Journalist Exposure at the World Trade Center

1. Physical Health Concerns

 
 25% 
Please feel free to answer honestly. Your answers are anonymous and confidential and your identity is not recorded at any point as part of this survey.

In this section we are trying to gauge the hazards journalists were exposed to at the World Trade Center and get an idea what physical health challenges exist as a result of our exposure. We are also going to establish a baseline with some of the questions. The responses are intended to identify what was or was not a problem before 9.11 and what is after 9.11.



1. Which of the following were you exposed to during your time at the World Trade Center site? (Check all that apply):

2. Did you suffer any physical injury or illnesses during your exposure at the World Trade Center site? If not, please go to question 5.
3. Which of the following physical injuries or illnesses did you suffer from as a result of your exposure at the World Trade Center. Please check all that apply.

4. Were you hospitalized at any time for treatment of any of the injuries or illnesses you suffered during your exposure at the World Trade Center?
5. Were you diagnosed with asthma or breathing problems BEFORE your exposure at the World Trade Center site?
6. Were you diagnosed with asthma or breathing problems AFTER your exposure at the World Trade Center site?
7. If so, how long did your asthma or breathing problems persist?
0123456789101112
months
years
8. Does your asthma or breathing problem still exist today? If the answer is no, please skip to question 10.
9. How would you rate your asthma or breathing problems today?
10. Did you have a persistent cough BEFORE your exposure at the World Trade Center?
11. Did you develop a persistent cough AFTER your exposure at the World Trade Center?

12. If so, how long did the cough persist?
0123456789101112
Months
Years
13. Has this developed into a chronic cough that still exists today?
14. How would you rate your cough today?
15. Have you ever or do you currently smoke cigarettes regularly?

16. Did you suffer from heart burn, GERD or acid reflux BEFORE your exposure at the World Trade Center? If the answer is no, please skip to question 20.
17. Did you suffer from heart burn, GERD or acid reflux AFTER your exposure at the World Trade Center?
18. Do you still have heartburn, GERD or acid reflux?
19. If so, how long did it persist?
0123456789101112
Months
Years
20. Are you currently taking prescription medication for illnesses as a result of your exposure at the World Trade Center?
yesno
Acid reflex
Asthma
Breathing problems
Cough
GERD
Heartburn
Other WTC exposure related illnesses
Sinus problems
Sleep problems
21. Which of the following sleep problems did you have prior to your exposure at the World Trade Center, after your exposure at the World Trade Center or currently have?
Never hadHad prior to exposure at WTCHave after exposure at WTCCurrently have
Trouble falling asleep
Trouble staying asleep
Wake at night suddenly gulping for air
Nightmares
Night sweats
Snoring
Sleep apnea
Unusual feeling of fatigue
Other sleep problems
22. Have health problems AFTER your exposure at the World Trade Center affected your career?
23. Have health problems AFTER your exposure at the World Trade Center affected your personal life?
24. Have you had any illnesses or health issues that doctors cannot explain?
25. Would you like to add anything to describe your current health challenges that you believe are related to your exposure at the World Trade Center
26. Do you believe you HAVE become sick from your exposure at ground zero?
27. Are you concerned that you MIGHT become sick from your exposure at ground zero?
28. Do you feel you are getting adequate medical care for injuries related to your exposure at the World Trade Center?
Powered by SurveyMonkey
Check out our sample surveys and create your own now!