Table 1.

Data Elements Captured on Exposure Questionnaire.

Examples of Specific Elements
Demographics	Date of birth, race, sex, education, marital status, etc.
Medical History	History of certain medical conditions (e.g., hypertension, diabetes, endometriosis, etc.) History of pleural effusion, pleural plaques, or pulmonary fibrosis Cancer history Family cancer history Current medications Allergies
Occupational History	Employment status and work history Enrollment in asbestos surveillance program at work Involvement with specific exposure activities (e.g., firefighting, manufacturing of ceramics, brake repair, etc.) Use of personal protective equipment Military history
Residential History	Lived in close proximity to specific industries (e.g., shipyards, quarries, railway yards, waste disposal sites, etc.) Lived or worked abroad Known or suspected presence of asbestos at home Locations where lived for more than two years
Occupational history of potentially exposed household member	Lived with someone exposed to asbestos Occupational history of asbestos-exposed individuals At risk behaviors (handling contaminated clothes, etc.)
Hobbies and extra-curricular activities	Home repairs/renovations Motor vehicle work (brakes) Use of specific items (i.e., talcum powder, etc.)
Additional exposure information	Smoking history Patients’ thoughts on source believed to cause their mesothelioma