N˚ | Questions | Codes | Answer | ||
General Information | |||||
Q1 | Record number |
| |_________| | ||
Q2 | Date of registration | Date of registration in the study | |___|___|___| | ||
Q3 | Personnel number | Give the participant’s registration number in the structure | |_________| | ||
Q4 | Phone number | ............................................................... | |||
Socio-demographic characteristics | |||||
Q5 | Age (Years) | Number of years completed | |_________| | ||
Q6 | Sex | Female = 0; Male = 1 | |_________| | ||
Q7 | Nationality | Beninese = 0; Others = 1(Specify.............) | |_________| | ||
Q8 | Marital status | Single = 0; Couple = 1; Divorced = 2; Widowed = 3 | |_________| | ||
Q13 | Level of education | Never attended = 0; Literate = 1; Primary = 2; Secondary = 3; Higher = 4 | |_________| | ||
Work center information | |||||
Q14 | How many years have you been working in the milling factory of Dantokpa market? | Specify the number of years of exercise; 999 if not applicable | |_________| | ||
Q15 | What is your professional status? | Mill owner = 0 Serving a leader = 1 | |_________| | ||
Q16 | How many hours do you work a day? | 1-2 years = 0 More than 2 years = 1 | |_________| | ||
Q17 | Noise level measurement at the station | Inf 85 dB = 0 85 - 90 dB = 1 Sup 90 dB = 2 | |_________| | ||
Q18 | Do you have personal protective equipment (PPE) against noise? | No = 0; Yes = 1 |
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Q19 | If yes, name them and show them |
| |_________| | ||
Q20 | Does your job require you to be in constant noise all day? | No = 0; Yes = 1 |
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Q21 | Do you take a break at your workstation? | No = 0; Yes = 1 |
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Q22 | If so, what do you do during the break? | You stay at the station = 1 |
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| You are leaving the position = 2 Other to be specified = 3 |
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Q23 | Do you have any activities outside of milling that expose you to noise? | No = 0; Yes = 1 | |_________| | ||
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Background |
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Q24 | What is your smoking status? | Non-smoker = 0; Current smoker = 1; Ex-smoker = 2; Passive smoker = 3 | |_________| | ||
Q25 | Do you have an ENT history before starting to work in the milling industry? (otitis, tympanic perforation, trauma) | No = 0; Yes = 1 | |_________| | ||
Complaints |
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Q26 | Do you speak normally at work to make yourself heard? | No = 0; Yes = 1 | |_________| | ||
Q27 | Do you know the health effects of noise? | Acute cough = 0; Chronic dry cough = 1; Chronic productive cough = 2; Not applicable = 9 | |_________| | ||
| After 8 hours of work do you experience the following symptoms? | No = 0; Yes = 1 | |_________| | ||
Q28 | Headaches | No = 0; Yes = 1 | |_________| | ||
Q29 | Ringing/whistling in the ears | No = 0; Yes = 1 | |_________| | ||
Q30 | Sensation of hearing loss | No = 0; Yes = 1 | |_________| | ||
Q31 | Fatigue | No = 0; Yes = 1 | |_________| | ||
Q32 | Perceived stress (visual stress scale reading) | No = 0; Yes = 1 | |_________| | ||
Q33 | Irritability | No = 0; Yes = 1 | |_________| | ||
Q34 | Sleep disorder | No = 0; Yes = 1 | |_________| | ||
Q35 | Dizziness | No = 0; Yes = 1 | |_________| | ||
Q36 | Palpitation | No = 0; Yes = 1 | |_________| | ||
Q37 | Anxiety | No = 0; Yes = 1 | |_________| | ||
Q38 | Concentration problems | No = 0; Yes = 1 | |_________| | ||
General review |
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Q39 | Weight (kgs) |
| |_________| | ||
Q40 | Size (cm) |
| |_________| | ||
Q41 | Body mass index (kg/m²) |
| |_________| | ||
Q42 | Systolic blood pressure (mmHg) |
| |_________| | ||
Q43 | Diastolic blood pressure (mmHg) |
| |_________| | ||
Physical examination |
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Q44 | Otoscopic examination | Normal = 0 ; Abnormal = 1 (discharge, inflamed EAC, AOM, perforated eardrum) | |_________| | ||
Audiometric results |
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