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. 2009 Apr 10;33(4):463–471. doi: 10.1016/j.habitatint.2009.03.001

General information

  • 1.

    What is your gender?

  •  Male/Female

  • 2.

    What was your age on your last birthday?

  •  Below 18/18–29/30–39/40–49/50–59/60–69/above 70 years old

  • 3.

    What is your highest educational level?

  •  Primary education or below/Secondary education/Tertiary education or above

  • 4.

    Which is your current employment status?

  •  Employed/Unemployed/Housewife/Retired/Student/Others: ______

Health status

  • 1.

    Are you a smoker?

  •  No/Yes: ____ cigarettes per day

  • 2.

    Have you ever been diagnosed by a Western doctor to have any of the following respiratory diseases?

  •  No/Yes: Asthma/Emphysema/Chronic bronchitis/Other chronic lung diseases

  • 3.

    Do you feel the following symptoms while you stay at home?

  • a.

    Eye discomfort (e.g. tearing) Never/Sometimes/Often (at least weekly)

  • b.

    Nose discomfort (e.g. running nose, sneezing) Never/Sometimes/Often (at least weekly)

  • c.

    Throat discomfort (e.g. coughing, sore throat) Never/Sometimes/Often (at least weekly)

  • d.

    Head discomfort (e.g. headache, dizzy) Never/Sometimes/Often (at least weekly)

  • e.

    Skin discomfort (e.g. allergy, feeling dry) Never/Sometimes/Often (at least weekly)

  • f.

    Fatigue Never/Sometimes/Often (at least weekly)

  • 4.

    For the symptoms you often feel above, do you think their occurrences are related to your living environment?

  • a.

    Eye discomfort (e.g. tearing) No/Yes/Not applicable

  • b.

    Nose discomfort (e.g. running nose, sneezing) No/Yes/Not applicable

  • c.

    Throat discomfort (e.g. coughing, sore throat) No/Yes/Not applicable

  • d.

    Head discomfort (e.g. headache, dizzy) No/Yes/Not applicable

  • e.

    Skin discomfort (e.g. allergy, feeling dry) No/Yes/Not applicable

  • f.

    Fatigue No/Yes/Not applicable

Environmental quality

  • 1.

    Are you satisfied with the noise level from inside the building (e.g. neighbors or drainage pipes) while you stay at home?

  •  Dissatisfied/Neutral/Satisfied

  • 2.

    Are you satisfied with the noise level from outside the building (e.g. traffic) while you stay at home?

  •  Dissatisfied/Neutral/Satisfied

  • 3.

    Are you satisfied with the adequacy of sunlight in your flat while you stay at home?

  •  Dissatisfied/Neutral/Satisfied

  • 4.

    Are you satisfied with the air ventilation in your flat while you stay at home?

  •  Dissatisfied/Neutral/Satisfied

  • 5.

    Overall, are you satisfied with your living environment?

  •  Dissatisfied/Neutral/Satisfied