0 Ratings

ID

27662

Description

The occupational health check provides information about possibly unhealthy or hazardous working conditions. In this way it can aid in the improvement of work places, the reduction of risks as well as in the early detection and prevention of work-related health problems. The aim is to ensure employability and occupational health protection. https://www.medituev.de/de/arbeitsmedizin/vorsorge/ TÜV Nord MEDITUEV. Provided by Dr. med. Rudolf Richter.

Link

https://www.medituev.de/de/arbeitsmedizin/vorsorge/

Keywords

  1. 25.11.17 25.11.17 -
  2. 27.11.17 27.11.17 -
Copyright Holder

TÜV Nord MEDITUEV

Uploaded on

25. November 2017

DOI

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License

Creative Commons BY-NC 3.0

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    MEDITUEV Occupational health check

    MEDITUEV Occupational health check

    Personal data
    Description

    Personal data

    Name
    Description

    Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C0027365
    First Name
    Description

    First Name

    Data type

    text

    Alias
    UMLS CUI [1]
    C1443235
    Date of birth
    Description

    Date of birth

    Data type

    date

    Alias
    UMLS CUI [1]
    C0421451
    Birth name
    Description

    birth name

    Data type

    text

    Alias
    UMLS CUI [1]
    C1549652
    Street address (street/number)
    Description

    street address

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C1301826
    UMLS CUI [1,2]
    C0421449
    Postal code code/place of residence
    Description

    postal code code and place of residence

    Data type

    text

    Telephone number
    Description

    telephone number

    Data type

    text

    Alias
    UMLS CUI [1]
    C1515258
    Sex
    Description

    sex

    Data type

    text

    Alias
    UMLS CUI [1]
    C0150831
    Date of employment (month/year)
    Description

    Date of employment

    Data type

    text

    Nationality
    Description

    Nationality

    Data type

    text

    Alias
    UMLS CUI [1]
    C0027473
    Employer
    Description

    Employer

    Data type

    text

    Alias
    UMLS CUI [1]
    C1274022
    Health insurance
    Description

    Health insurance

    Data type

    text

    Alias
    UMLS CUI [1]
    C0021682
    General practitioner
    Description

    General practitioner

    Data type

    text

    Alias
    UMLS CUI [1]
    C0017319
    Work history
    Description

    Work history

    1. Profession you were trained in?
    Description

    Professional training

    Data type

    text

    Alias
    UMLS CUI [1]
    C2698884
    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    Former occupations
    Description

    Former occupations

    2. Please state any former occupations (incl. military service) that you pursued for more than one year.
    Description

    Previous occupations

    Data type

    text

    Alias
    UMLS CUI [1]
    C0028811
    2. Beginning (year)
    Description

    Beginning year

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0439659
    2. End (year)
    Description

    End year

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0806020
    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0947611
    UMLS CUI [1,2]
    C0031831
    Current occupation
    Description

    Current occupation

    3. Which occupation/function are you supposed to take up?
    Description

    Current occupation

    Data type

    text

    Alias
    UMLS CUI [1]
    C0421456
    3. Since when? (year)
    Description

    Beginning year

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0439659
    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    Working conditions
    Description

    Working conditions

    4. What is your usual work place (e.g. office, workshop, warehouse, vehicle fleet, forge, foundry)?
    Description

    Workplace

    Data type

    text

    Alias
    UMLS CUI [1]
    C0162579
    5. Which kind of materials do you work with regularly? (e.g. metal, cement, paint, thinner, gases or other)
    Description

    Working material

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0520510
    UMLS CUI [1,2]
    C0520510
    6. Which work equipment do you use? (e.g. tools, screen, vehicle or other)
    Description

    Work equipment

    Data type

    text

    Alias
    UMLS CUI [1]
    C0220824
    7. Which means of protection do you use (e.g. protective helmet, ear protection, safety shoes, protective clothing)?
    Description

    Protection

    Data type

    text

    Alias
    UMLS CUI [1]
    C0262668
    8. Working hours
    Description

    Working hours

    Data type

    integer

    Alias
    UMLS CUI [1]
    C2135639
    9. Do you do shift work?
    Description

    shift work

    Data type

    integer

    Alias
    UMLS CUI [1]
    C1658633
    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    Working capacity
    Description

