Protocol - Water Source
The respondent is asked a series of questions about the homes source of drinking water, such as if the water comes from a communitys supply or a private well, the depth of the well, if the well is cased, and whether water filtration/treatment devices are used.
1. What was the primary source of drinking water [at your current residence]? (Only indicate one below)
1 [ ] Private Well (Continue)
2 [ ] Community Supply (Go to #4)
3 [ ] Bottled Water (Go to #4)
4 [ ] Other (Specify) ___________________ (Go to #4)
2. What was the depth of the private well? (Only indicate one below)
1 [ ] Less than 50 Feet
2 [ ] 50-100 Feet
3 [ ] 151-250 Feet
4 [ ] 251-500 Feet
5 [ ] 501 Feet or More
9 [ ] Don’t Know
3. Was the private well cased? (Only indicate one below)
1 [ ] Cased
2 [ ] Not Cased
9 [ ] Don’t Know
4. Are any of the water treatment devices listed on this card used in your home?
1 [ ] YES
2 [ ] NO
7 [ ] REFUSED
9 [ ] DON’T KNOW
5. Which of these water treatment devices are now used in your home?
REFER TO HAND CARD Q4
CODE ALL THAT APPLY
1 [ ] BRITA OR OTHER PITCHER WATER FILTER
2 [ ] CERAMIC OR CHARCOAL FILTER
3 [ ] WATER SOFTENER
4 [ ] AERATOR
5 [ ] REVERSE OSMOSIS
7 [ ] REFUSED
9 [ ] DON’T KNOW
Personnel and Training Required
The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews.*
* There are multiple modes to administer this question (e.g., paper-and-pencil and computer-assisted interviews).
The source instruments were developed to be administered via paper-and-pencil and a computer-assisted interview. The PhenX Working Group acknowledges these questions can be administered in either method. Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer or handheld computer to administer a computer-assisted questionnaire.
|Specialized requirements for biospecimen collection||No|
|Average time of greater than 15 minutes in an unaffected individual||No|
Mode of Administration
Adult 18+ who resides in the house
A protocol that includes questions about the water source and filtration systems provides more detailed information about the potential contaminants of the respondent’s drinking water.
Chinese, English, Other languages available at source
|caDSR Common Data Elements (CDE)||Person Home Water Source Text||2954138||CDE Browser|
|Logical Observation Identifiers Names and Codes (LOINC)||Environ exp water source proto||62516-0||LOINC|
Process and Review
The Expert Review Panel #2 (ERP 2) reviewed the measures in the Demographics, Environmental Exposures, and Social Environments domains.
Guidance from ERP 2 includes:
• Revised descriptions of the measure
Back-compatible: no changes to Data Dictionary
Previous version in Toolkit archive (link)
Protocol Name from Source
The Iowa Study of Environment and Health; National Health and Nutrition Examination Survey, 2005-2006
Lynch, C. Iowa Study of Environment and Health. Iowa City, IA: University of Iowa Medical School. Next-of-Kin Questionnaire, Question numbers 11–13 (source for Questions 1–3 in Protocol Text).
Centers for Disease Control and Prevention, National Center for Health Statistics. National Health and Nutrition Examination Survey. NHANES 2005–2006. Housing Characteristics Questionnaire, Question numbers HOQ.080, HOQ.083 (source for Questions 4 and 5 in Protocol Text).
U.S. Environmental Protection Agency. (2006). Ground water and drinking water: Drinking water standards. Washington, DC: Author.
|Variable Name||Variable ID||Variable Description||dbGaP Mapping|
|PX060201010000||What was the primary source of drinking more||Variable Mapping|
|PX060201010100||What was the primary source of drinking more||Variable Mapping|
|PX060201050000||Which of these water treatment devices are more||N/A|
|PX060201040000||Are any of the water treatment devices more||N/A|
|PX060201030000||Was the private well cased?||N/A|
|PX060201020000||What was the depth of the private well?||N/A|
October 30, 2009
Questions asking about the drinking water source and use of water filtration systems in the respondent’s home.
Some water sources contain contaminants and disinfection byproducts that may adversely affect a person’s health. Public (municipal) water systems receive disinfection and other treatments that may remove some contaminants to comply with the Environmental Protection Agency (EPA) drinking water regulations. Private wells are not regulated by EPA and can contain high levels of potentially dangerous chemicals such as arsenic, nitrate, and pesticides. The likelihood that a private well has contaminants differs by well depth, well construction, location, and characteristics of the soil and aquifer. Additional information about the type of water filtration system used by the household is also valuable because the effectiveness of contaminant removal varies by type of filtration system.
water source, Environmental Exposures, National Center for Health Statistics, NCHS, Centers for Disease Control and Prevention, CDC, Drinking Water, Private Well, Community Water, Iowa Study of Environment and Health, National Health and Nutrition Examination Survey, NHANES
|Protocol ID||Protocol Name|