NHIS

Injury and Poisoning Questions on the National Health Interview Survey: 1997-present

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Year Question ID Question Response categories* Universe

1997-1999

FIJ.010

Injuries are a major health problem. In order to develop new ways to help prevent both accidental and intentional injuries, we need to know more about them. In this next set of questions, I will ask about injuries that happened in the past 3 months; Note here that we are only interested in injuries that required medical advice or treatment.
DURING THE PAST THREE MONTHS, that is since {91 days before today’s date}, {were/was} {you/anyone in the family} injured seriously enough that {you/they} got medical advice or treatment?

(1) Yes (2) No (7) Refused (9) Don’t know

All families

2000-2003

FIJ.010

In this next set of questions, I will ask about INJURIES AND POISONINGS that happened in the PAST THREE MONTHS; that REQUIRED MEDICAL ADVICE OR TREATMENT, including calls to a poison control center.
DURING THE PAST THREE MONTHS, that is since {91 days before today’s date}, {were/was} {you/anyone in the family} injured or poisoned seriously enough that {you/they} got medical advice or treatment?

(1) Yes (2) No (7) Refused (9) Don’t know

All families

2004-present

FIJ.010_01.000

The next set of questions is about INJURIES AND POISONINGS. People can be injured or poisoned unexpectedly, accidentally or on purpose. They may have hurt themselves or others may have caused them to be hurt.
DURING THE PAST THREE MONTHS, that is since [fill1: (date 91 days before today’s date)], [fill2: did you/did you or anyone in your family] have an injury where any part of [fill3: your/the] body was hurt, for example, with a [fill4: (random set of injury examples)]?

(1) Yes (2) No (7) Refused (9) Don’t know

All families

1997-1999

FIJ.020

Who was this? (Anyone else?)

Assigned family number of person who was injured

All persons

2000-2003

FIJ.020

Who was this? (Anyone else?)

Assigned family number of person who was injured or poisoned

All persons

2004-present

FIJ.012_00.000

Who was this? (Anyone else?)

Assigned family number of person who was injured

All persons

2004-present

FIJ.014_00.000

DURING THE PAST THREE MONTHS, how many different times [fill: were you/was ALIAS] injured?

(01-91) 1-91 times (97) Refused (99) Don’t know

All persons injured during the past 3 months

2004-present

FIJ.016_00.000

Did [fill1: you /ALIAS] talk to or see a medical professional about [fill2: any of these injuries/this injury/your injury or injuries/his injury or injuries/her injury or injuries]?

(1) Yes (2) No (7) Refused (9) Don’t know

All persons with at least one or an unknown number of injury episodes during the past 3 months

1997-1999

FIJ.030

How many different times in the past three months {were/was} {you/subject’s name} injured seriously enough to seek medical advice?

01-94 times

Persons who were injured during the past 3 months

2000

FIJ.030

How many different times in the PAST THREE MONTHS did {you/subject’s name} SEEK MEDICAL ADVICE because {you/subject’s name} {were/was} injured or poisoned?

01-94 times

Persons who were injured and/or poisoned during the past 3 months

2001-2003

FIJ.030

How many different times in the PAST THREE MONTHS {were/was} {you/subject’s name} injured or poisoned seriously enough to seek medical advice or treatment?

01-94 times

Persons who were injured and/or poisoned during the past 3 months

2004-present

FIJ.018_00.000

Of [fill1: the number of times reported in question FIJ.014_00.000/all the] times that [fill2: you were/ALIAS was] injured, how many of those times was the injury serious enough that a medical professional was consulted?

(01-91) 1-91 times (97) Refused (99) Don’t know

All persons who consulted a medical professional for their injury episode(s)

1997

FIJ.040

If only one injury: When did {subject’s name} injury happen?
If more than one injury: Now I’m going to ask a few question about {subject’s name} most recent injury. When did that injury happen? We just talked about {subject’s name} injury on {recent injury date}. When did {subject’s name} injury BEFORE THAT happen?

Month: (1) January (2) February (3) March (4) April (5) May (6) June (7) July (8) August (9) September (10) October (11) November (12) December (97) Refused (99) Don’t know
Day: (01-31) 1-31 (97) Refused (99) Don’t know
Year: (1996-1998) 1996-1998 (9997) Refused (9999) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months

1998

Same as 1997

Same as 1997

Same as 1997 except Year changed to 1997-1999

Same as 1997

1999

Same as 1997

Same as 1997

Same as 1997 except Year changed to 1998-2000

Same as 1997

2000

Same as 1997

If only one injury/poisoning: Now I’m going to ask a few questions about {your/subject’s name}’s most recent injury/poisoning. When did it happen?
If there are additional injuries/poisonings: We just talked about {your/subject’s name}’s injury/poisoning on {recent injury/poisoning date}. When did {your/subject’s name}’s injury/poisoning BEFORE THAT happen?

Same as 1997 except Year changed to 1999-2001

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2001

Same as 1997

Same as 2000

Same as 1997 except Year changed to 2000-2002

Same as 2000

2002

Same as 1997

Same as 2000

Same as 1997 except Year changed to 2001-2003

Same as 2000

2003

Same as 1997

Same as 2000

Same as 1997 except Year changed to 2002-2004

Same as 2000

2004

FIJ.050_01.000
FIJ.050_02.000
FIJ.050_03.000

{if only 1 injury/poisoning episode for the person}: When did [fill1: your/ALIAS’s] [fill2: injury/poisoning] happen for which a medical professional was consulted?
{first of multiple injury/poisoning episodes for the person}: Now I’m going to ask a few questions about the [fill3: the number of times injured/poisoned reported in question FIJ.018_00.00/FIJ.028_00.000] times [fill4: you were/ALIAS was[fill5: injured/poisoned] for which a medical professional was consulted. Starting with the most recent time, when did this [fill2: injury/poisoning] happen?
{second plus of multiple injury/poisoning episodes for the person}: You just told me about [fill1: your/ALIAS’s] [fill6: (month, day of previous event)] [fill7:most recent/second most recent/third most recent/fourth most recent][fill2: injury/poisoning]. What was the date of the [fill2: injurybefore that for which a medical professional was consulted?