    Working capacity

    10. Have you ever been incapable to work for more than 14 consecutive days within the last 12 months?
    Description

    Incapacity to work

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C2984044
    11. Do you receive a pension?
    Description

    Pension

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0425022
    14. Do you have a certificate of disability?
    Description

    certificate of disability

    Data type

    integer

    Alias
    UMLS CUI [1]
    C0018576
    14. If yes, what is your degree of disability?
    Description

    degree of disability

    Data type

    integer

    Measurement units
    • %
    Alias
    UMLS CUI [1]
    C0231170
    %
    15. Did you change your workplace due to health-related reasons?
    Description

    health-related change of workplace

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0162579
    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    Medical examinations
    Description

    Medical examinations

    16. Did you ever undergo an occupational health check?
    Description

    Occupational health check

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C2973270
    16. If yes, where?
    Description

    place of occupational health check

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C2973270
    UMLS CUI [1,2]
    C2986042
    17. Have you been X-rayed in recent years?
    Description

    X-ray

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0043309
    17. If yes, which body parts?
    Description

    X-ray body part

    Data type

    text

    Alias
    UMLS CUI [1,1]
    C0043309
    UMLS CUI [1,2]
    C0229962
    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Alias
    UMLS CUI [1]
    C0947611
    18. Which stress factors are/were you exposed to?
    Description

    18. Which stress factors are/were you exposed to?

    1 Heat
    Description

    heat

    Data type

    text

    Alias
    UMLS CUI [1]
    C0018837
    2 Cold, wetness, moisture
    Description

    cold, wetness, moisture

    Data type

    text

    Alias
    UMLS CUI [1]
    C0009264
    UMLS CUI [2]
    C1830752
    UMLS CUI [3]
    C0868994
    3 Gas, fumes, dust, smell
    Description

    gas, fumes, dust, smell

    Data type

    text

    4 Noise [more than 85 dB(A)]
    Description

    noise

    Data type

    text

    5 Solvent
    Description

    solvent

    Data type

    text

    6 Cooling lubricant
    Description

    cooling lubricant

    Data type

    text

    8 Pressure of time
    Description

    pressure of time

    Data type

    text

    9 Bad posture
    Description

    bad posture

    Data type

    text

    10 Hard work
    Description

    hard work

    Data type

    text

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Work-related sources of irritation
    Description

    Work-related sources of irritation

    19 Are there factors that irritate you at your workplace?
    Description

    source of irritation

    Data type

    text

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Please answer the following questions about your personal living conditions
    Description

    Please answer the following questions about your personal living conditions

    20. Do you live together with other people?
    Description

    living with other people

    Data type

    integer

    21. How many children do you have that live with you?
    Description

    Number of children

    Data type

    integer

    21. Age (years)
    Description

    Please state the age of each child.

    Data type

    text

    22. Do you smoke?
    Description

    Smoking

    Data type

    integer

    23. Do you consume alcohol?
    Description

    Alcohol consumption

    Data type

    integer

    24. Do you do sports?
    Description

    sports

    Data type

    integer

    25. What do you do to benefit your health?
    Description

    actions to benefit health

    Data type

    text

    26. Do you go to cancer screenings?
    Description

    cancer screening

    Data type

    integer

    26. When was the last time?
    Description

    year

    Data type

    integer

    27.Have you ever undergone a treatment at a health resort?
    Description

    Treatment at a health resort

    Data type

    integer

    27. When was the last time?
    Description

    year

    Data type

    integer

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Are/were there any diseases in your family?
    Description

    Are/were there any diseases in your family?

