Work experience | How long have you been working in this job? | |
Pesticide use | Do you use pesticide at home for pest control? (yes/no) | |
Do you use pesticides on your own farm? (if a farmer) (yes/no) | ||
Do they use/spray pesticides in the flower farm? (if you are working in the flower farm) (yes/no) | ||
Pesticide-related health problems experienced | Have you ever felt health problems within 48 h of exposure to pesticides in the last 12 months? | |
1. Never 2. Once 3. Several times 4. Not exposed to pesticides | ||
If you ever had health problem within 48 h of exposure to pesticides, which health symptoms did you experienced? (Tick off all the symptom (s) mentioned by the respondents from the below list) | ||
1. Headache | 12. Abdominal cramp | |
2. Dizziness | 13. Chest tightness | |
3. Excessive sweeting | 14. Dyspnea | |
4. Salivation | 15. Morning cough | |
5. Confusion | 16. Day/night time cough | |
6. Weakness | 17. Shortness of breath | |
7. Anxiety | 18. Wheezing | |
8. Loss of consciousness | 19. Miosis | |
9. Bradycardia | 20. Eye tear | |
10. Vomiting | 21. Rash on hand | |
11. Diarrhea | 22. Skin rash | |
Exposure to pesticides | If you ever had health problem within 48 h of exposure to pesticides, the exposure to pesticides occurred through: | |
1. Pesticide application for household pest control | ||
2. Pesticide application at own farm or working at sprayed farm | ||
3. While pesticide application or working at sprayed flower farm | ||
Smoking | Do you currently smoke cigarette (tobacco) daily? (yes/no) |