Month: (1) January (2) February (3) March (4) April (5) May (6) June (7) July (8) August (9) September (10) October (11) November (12) December (97) Refused (99) Don’t know
Day: (01-31) 1-31 (97) Refused (99) Don’t know
Year: (2003-2005) 2003-2005 (9997) Refused (9999) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2005-present

Same as 2004

Same as 2004

Same as 2004 except Year changed to the year before the current survey year, the current survey year, and the year after the current survey year; for example, if the survey year is 2005 then the values for Year would be 2004-2006

Same as 2004

2004-present

FIJ.051_01.000
FIJ.051_02.000

Can you tell me approximately how long ago [fill1: your/ALIAS’s] [fill2: injury/poisoning] happened?
Enter number for time since event.
Enter number for time period since event.

(01-91) 1-91 (97) Refused (99) Don’t know
(1) Days (2) Weeks (3) Months (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where “don’t know” is entered for the month of the episode

2004-present

FIJ.052_00.000

Was this in the beginning of [fill: month reported in question FIJ.050_01.000] the middle of [fill: month reported in question FIJ.050_01.000], or the end of [fill: month reported in question FIJ.050_01.000]?

(1) Beginning (2) Middle (3) End (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where “don’t know” is entered for the day of the episode

2000-2003

FIJ.045

Where did {you/subject’s name} receive MEDICAL ADVICE OR TREATMENT for this injury/poisoning? Anywhere else? (Mark all that apply)

(01) Did not receive medical treatment or advice (02) Phone call to doctor or health care professional (03) Phone call to poison control center (04) Visit to doctor’s office (05) Visit to clinic or outpatient department (06) Visit to emergency department (07) Visit to hospital (stayed at least one night) (97) Refused (99) Don’t know

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004

This became separate questions. The same information or similar information is now found in questions FIJ.080_1.000 – FIJ.081_00.00

2004-present

FIJ.080_02.000

Did [fill1: you/ALIAS] get MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this [fill2: injury/poisoning] from… An emergency vehicle, such as an ambulance or fire truck?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.080_03.000

Did [fill1: you/ALIAS] get MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this [fill2: injury/poisoning]… A visit to an emergency room?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.080_04.000

Did [fill1: you/ALIAS] get MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this [fill2: injury/poisoning]… A visit to a doctor’s office or other health clinic?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.080_05.000

Did [fill1: you/ALIAS] get MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this [fill2: injury/poisoning]… A phone call to a doctor, nurse, or other health care professional?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.080_06.000

Did [fill1: you/ALIAS] get MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this [fill2: injury/poisoning]… Any place else?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.081_00.000

Where else did [fill1: you/ALIAS get MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this [fill2: injury/poisoning]?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, where medical advice, treatment, or follow-care was received from some “other” place

2004-present

FIJ.082_00.000

[fill1: You/ALIAS] DID NOT receive any medical advice, treatment, or follow-up for this [fill2: injury/poisoning]. Is that correct?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where no source of medical advice, treatment, or follow-up care was selected

1997-1999

FIJ.050

At the time of the injury, what part(s) of {subject’s name} body was hurt? What kind of injury was it? Anything else?

Verbatim response. Respondents can list up to four body parts and four kinds of injuries

Injury episodes for persons who had at least one injury during the past 3 months

2000-2003

FIJ.050

At the time, what part(s) of {your/subject’s name}’s body was/were hurt? What kind of injury/poisoning was it? Anything else?

Verbatim response. Respondents can list up to four body parts and four kinds of injuries or poisonings

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004

This became separate questions that only ask about injuries. This injury information can now be found in questions FIJ.070_00.000 – FIJ.079_00.000.

2004-present

FIJ.070_00.000

In this injury, what parts of [fill: your/ALIAS’s] body were hurt? (Record up to 4 responses)

(01) Ankle (02) Back (03) Buttocks (04) Chest (05) Ear (06) Elbow (07) Eye (08) Face (09) Finger/thumb (10) Foot (11) Forearm (12) Groin (13) Hand (14) Head (not face) (15) Hip (16) Jaw (17) Knee (18) Lower leg (19) Mouth (20) Neck (21) Nose (22) Shoulder (23) Stomach (24) Teeth (25) Thigh (26) Toe (27) Upper arm (28) Wrist (29) Other, specify (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.071_00.000

What other parts of the body were hurt?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, where some “other” part of the body was hurt

2004-present

FIJ.072_00.000

In what way was [fill1: your/ALIAS’s] [fill2: first recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt? (Record up to 2 responses)

(01) Broken bone or fracture (02) Sprain, strain, or twist (03) Cut (04) Scrape (05) Bruise (06) Burn (07) Insect bite (08) Animal bite (09) Other, specify (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where a first body part was reported to be hurt

2004-present

FIJ.073_00.000

How was [fill1: your/ALIAS’s] [fill2: first recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, where a first body part was reported to be hurt in some “other” way

2004-present

FIJ.074_00.000

In what way was [fill1: your/ALIAS’s] [fill2: second recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt? (Record up to 2 responses)

