Questionnaire Summary
G/ MEDICAL CONDITIONS PRIOR TO DIAGNOSIS (FOR WOMEN ONLY):
1. Did you ever suffer from prolonged vaginal infections?
| Yes - 11 |
| No - 27 |
2. If yes, what kind of infection?
| Yeast (x8) |
| Gardinerella, Trichimonis, Monillia |
| Yeast, as well as some kind of bacterial infection |
3. How long did it last?
| one month (x2) |
| one year |
| one year reoccurring often |
| 2 years off and on |
| 2 years frequently reoccurring then again several years later |
| one or two weeks |
| 2-3 years off and on |
| 7-10 days |
4. How did it finally go away?
| diabetic - was able to cure |
| antibiotics |
| after doctor visit |
| got divorced |
| repeated treatment (x2) |
| chlorambucil - tx for lymphoma - not one since |
| medicine (x2) |
| monistat |
5. Did you ever have infertility problems?
| Yes - 10 |
| No - 29 |
6. If yes what was the cause of the infertility?
| Unknown (x3) | blocked tubes |
| anti-sperm antibodies | infrequent cycles |
| failure to ovulate (x3) | elevated prolactin |
| lack of menstruation |
7. Did you take fertility drugs?
| Yes - 4 |
| No - 29 |
8. Did you take pregnancy sustaining drugs?
| Yes - 4 |
| No - 33 |
9. Did you take birth control pills?
| Yes - 30 |
| No - 9 |
10. For how many years?
| 5 years (x6) | 20 years |
| 1 year (x5) | 2 years (x3) |
| 10 years | 12 years (x2) |
| 14 years | 4 years |
| 3 years (x4) | 3-5 years |
| 7 years (x2) | 10-12 years |
| 6 years | 18 years |
| 10+ years - started again a year ago |
H/ LIFE STYLE AND ENVIRONMENT (PRIOR TO DIAGNOSIS):
