Journalist Exposure at the World Trade Center

1. Physical Health Concerns

25% of survey complete.

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.

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

Smoke

Dust

Debris

Blood

Came in contact with blood or other biohazard

Came in contact with known or unknown chemicals

Other (please specify)

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* 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.

Yes

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* 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.

Allergies

Breathing problems

Broken bones

Bruises

Burns

Cancer

Cuts

Death

Heavy metals present in body or blood

Inhaled unknown substances

Leukemia

Lung damage

Lung disease

Tumors

Other injury or illnesses

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* 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?

Yes

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* 5. Were you diagnosed with asthma or breathing problems BEFORE your exposure at the World Trade Center site?

Yes

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* 6. Were you diagnosed with asthma or breathing problems AFTER your exposure at the World Trade Center site?

Yes

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* 7. If so, how long did your asthma or breathing problems persist?

	0	1	2	3	4	5	6	7	8	9	10	11	12
months	months 0	months 1	months 2	months 3	months 4	months 5	months 6	months 7	months 8	months 9	months 10	months 11	months 12
years	years 0	years 1	years 2	years 3	years 4	years 5	years 6	years 7	years 8	years 9	years 10	years 11	years 12

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* 8. Does your asthma or breathing problem still exist today? If the answer is no, please skip to question 10.

Yes

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* 9. How would you rate your asthma or breathing problems today?

mild

moderate

severe

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* 10. Did you have a persistent cough BEFORE your exposure at the World Trade Center?

Yes

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* 11. Did you develop a persistent cough AFTER your exposure at the World Trade Center?

Yes

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* 12. If so, how long did the cough persist?

	0	1	2	3	4	5	6	7	8	9	10	11	12
Months	Months 0	Months 1	Months 2	Months 3	Months 4	Months 5	Months 6	Months 7	Months 8	Months 9	Months 10	Months 11	Months 12
Years	Years 0	Years 1	Years 2	Years 3	Years 4	Years 5	Years 6	Years 7	Years 8	Years 9	Years 10	Years 11	Years 12

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* 13. Has this developed into a chronic cough that still exists today?

Yes

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* 14. How would you rate your cough today?

mild

moderate

severe

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* 15. Have you ever or do you currently smoke cigarettes regularly?

Never smoked

Smoked in the past

Still smoke

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* 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.

Yes

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* 17. Did you suffer from heart burn, GERD or acid reflux AFTER your exposure at the World Trade Center?

Yes

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* 18. Do you still have heartburn, GERD or acid reflux?

Yes

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* 19. If so, how long did it persist?

	0	1	2	3	4	5	6	7	8	9	10	11	12
Months	Months 0	Months 1	Months 2	Months 3	Months 4	Months 5	Months 6	Months 7	Months 8	Months 9	Months 10	Months 11	Months 12
Years	Years 0	Years 1	Years 2	Years 3	Years 4	Years 5	Years 6	Years 7	Years 8	Years 9	Years 10	Years 11	Years 12

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* 20. Are you currently taking prescription medication for illnesses as a result of your exposure at the World Trade Center?

	yes	no
Acid reflex	Acid reflex yes	Acid reflex no
Asthma	Asthma yes	Asthma no
Breathing problems	Breathing problems yes	Breathing problems no
Cough	Cough yes	Cough no
GERD	GERD yes	GERD no
Heartburn	Heartburn yes	Heartburn no
Other WTC exposure related illnesses	Other WTC exposure related illnesses yes	Other WTC exposure related illnesses no
Sinus problems	Sinus problems yes	Sinus problems no
Sleep problems	Sleep problems yes	Sleep problems no

What other WTC exposure related illness are you taking medication for?

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* 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 had	Had prior to exposure at WTC	Have after exposure at WTC	Currently have
Trouble falling asleep	Trouble falling asleep Never had	Trouble falling asleep Had prior to exposure at WTC	Trouble falling asleep Have after exposure at WTC	Trouble falling asleep Currently have
Trouble staying asleep	Trouble staying asleep Never had	Trouble staying asleep Had prior to exposure at WTC	Trouble staying asleep Have after exposure at WTC	Trouble staying asleep Currently have
Wake at night suddenly gulping for air	Wake at night suddenly gulping for air Never had	Wake at night suddenly gulping for air Had prior to exposure at WTC	Wake at night suddenly gulping for air Have after exposure at WTC	Wake at night suddenly gulping for air Currently have
Nightmares	Nightmares Never had	Nightmares Had prior to exposure at WTC	Nightmares Have after exposure at WTC	Nightmares Currently have
Night sweats	Night sweats Never had	Night sweats Had prior to exposure at WTC	Night sweats Have after exposure at WTC	Night sweats Currently have
Snoring	Snoring Never had	Snoring Had prior to exposure at WTC	Snoring Have after exposure at WTC	Snoring Currently have
Sleep apnea	Sleep apnea Never had	Sleep apnea Had prior to exposure at WTC	Sleep apnea Have after exposure at WTC	Sleep apnea Currently have
Unusual feeling of fatigue	Unusual feeling of fatigue Never had	Unusual feeling of fatigue Had prior to exposure at WTC	Unusual feeling of fatigue Have after exposure at WTC	Unusual feeling of fatigue Currently have
Other sleep problems	Other sleep problems Never had	Other sleep problems Had prior to exposure at WTC	Other sleep problems Have after exposure at WTC	Other sleep problems Currently have

Specify other sleep problems

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* 22. Have health problems AFTER your exposure at the World Trade Center affected your career?

Yes

How

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* 23. Have health problems AFTER your exposure at the World Trade Center affected your personal life?

Yes

How?

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* 24. Have you had any illnesses or health issues that doctors cannot explain?

Yes

Please describe the unexplainable health issues that you faced

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* 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

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* 26. Do you believe you HAVE become sick from your exposure at ground zero?

Yes

I'm not sure

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* 27. Are you concerned that you MIGHT become sick from your exposure at ground zero?

Yes

I'm not sure

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* 28. Do you feel you are getting adequate medical care for injuries related to your exposure at the World Trade Center?

Yes