(01) Broken bone or fracture (02) Sprain, strain, or twist (03) Cut (04) Scrape (05) Bruise (06) Burn (07) Insect bite (08) Animal bite (09) Other, specify (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where a second body part was reported to be hurt

2004-present

FIJ.075_00.000

How was [fill1: your/ALIAS’s] [fill2: second recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, where a second body part was reported to be hurt in some “other” way

2004-present

FIJ.076_00.000

In what way was [fill1: your/ALIAS’s] [fill2: third recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt? (Record up to 2 responses)

(01) Broken bone or fracture (02) Sprain, strain, or twist (03) Cut (04) Scrape (05) Bruise (06) Burn (07) Insect bite (08) Animal bite (09) Other, specify (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where a third body part was reported to be hurt

2004-present

FIJ.077_00.000

How was [fill1: your/ALIAS’s] [fill2: third recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, where a third body part was reported to be hurt in some “other” way

2004-present

FIJ.078_00.000

In what way was [fill1: your/ALIAS’s] [fill2: fourth recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt? (Record up to 2 responses)

(01) Broken bone or fracture (02) Sprain, strain, or twist (03) Cut (04) Scrape (05) Bruise (06) Burn (07) Insect bite (08) Animal bite (09) Other, specify (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, where a fourth body part was reported to be hurt

2004-present

FIJ.079_00.000

How was [fill1: your/ALIAS’s] [fill2: fourth recorded response to question FIJ.070_00.000 or response to question FIJ.071_00.000] hurt?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, where a fourth body part was reported to be hurt in some “other” way

1997-1999

FIJ.070

How did {subject’s name} injury(s) happen? Please describe fully the circumstances or events leading to the injury(s), and any object, substance, or other person involved.

Verbatim response

Injury episodes for persons who had at least one injury during the past 3 months

2000-2003

FIJ.070

How did {your/subject’s name}’s injury/poisoning happen? Please describe fully the circumstances or events leading to the injury/poisoning, and any object, substance, or other person involved.

Verbatim response

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.060_00.000

[fill1: How did [fill2: your/ALIAS’s] [fill3: injury/poisoning] on [fill4: response to questions FIJ.050_01.000 and FIJ.050_02.000 (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000

1997-1999

FIJ.080

This is not a question. The FR is asked to select from a list the one that best describes the person’s injury.

(1) Vehicle as transportation, including Motor Vehicle/bicycle/motorcycle/pedestrian/train/boat/airplane (2) Gun/being shot (3) Fire/burn/scald related (4) Near drowning/water in lungs (5) Fall (6) Other (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months

2000-2003

FIJ.080

This is not a question. The FR is asked to select from a list the one that best describes the person’s injury.

(01) Transportation, including motor vehicle/bicycle/motorcycle/pedestrian/train/boat/airplane (02) Fire/burn/scald related (03) Fall (04) Poisoning (05) Overexertion/strenuous movements (06) Struck by object or person (07) Animal or insect bite (08) Cut/pierce (09) Machinery (10) Other (97) Refused (99) Don’t know

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.065_00.000

This is not a question. The FR is asked to select from a list the one that best describes the person’s injury.

(01) In a motor vehicle (02) On a bike, scooter, skateboard, skates, skis, horse, etc. (03) Pedestrian who was struck by a vehicle such as a car or bicycle (04) In a boat, train, or plane (05) Fall (06) Burned or scalded by substances such as hot objects or liquids, fire, or chemicals (07) Other (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.109_00.000

Did this accident occur on a public highway, street, or road?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, that occurred while in a motor vehicle; while on a bike, scooter, skateboard, skis, horse, etc.; or as a pedestrian struck by a vehicle

1997-2003

FIJ.090

{Were/Was} {you/subject’s name} injured as the driver of a vehicle, a passenger in a vehicle, a bicycle rider, or as a pedestrian?

(1) Driver of a vehicle (2) Passenger of a vehicle (3) Bicycle rider (4) Pedestrian (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months caused by a vehicle used for transportation

2004-present

FIJ.110_00.000

[fill: Were you/Was ALIAS] injured as:

(1) The driver of a motor vehicle (2) A passenger in a motor vehicle (3) A pedestrian (4) A bicycle rider or tricycle rider (5) The rider of a scooter, skateboard, skates, or other non-motorized vehicle (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, that occurred while in a motor vehicle; while on a bike, scooter, skateboard, skis, horse, etc.; or as a pedestrian struck by a vehicle

1997-2002

FIJ.100

What type of vehicle {were/was} {you/subject’s name} in?

(01) Passenger car (02) Light truck (including pickups, vans and utility vehicles) (03) Bus (04) Large truck (05) Motorcycles (including mopeds, minibikes) (06) All terrain vehicle or ski/snow mobile (07) Farm equipment (tractor) (08) Airplane (09) Boat (10) Train (11) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months while a driver or passenger in a vehicle

2003

FIJ.100

What type of vehicle {were/was} {you/subject’s name} in?

(01) Passenger car (02) Light truck (including pickups, vans and utility vehicle/SUVs) (03) Bus (04) Large truck (05) Motorcycles (including mopeds, minibikes) (06) All terrain vehicle or ski/snow mobile (07) Farm equipment (tractor) (08) Airplane (09) Boat (10) Train (11) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months while a driver or passenger in a vehicle

2004-present

FIJ.111_00.000

What type of vehicle {were/was} {you/subject’s name} in?