1. Where was your primary residence?
CANADA
| Toronto, ON | Sudbury, ON | British Columbia |
| Mississauga, ON | Victoria, BC | Nova Scotia |
UNITED STATES
| Sacramento, CA | Grand Junction, CO | Vergennes, Vermont |
| Camarillo, CA | Vale, CO | Tucson, AZ |
| Escondia, CA | Denver, CO | Scottsdale, AZ |
| Santa Barbara, CA | Jackson, Mississippi | Las Cruces |
| Fair Oaks, CA | Connecticut and NY | NM |
| Bakersfield, CA | PA and NY | Pennsylvania |
| California | Detroit, Michigan | Miami Beach, Florida |
| Tampa, FL | Michigan | Virginia |
| Sanford, FL | Rising Sun, MD | New Jersey (x2) |
| Brandon, FL | Reading, PA | Hampton, NJ |
| Rochester, NY | Allentown, PA | North Carolina |
| New York, NY | NY/PA | Massachusetts (x2) |
| Caledonia, NY | Ohio | South Dakoka |
| Massapequa Park, NY | Columbus, Ohio | Arlington Tx Tarrant |
| Providence County, RI | Indiana | Several Rural Areas, PA |
| Bothell, WA | Alabama | |
| Minn, WA | Georgia |
SOUTH AFRICA
| Marina Beach, Natal |
AUSTRALIA
| Proserpine, Queensland |
ITALY
2. If yes, for how many years?
| 6 (x2) | 15 | 22 (x2) | All my life |
| 7 | 11 (x2) | 3 | almost all my life |
| 27 (x3) | 20 (x5) | 9 | Life |
| 50 (x2) | 40+ | 39 (x3) | 10 (x2) |
| 31 | 16 | 45 (x2) | 18 (x4) |
| 51 | 13 | 1.5 | 30 (x2) |
| 33 | 32 | 29 | 41 |
| 38 | 12 | 60 | 36 |
| 54 | 8 | 19 | |
| 47 | 12 | 35 |
3. Did you ever live on or near a farm?
| Yes - 26 |
| No - 33 |
4. If yes, for how many years?
| 20 | 18 | 30 (x2) | life | visit often |
| 15 | 5 (x2) | 25 ( x2) | 49 | 10 |
| 3 | 16 (x3) | 2 | 6 | 22 |
| 4 |
5. Did you ever live near smoke stacks?
| Yes - 13 |
| No - 44 |
6. If yes, for how many years?
| 1 (x2) | 7 | 10 | 15 | 22 |
| 20 (x3) | 9 | 13 | 18 |
7. Did you ever live near a highly industrialized area?
| Yes - 13 |
| No - 43 |
8. If yes, for how many years?
| 1 | 5 | 10 (x3) | 23 (x2) | 37 |
| 4 | 9 | 20 (x2) | 24 | 50 |
9. Did you ever live near an airport?
| Yes - 11 |
| No - 47 |
10. If yes, for how many years?
| 2 (x2) | 17 (x2) | 13 | 15 | 25 |
| 10 (x3) | 3 |
11. Was your residence ever treated for termites/other?
| Yes - 34 |
| No - 25 |
12. If yes, how often?
| once (x10) | every 2 years | Outside bugs every 3 months |
| twice (x5) | twice a year | twice, 10 years apart |
| once or twice | 4 or 5 times | once every 10 years |
| monthly (x9) | once a year | occasionally |
| 3-4 times | 1-2 a year |
13. Were you religious?
| Yes - 31 |
| No - 25 |
14. Did you ever own any pets(s)?
| Yes - 54 |
| No - 4 |
15. If yes, what kind(s)?
| dogs (x44) | fish (x8) | iguana (x2) | horse (x2) |
| cats (x35) | skink lizard | cow | rabbit (x4) |
| birds (x10) | ferrets | goat | pig |
| mice (x2) | hamster | chicken | wallabies |
| gerbils | guinea pigs | duck | snake |
16. Did you ever smoke tobacco?
| Yes - 38 |
| No - 24 |
17. If yes, how long (years)?
| 2 (x2) | 11 | 18 | 35 (x3) |
| 3 | 12 | 20 | 40 (x5) |
| 4 | 13 | 25 (x25) | 53 |
| 5 (x4) | 15 (x6) | 30 (x3) | 55 |
| 10 (x2) | 17 | 32 | several years |
18. How many packs (per day)?
| dont recall | ½ (x4) | 1-1/2 (x2) | 5-10/day |
| ¼ | 1 (x17) | 1-2 (x4) | 1 pack/week |
| 1/3 | 1+ (x2) | 2 (x2) | 3 packs/week |
19. If you quit, how long ago (years)?
| 6 months | 7 | 16 | 29 | 40 |
| 1 | 8 | 17 (x2) | 30+ | many years ago |
| 2 (x3) | 10 (x2) | 18 | 32 | |
| 4 | 12 (x3) | 20 (x2) | 35 (x2) | |
| 6 (x2) | 14 | 22 | 36 |
20. How often did you experience major stresses in your life?
| Often - 23 |
| Average - 27 |
| Rarely - 8 |
| Never - 0 |
21. Did the majority of theses stresses occur 5 years prior to diagnosis?
| Yes - 42 |
| No - 16 |
22. Did you ever experience any personal traumas?
| Yes - 28 |
| No - 29 |
23. What was your occupation(s)?
| Nurse (x3) | fast track business women/entrepreneur |
| chemist | computer operator/esthetician/recruiter |
| property manager | drafting/communicati00000on |
| preschool teacher aid | computer programmer/teacher |
| scholor manager | preschool director/teacher |
| navel electrical technician | homemaker/bank teller |
| exec/professional | student/research/teacher |
| software engineer | electrical technician (x2) |
| patient trust clerk | homemaker/preschool teacher |
| roofer, system analyst | government scientist engineer |
| forester, logger | wife/mom/bookkeeper |
| computer analyst | contracts admin/mgr |
| pharmacy technician | auto safety researcher |
| accountant (x3) | police officer/truck driver |
| hairdresser | electrical engineer |
| homemaker (x2) | law firm administrator |
| bridge engineer | attorney then writer |
| technician | corporate tax manager |
| administrator | medical lab technician |
| CPA | consultant/sales |
| marketing | mother/secretary |
| fisherman | travel consultant |
| teacher | nurses aid/student |
| social worker | professional |
| attorney | designer/engineer |
| engineer |
24. For how many years?
| 13 | 30 (x3) | 22 (x2) | 28 | 25 | 15 (x5) |
| 20 (x6) | 16 (x2) | 14 | 7 (x2) | 30+ | 24 (x2) |
| 23 | 33 (x3) | 26 | 1 | 8 | 32 (x3) |
| 40 | 6 | 45 | 4(x2) | 35 | 42 |
| 10 (x3) | 12 | 18 | 21 | 31 | 44 |
| 3 |
25. Did you ever work with paints that treat boats or work in a boat yard?
| Yes - 4 |
| No - 55 |
26. Have you ever been exposed to agent orange through working in the military?
| Yes - 0 |
| No - 54 |
| Possibly - 5 |
27. Did you ever work as a farmer?
| Yes - 6 |
| No - 53 |
28. Did you ever work as a logger?
| Yes - 4 |
| No - 55 |
29. Did you ever work with hazardous material?
| Often - 1 |
| Sometimes - 13 |
| Rarely - 11 |
| Never - 34 |
30. Did you ever work with hobby or gardening chemicals?
| Often - 2 |
| Sometimes - 18 |
| Rarely - 25 |
| Never - 13 |
31. Did you ever use household chemicals?
| Often - 10 |
| Sometimes - 24 |
| Rarely - 22 |
| Never - 3 |
32. Did you ever dye your hair?
| Often - 17 |
| Sometimes - 6 |
| Rarely - 6 |
| Never - 30 |
33. What dye color?
| Blonde (x8), | light colors | bleach or blonde tones |
| golden brown | brown (x3) | auburn/golden brown |
| blonde/brown | dark brown (x4) | auburn (x4) |
| black (x2) | frosted | blonde hi-lights (x2) |
| hi-lights | brown/red |
34. Did you use deodorant with aluminum?
| Often - 23 |
| Average - 11 |
| Rarely - 10 |
| Never - 11 |
35. How much sun exposure did you have?
| High - 9 |
| Above Average - 19 |
| Average - 21 |
| Low - 9 |
36. Five years prior to diagnosis, did you spend a lot of time in the sun with a fever or other illness?
| Yes - 5 |
| No - 54 |
37. Did your fever or illness get worse after the exposure?
| Yes - 5 |
| No - 21 |
38. Quality of water supply?
| Excellent - 5 |
| Good - 27 |
| Average - 16 |
| Poor - 2 |
| Unknown - 8 |
39. Source of water?
| Public - 49 |
| Well - 7 |
| Purified - 4 |
40. Did you have restful sleeps?
| Often - 23 |
| Average - 19 |
| Rarely - 13 |
| Never - 3 |
41. Did you exercise?
| Often - 19 |
| Average - 18 |
| Rarely - 19 |
| Never - 2 |
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