(01) Passenger car (02) Passenger truck such as a pickup truck, van or SUV (03) Bus (04) Large commercial truck such as a semi-truck, big rig, or 18 wheeler (05) Motorcycles (including mopeds and minibikes) (06) All terrain vehicle or ski/snow mobile (07) Farm equipment (such as tractor) (08) Industrial or construction vehicle (09) Other (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, that occurred while a driver or passenger of a vehicle

1997-2003

FIJ.120

If age is greater than 4 years: {Were/Was} {you/subject’s name} wearing a safety belt at the time of the accident?
If age is less than 5 years: {Were/Was} {you/subject’s name} buckled in a car safety seat at the time of the accident?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months while a driver or passenger in a car or truck

2004-present

FIJ.112_00.000

[fill: Were you/Was ALIAS] restrained at the time of the accident?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, that occurred while a driver or passenger of a car or truck

1997-2003

FIJ.130

{Were/Was} {you/subject’s name} wearing a helmet at the time of the accident?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months while riding a bicycle, motorcycle (including mopeds, minibikes), or an all terrain vehicle or ski/snow mobile

2004-present

FIJ.113_00.000

{Were/Was} {you/subject’s name} wearing a helmet at the time of the accident?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, that occurred while riding a bicycle or tricycle; a scooter, skateboard, skates, or other non-motorized vehicle; a motorcycle; or an all terrain vehicle or ski/snow-mobile

1997-2003

FIJ.140

What type of vehicle {were/was} {you/subject’s name} struck by?

(01) Passenger car (02) Light truck (including pickups, vans and utility vehicles) (03) Bus (04) Large truck (05) Motorcycle (including mopeds, minibikes) (06) All terrain vehicle or ski/snow mobile (07) Farm equipment (tractor) (08) Bicycle (09) Train (10) Boat (includes all on water vehicles) (11) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months that involved being struck by a vehicle while a pedestrian

2004

Question no longer included in the survey.

1997-2003

FIJ.150

What was it that burned/scalded {you/subject’s name}? IF RESPONSE IS FIRE OR SMOKE ASK: What caused the fire/smoke?

(01) Cigarette, cigar, pipe (02) Cooking unit (03) Heater (04) Wiring (05) Motor vehicle battery caps, radiator caps (06) Fireworks (07) Other explosive (08) Water or steam (09) Food (10) Chemicals (11) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months caused by fire/burn/scald related

2004

Question no longer included in the survey.

1997-1999

FIJ.160

What body of water was involved?

(1) Bathtub (2) Swimming pool (3) Lake, pond (4) Bay, ocean, sea (5) River, creek (6) Other (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months that involved water

2000

Question no longer included in the survey.

1997-1999

FIJ.170

How did {you/subject’s name} fall? Anything else? (Record up to 2 responses)

On or down or from: (01) Escalator (02) Stairs or steps (03) Floor/level ground (04) Curb, including sidewalk (05) Ladder or scaffolding (06) Playground equipment (07) Building or other structure (08) Chair, bed, sofa or other furniture (09) Tree (10) Toilet, commode (11) Bathtub, shower Into: (12) Swimming pool (13) Hole or other opening (14) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months due to a fall

2000-2003

FIJ.171

How did {you/subject’s name} fall? Anything else? (Record up to 2 responses)

On, down, from or into: (01) Stairs, steps or escalator (02) Floor/level ground (03) Curb, including sidewalk (04) Ladder or scaffolding (05) Playground equipment (06) Building or other structure (07) Chair, bed, sofa or other furniture (08) Bathtub, shower, toilet or commode (09) Hole or other opening (10) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months due to a fall

2004-present

FIJ.130_00.000

How did {you/subject’s name} fall? Anything else? (Record up to 2 responses)

(01) Stairs, steps or escalator (02) Floor or level ground (03) Curb (including sidewalk) (04) Ladder or scaffolding (05) Playground equipment (06) Sports field, court, or rink (07) Building or other structure (08) Chair, bed, sofa or other furniture (09) Bathtub, shower, toilet or commode (10) Hole or other opening (11) Other (97) Refused (99) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, due to a fall

1997-2003

FIJ.180

What caused {you/subject’s name} to fall? Was it due to:

(1) Slipping, tripping or stumbling (2) Jumping or diving (3) Collision with/pushing, shoving by another person (4) Loss of balance/dizziness/becoming faint/seizure (5) Or something else (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months due to a fall

2004-present

FIJ.131_00.000

What caused [fill: you/ALIAS] to fall?

(1) Slipping or tripping (2) Jumping or diving (3) Bumping into an object or another person (4) Being shoved or pushed by another person (5) Loss of balance or having dizziness (becoming faint or having a seizure) (6) Other (7) Refused (9) Don’t know

All medically-consulted injury episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, due to a fall

1997-1999

FIJ.190

What kind of gun was it?

(1) Firearm (handgun, shotgun, rifle) (2) BB or pellet gun (3) Dart gun (4) Other (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months due to a gun/being shot

2000

Question no longer included in the survey.

2000-2003

FIJ.191

What type of animal or insect bit {you/subject’s name}?

(01) Dog (02) Cat (03) Poisonous snake/reptile (04) Nonpoisonous snake/reptile (05) Unknown snake/reptile (06) Poisonous insect (07) Nonpoisonous insect (08) Unknown insect (09) Rodent (10) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months due to an animal or insect bite

2004

Question no longer included in the survey.

1997-1999

FIJ.200

What {were/was} {you/subject’s name} doing when the injury(s) happened? (Record up to 2 responses)

(01) Driving (02) Working at paid job (03) Working around the house or yard (04) Attending school (05) Unpaid work (incl. housework, shopping, volunteer work) (06) Sports (organized team or individual sport such as running, biking, skating) (07) Leisure activity (excluding sports) (08) Sleeping, resting, eating, drinking (09) Cooking (10) Being cared for (hands on care from other person) (11) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months

2000-2003

FIJ.200

What {were/was} {you/subject’s name} doing when the injury/poisoning happened? (Record up to 2 responses)

(01) Driving or riding in a motor vehicle (02) Working at paid job (03) Working around the house or yard (04) Attending school (05) Unpaid work (incl. housework, shopping, volunteer work) (06) Sports (organized team or individual sport such as running, biking, skating) (07) Leisure activity (excluding sports) (08) Sleeping, resting, eating, drinking (09) Cooking (10) Being cared for (hands on care from other person) (11) Other (97) Refused (99) Don’t know

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.150_00.000

What activity [fill1: were you/was ALIAS] involved in at the time of the [fill2: injury/poisoning]? (Record up to 2 responses)

(01) Driving or riding in a motor vehicle (02) Working at a paid job (03) Working around the house or yard (04) Attending school (05) Unpaid work (such as volunteer work) (06) Sports and exercise (07) Leisure activity (excluding sports) (08) Sleeping, resting, eating, or drinking (09) Cooking (10) Being cared for (hands-on care from other person) (11) Other, please specify (97) Refused (99) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.151_00.000

What other activity [fill1: were you/was ALIAS] involved in at the time of the [fill2: inury/poisoning]?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, involving some “other” activity at the time

1997-1998

FIJ.220

Where (were/was} {you/subject’s name} when the injury(s) happened? (Record up to 2 responses)

(01) Home (inside) (02) Home (outside) (03) School (not residential) (04) Child care center or preschool (05) Residential institution (excl. hospital) (06) Health care facility (incl. hospital) (07) Street/highway (08) Parking lot (09) Sport facility, ath. field or playground (10) Trade and service areas (restaurant, store, bank, gas station) (11) Farm (12) Park/recreation area (fields, bike or jog path) (13) River/lake/stream/ocean (14) Swimming pool (15) Industrial or construction area (16) Mine/quarry (17) Other public building (18) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months

1999

FIJ.220

Where (were/was} {you/subject’s name} when the injury(s) happened? (Record up to 2 responses)

(01) Home (inside) (02) Home (outside) (03) School (not residential) (04) Child care center or preschool (05) Residential institution (excl. hospital) (06) Health care facility (incl. hospital) (07) Street/highway (08) Parking lot (09) Sport facility, ath. field or playground (10) Trade and service areas (shopping center, restaurant, store, bank, gas station) (11) Farm (12) Park/recreation area (fields, bike or jog path) (13) River/lake/stream/ocean (14) Swimming pool (15) Industrial or construction area (16) Mine/quarry (17) Other public building (18) Other (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months

2000-2003

FIJ.221

Where (were/was} {you/subject’s name} when the injury/poisoning happened? (Record up to 2 responses)

(01) Home (inside) (02) Home (outside) (03) School (not residential) (04) Child care center or preschool (05) Residential institution (excl. hospital) (06) Health care facility (incl. hospital) (07) Street/highway (08) Parking lot (09) Sport facility, ath. field or playground (10) Trade and service areas (shopping center, restaurant, store, bank, gas station) (11) Farm (12) Park/recreation area (fields, bike or jog path) (13) River/lake/stream/ocean (14) Industrial or construction area (15) Other public building (16) Other (97) Refused (99) Don’t know

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.160_00.000

Where (were/was} {you/subject’s name} when the injury/poisoning happened? (Record up to 2 responses)

(01) Home (inside) (02) Home (outside) (03) School (not residential) (04) Child care center or preschool (05) Residential institution (excl. hospital) (06) Health care facility (incl. hospital) (07) Street/highway (08) Sidewalk (09) Parking lot (10) Sport facility, athletic field, or playground (11) Shopping center, restaurant, store, bank, gas station, or other place of business (12) Farm (13) Park/recreation area (include bike or jog path) (14) River, lake, stream, or ocean (15) Industrial or construction area (16) Other public building (17) Other (97) Refused (99) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

1997-1999

FIJ.240

{Were/Was} {you/subject’s name} hospitalized for at least one night as a result of this injury/these injuries?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months

2000-2003

No longer a separate question. Now included as a response category for question FIJ.045

2004-present

FIJ.090_00.000

F1[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

1997-1999

FIJ.250

How many nights {were/was} {you/subject’s name} in the hospital?

(01-94) 1-94 nights (95) 95+ nights (97) Refused (99) Don’t know

Injury episodes for persons who had at least one injury during the past 3 months that resulted in hospitalization

2000-2003

FIJ.047

How many nights {were/was} {you/subject’s name} in the hospital?

(01-94) 1-94 nights (95) 95+ nights (97) Refused (99) Don’t know

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months that resulted in hospitalization

2004-present

FIJ.091_00.000

How many nights {were/was} {you/subject’s name} in the hospital?

(01-94) 1-94 nights (95) 95+ nights (97) Refused (99) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, resulting in hospitalization

2004-present

FIJ.170_00.000

At the time of this [fill1: injury/poisoning], [fill2: were you/was ALIAS] employed full-time, part-time, or not employed?

(1) Full-time (2) Part-time (3) Not employed (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000 to persons 13 years of age or older

1997-1999

FIJ.260

As a result of this injury/these injuries, how much work did{you/subject’s name} miss?

(0) None (1) Less than 1 day (2) 1 to 5 days (3) Six or more days (6) Not employed at the time of the injury (7) Refused (9) Don’t know

Injury episodes for persons > 13 years who had at least one injury during the past 3 months

2000-2003

FIJ.260

As a result of this injury/poisoning, how much work did {you/subject’s name} miss?

(1) Not employed at the time of the injury/poisoning (2) None (3) Less than 1 day (4) 1 to 5 days (5) Six or more days (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 13 years who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.171_00.000

As a result of this [fill1: injury/poisoning], how many days of work did [fill2: you/ALIAS] miss?

(1) None (2) Less than one day (3) One to five days (4) Six or more days (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000 to persons 13 years of age or older, where the person was employed at the time

2004-present

FIJ.180_00.000

At the time of this [fill1: injury/poisoning], [fill2: were you/was ALIAS] a full-time student, part-time student or not a student?

(1) Full-time (2) Part-time (3) Not a student (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000 to persons 5 years of age or older

1997-1999

FIJ.270

As a result of this injury/these injuries, how much school did {you/subject’s name} miss?

(0) None (1) Less than 1 day (2) 1 to 5 days (3) Six or more days (6) Not in school at the time of the injury (7) Refused (9) Don’t know

Injury episodes for persons > 4 years who had at least one injury during the past 3 months

2000-2003

FIJ.270

As a result of this injury/poisoning, how much school did {you/subject’s name} miss?

(1) Not in school at the time of the injury/poisoning (2) None (3) Less than 1 day (4) 1 to 5 days (5) Six or more days (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 4 years who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.181_00.000

As a result of this [fill1: injury/poisoning], how many days of school did [fill2: you/ALIAS] miss?

(1) None (2) Less than one day (3) One to five days (4) Six or more days (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000 to persons 5 years of age or older, where the person was a student at the time

1997-1999

FIJ.280

As a result of this injury/theses injuries {do/does}{you/subject’s name} now need the help of other persons with {your/his/her} personal care needs, such as eating, bathing, dressing or getting around this home?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons > 4 years who had at least one injury during the past 3 months

2000-2003

FIJ.280

As a result of this injury/poisoning {do/does}{you/subject’s name} now need the help of other persons with {your/his/her} personal care needs, such as eating, bathing, dressing, or getting around this home?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 4 years who had at least one injury or poisoning during the past 3 months

2004

Question no longer included in the survey.

1997-1999

FIJ.285

Do you expect {you/subject’s name} will need this help for a total of 6 months or longer?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons > 4 years who had at least one injury during the past 3 months that caused ADL limitations

2000-2003

FIJ.285

Do you expect {you/subject’s name} will need this help for a total of 6 months or longer?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 4 years who had at least one injury or poisoning during the past 3 months that caused ADL limitations

2004

Question no longer included in the survey.

1997-1999

FIJ.290

As a result of this injury/these injuries {do/does} {you/subject’s name} now need the help of other persons in handling routine needs such as everyday household chores, doing necessary business, shopping or getting around for other purposes?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons > 4 years who had at least one injury during the past 3 months

2000-2003

FIJ.290

As a result of this injury/poisoning {do/does} {you/subject’s name} now need the help of other persons in handling routine needs such as everyday household chores, doing necessary business, shopping or getting around for other purposes?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 4 years who had at least one injury or poisoning during the past 3 months

2004

Question no longer included in the survey.

1997-1999

FIJ.295

Do you expect {you/subject’s name} will need this help for a total of 6 months or longer?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury episodes for persons > 4 years who had at least one injury during the past 3 months that caused IADL limitations

2000-2003

FIJ.295

Do you expect {you/subject’s name} will need this help for a total of 6 months or longer?

(1) Yes (2) No (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 4 years who had at least one injury or poisoning during the past 3 months that caused IADL limitations

2004

Question no longer included in the survey.

1997-1999

FIJ.300

The next questions are about POISONING, which includes coming into contact with harmful substances, and overdose or wrong use of any drug or medication. Do not include any illnesses such as poison ivy or food poisoning. DURING THE PAST THREE MONTHS, that is since {91 days before today’s date}, did {you/anyone in the family} have a poisoning that caused someone to seek medical advice or treatment, including calls to a poison control center?

(1) Yes (2) No (7) Refused (9) Don’t know

All families

2000-2003

FIJ.010

In this next set of questions, I will ask about INJURIES AND POISONINGS that happened in the PAST THREE MONTHS; that REQUIRED MEDICAL ADVICE OR TREATMENT, including calls to a poison control center.
DURING THE PAST THREE MONTHS, that is since {91 days before today’s date}, {were/was} {you/anyone in the family} injured or poisoned seriously enough that {you/they} got medical advice or treatment?

(1) Yes (2) No (7) Refused (9) Don’t know

All families

2004-present

FIJ.020_00.000

DURING THE PAST THREE MONTHS, that is since [fill1: (date 91 days before today’s date)], [fill2: were you/was anyone in your family] poisoned by swallowing or breathing in a harmful substance such as bleach, carbon monoxide, or too many pills or drugs? Do not include food poisoning, sun poisoning, or poison ivy rashes.

(1) Yes (2) No (7) Refused (9) Don’t know

All families

1997-1999

FIJ.310

Who was this? (Anyone else?)

Assigned family number of person who was poisoned

All persons

2000-2003

FIJ.020

Who was this? (Anyone else?)

Assigned family number of person who was injured or poisoned

All persons

2004-present

FIJ.022_00.000

Who was this? (Anyone else?)

Assigned family number of person who was poisoned

All persons

2004-present

FIJ.024_00.000

DURING THE PAST THREE MONTHS, how many different times [fill: were you/was ALIAS] poisoned? Do not include food poisoning, sun poisoning, or poison ivy rashes.

(01-91) 1-91 times (97) Refused (99) Don’t know

All persons poisoned during the past 3 months

2004-present

FIJ.026_00.000

Did [fill1: you /ALIAS] talk to or see a medical professional about [fill2: any of these poisonings/this poisoning/your poisoning or poisonings/his poisoning or poisonings/her poisoning or poisonings]?

(1) Yes (2) No (7) Refused (9) Don’t know

All persons with at least one or an unknown number of poisoning episodes during the past 3 months

1997-1999

FIJ.320

How many different times in the PAST THREE MONTHS {were/was}{you/subject’s name} poisoned?

(01-94) 1-94 times (95) 95+ times (97) Refused (99) Don’t know

Persons who were poisoned during the past 3 months

2000

FIJ.030

How many different times in the PAST THREE MONTHS did {you/subject’s name} SEEK MEDICAL ADVICE because {you/subject’s name} {were/was} injured or poisoned?

01-94 times

Persons who were injured and/or poisoned during the past 3 months

2001-2003

FIJ.030

How many different times in the PAST THREE MONTHS {were/was} {you/subject’s name} injured or poisoned seriously enough to seek medical advice or treatment?

01-94 times

Persons who were injured and/or poisoned during the past 3 months

2004-present

FIJ.028_00.000

Of [fill1: the number of times reported in question FIJ.024_00.000/all the] times that [fill2: you were/ALIAS was] poisoned, how many of those times was the poisoning serious enough that a medical professional was consulted?

(01-91) 1-91 times (97) Refused (99) Don’t know

All persons who consulted a medical professional for their poisoning episode(s)

1997

FIJ.330

If only one poisoning: When did {subject’s name} poisoning happen?
If more than one poisoning: Now I’m going to ask a few question about {subject’s name} most recent poisoning. When did that poisoning happen? We just talked about {subject’s name} poisoning on {recent poisoning date}. When did {subject’s name} poisoning BEFORE THAT happen?

Month: (1) January (2) February (3) March (4) April (5) May (6) June (7) July (8) August (9) September (10) October (11) November (12) December (97) Refused (99) Don’t know
Day: (01-31) 1-31 (97) Refused (99) Don’t know
Year: (1996-1998) 1996-1998 (9997) Refused (9999) Don’t know

Poison episodes for persons who had at least onepoisoning during the past 3 months

1998

Same as 1997

Same as 1997

Same as 1997 except Year changed to 1997-1999

Same as 1997

1999

Same as 1997

Same as 1997

Same as 1997 except Year changed to 1998-2000

Same as 1997

2000

FIJ.040

If only one injury/poisoning: Now I’m going to ask a few questions about {your/subject’s name}’s most recent injury/poisoning. When did it happen?
If there are additional injuries/poisonings: We just talked about {your/subject’s name}’s injury/poisoning on {recent injury/poisoning date}. When did {your/subject’s name}’s injury/poisoning BEFORE THAT happen?

Same as 1997 except Year changed to 1999-2001

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2001

Same as 2000

Same as 2000

Same as 1997 except Year changed to 2000-2002

Same as 2000

2002

Same as 2000

Same as 2000

Same as 1997 except Year changed to 2001-2003

Same as 2000

2003

Same as 2000

Same as 2000

Same as 1997 except Year changed to 2002-2004

Same as 2000

2004

FIJ.050_01.000
FIJ.050_02.000
FIJ.050_03.000

{if only 1 injury/poisoning episode for the person}: When did [fill1: your/ALIAS’s] [fill2: injury/poisoning] happen for which a medical professional was consulted?
{first of multiple injury/poisoning episodes for the person}: Now I’m going to ask a few questions about the [fill3: the number of times injured/poisoned reported in question FIJ.018_00.00/FIJ.028_00.000] times [fill4: you were/ALIAS was[fill5: injured/poisoned] for which a medical professional was consulted. Starting with the most recent time, when did this [fill2: injury/poisoning] happen?
{second plus of multiple injury/poisoning episodes for the person}: You just told me about [fill1: your/ALIAS’s] [fill6: (month, day of previous event)] [fill7:most recent/second most recent/third most recent/fourth most recent][fill2: injury/poisoning]. What was the date of the [fill2: injurybefore that for which a medical professional was consulted?

Month: (1) January (2) February (3) March (4) April (5) May (6) June (7) July (8) August (9) September (10) October (11) November (12) December (97) Refused (99) Don’t know
Day: (01-31) 1-31 (97) Refused (99) Don’t know
Year: (2003-2005) 2003-2005 (9997) Refused (9999) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2005-present

Same as 2004

Same as 2004

Same as 2004 except Year changed to the year before the current survey year, the current survey year, and the year after the current survey year; for example, if the survey year is 2005 then the values for Year would be 2004-2006

Same as 2004

1997-1999

FIJ.340

Did {you/subject’s name} poisoning result from:

(1) A drug or medical substance used mistakenly or in overdose (2) A harmful or toxic solid or liquid substance (3) Inhaling gases or vapors (4) Eating a poisonous plant or other substance mistaken for food (5) A venomous animal or plant (6) Something else (7) Refused (9) Don’t know

Poison episodes for persons who had at least one poisoning during the past 3 months

2000-2003

FIJ.195

Did {you/subject’s name} poisoning result from:

(01) A drug or medical substance used mistakenly or in overdose (02) A harmful or toxic solid or liquid substance (03) Inhaling gases or vapors (04) Eating a poisonous plant or other substance mistaken for food (05) A venomous animal or plant (06) Food poisoning (07) Allergic reaction (08) Something else (97) Refused (99) Don’t know

Poison episodes for persons who had at least one poisoning during the past 3 months

2004-present

FIJ.140_00.000

What did [fill: your/ALIAS’s] poisoning result from?

(01) Swallowing a drug or medical substance mistakenly or in overdose (02) Swallowing or touching a harmful solid or liquid substance (03) Inhaling harmful gases or vapors (04) Eating a poisonous plant or other substance mistaken for food (05) Being bitten by a poisonous animal (06) Other, specify (7) Refused (9) Don’t know

All medically-consulted poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

2004-present

FIJ.141_00.000

How did [fill: your/ALIAS’s] poisoning occur?

Verbatim response (7) Refused (9) Don’t know

All medically-consulted poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000, involving some “other” cause of the poisoning

1997-1999

FIJ.350

Not a question. Description of how the poisoning happened

Verbatim response

Poison episodes for persons who had at least one poisoning during the past 3 months

2000-2003

FIJ.070

How did {your/subject’s name}’s injury/poisoning happen? Please describe fully the circumstances or events leading to the injury/poisoning, and any object, substance, or other person involved.

Verbatim response

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.060_00.000

[fill1: How did [fill2: your/ALIAS’s] [fill3: injury/poisoning] on [fill4: response to questions FIJ.050_01.000 and FIJ.050_02.000 (starting with most recent if multiple)] happen?/How did this [fill3: injury/poisoning] happen?] Please describe fully the circumstances or events leading to the [fill3: injury/poisoning], and any objects, substances, or other people involved.

Verbatim response (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01 to FIJ.028_00.000

1997-1999

FIJ.360

Did you or did someone else call a poison control center for advice in treating {subject’s name} poisoning?

(1) Yes (2) No (7) Refused (9) Don’t know

Poison episodes for persons who had at least one poisoning during the past 3 months

2000-2003

Combined with injury question. No longer a separate question. Now included as a response category for question FIJ.045

2004-present

FIJ.080_01.000

Did [fill: you/ALIASget MEDICAL ADVICE, TREATMENT, or FOLLOW-UP CARE for this poisoning from.. A phone call to a poison control center?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

1997-1999

FIJ.370

{Were/Was} {you/subject’s name} hospitalized for at least one night as a result of this poisoning?

(1) Yes (2) No (7) Refused (9) Don’t know

Poison episodes for persons who had at least one poisoning during the past 3 months

2000-2003

Combined with injury question. No longer a separate question. Now included as a response category for question FIJ.045

2004-present

FIJ.090_00.000

F1[fill1: Were you/Was ALIAS] hospitalized for at least one night as a result of this [fill2: injury/poisoning]?

(1) Yes (2) No (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000

1997-1999

FIJ.380

How many nights {were/was} {you/subject’s name} in the hospital?

(01-94) 1-94 nights (95) 95+ nights (97) Refused (99) Don’t know

Poison episodes for persons who had at least one poisoning during the past 3 months that resulted in hospitalization

2000-2003

FIJ.047

How many nights {were/was} {you/subject’s name} in the hospital?

(01-94) 1-94 nights (95) 95+ nights (97) Refused (99) Don’t know

Injury and/or poisoning episodes for persons who had at least one injury or poisoning during the past 3 months that resulted in hospitalization

2004-present

FIJ.091_00.000

How many nights {were/was} {you/subject’s name} in the hospital?

(01-94) 1-94 nights (95) 95+ nights (97) Refused (99) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000, resulting in hospitalization

1997-1999

FIJ.400

As a result of this poisoning, how much work did {you/subject’s name} miss?

(0) None (1) Less than 1 day (2) 1 to 5 days (3) Six or more days (6) Not employed at the time of the poisoning (7) Refused (9) Don’t know

Poison episodes for persons > 13 years who had at least one poisoning during the past 3 months

2000-2003

FIJ.260

As a result of this injury/poisoning, how much work did {you/subject’s name} miss?

(1) Not employed at the time of the injury/poisoning (2) None (3) Less than 1 day (4) 1 to 5 days (5) Six or more days (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 13 years who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.171_00.000

As a result of this [fill1: injury/poisoning], how many days of work did [fill2: you/ALIAS] miss?

(1) None (2) Less than one day (3) One to five days (4) Six or more days (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000 to persons 13 years of age or older, where the person was employed at the time

1997-1999

FIJ.410

As a result of this poisoning, how many days of school did {you/subject’s name} miss?

(0) None (1) Less than 1 day (2) 1 to 5 days (3) Six or more days (6) Not in school at the time of the poisoning (7) Refused (9) Don’t know

Poison episodes for persons > 4 years who had at least one poisoning during the past 3 months

2000-2003

FIJ.270

As a result of this injury/poisoning, how much school did {you/subject’s name} miss?

(1) Not in school at the time of the injury/poisoning (2) None (3) Less than 1 day (4) 1 to 5 days (5) Six or more days (7) Refused (9) Don’t know

Injury and/or poisoning episodes for persons > 4 years who had at least one injury or poisoning during the past 3 months

2004-present

FIJ.181_00.000

As a result of this [fill1: injury/poisoning], how many days of school did [fill2: you/ALIAS] miss?

(1) None (2) Less than one day (3) One to five days (4) Six or more days (7) Refused (9) Don’t know

All medically-consulted injury/poisoning episodes that reportedly occurred during the past 3 months based on responses to family level questions FIJ.010_01.000 to FIJ.028_00.000 to persons 5 years of age or older, where the person was a student at the time

* The response categories listed are those found in the questionnaire. During the editing process, an additional category of “Not ascertained” (8, 98, 998, or 9998) was added to account for persons who did not select any of the response categories associated with the question.

Page last reviewed: November 6, 2015