    Diabetes
    Description

    Diabetes

    Data type

    boolean

    Hypertension
    Description

    Hypertension

    Data type

    boolean

    Stroke
    Description

    Stroke

    Data type

    boolean

    Alias
    UMLS CUI [1]
    C0038454
    Myocardial infarction
    Description

    Myocardial infarction

    Data type

    boolean

    Allergies/Hypersensitivity to substances, food, etc.
    Description

    Allergies

    Data type

    boolean

    Respiratory diseases
    Description

    Respiratory diseases

    Data type

    boolean

    Gout
    Description

    Gout

    Data type

    boolean

    Deformities
    Description

    Deformities

    Data type

    boolean

    Cancer
    Description

    cancer

    Data type

    boolean

    Other diseases
    Description

    Other disease

    Data type

    boolean

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Please answer the following questions about your diseases and health problems
    Description

    Please answer the following questions about your diseases and health problems

    1 Do you suffer from headaches frequently?
    Description

    heachaches

    Data type

    boolean

    2 Do you suffer from lack of appetite?
    Description

    Lack of appetite

    Data type

    boolean

    3 Do you suffer from increased thirst?
    Description

    thirst

    Data type

    boolean

    4 Do you have sleep disturbances?
    Description

    sleep disturbances

    Data type

    boolean

    4 If yes, do you have difficulties falling asleep?
    Description

    difficulty falling asleep

    Data type

    boolean

    4 If yes, do you wake during the night?
    Description

    waking during the night

    Data type

    boolean

    5 Do you have irregular bowel movements?
    Description

    irregular bowel movements

    Data type

    boolean

    6 Do you wear glasses/contact lenses?
    Description

    glasses/contact lenses

    Data type

    boolean

    7 Do you have an eye complaint?
    Description

    Eye complaint

    Data type

    boolean

    8 Is your hearing impaired?
    Description

    impaired hearing

    Data type

    boolean

    9 Do you have ear problems?
    Description

    Ear problems

    Data type

    boolean

    12 Are you prone to diseases of the frontal sinus and the maxillary sinus of the throat?
    Description

    diseases of frontal sinus and maxillary sinus, throat

    Data type

    boolean

    13 Do/did you have a common cold multiple times a year?
    Description

    common cold

    Data type

    boolean

    14 Do you cough frequently (regularly every day)?
    Description

    Cough

    Data type

    boolean

    15 Are you prone to bronchial asthma/bronchitis?
    Description

    bronchial asthma/bronchitis

    Data type

    boolean

    17 Did you ever have pneumonia/pleurisy/tuberculosis?
    Description

    pneumonia, pleurisy, tuberculosis

    Data type

    boolean

    18 Have you ever been diagnosed with hypertension?
    Description

    Hypertension

    Data type

    boolean

    19 Do you suffer from dyspnea?
    Description

    dyspnea

    Data type

    boolean

    20 Do you feel a tightness in the chest (chest pain) during physical stress?
    Description

    Chest tightness

    Data type

    boolean

    21 Did you ever have a myocardial infarction?
    Description

    myocardial infarction

    Data type

    boolean

    22 Do you have other cardiovascular problems?
    Description

    other cardiovascular problems

    Data type

    boolean

    23 Are you prone to dizziness/disturbed balance?
    Description

    dizziness, disturbed balance

    Data type

    boolean

    24 Have you been diagnosed with diabetes?
    Description

    Diabetes

    Data type

    boolean

    25 Were your blood lipid levels ever found to be elevated?
    Description

    elevated blood lipid levels

    Data type

    boolean

    26 Were your uric acid levels ever found to be elevated (gout)?
    Description

    elevated uric acid levels

    Data type

    boolean

    27 Have you ever been diagnosed with a thyroid disease?
    Description

    thyroid disease

    Data type

    boolean

    28 Do you have gastro-intestinal problems/heartburn?
    Description

    gastro-intestinal problems, heartburn

    Data type

    boolean

    30 Do you have bilious complaints?
    Description

    Bilious complaints

    Data type

    boolean

    31 Did you ever have jaundice?
    Description

    jaundice

    Data type

    boolean

    32 Have you been diagnosed with a liver disease?
    Description

    liver disease

    Data type

    boolean

    33 Are you prone to uropathies (kidney, bladder)?
    Description

    uropathy

    Data type

    boolean

    34 Do you have problems when urinating?
    Description

    problems when urinating

    Data type

    boolean

    35 Do you have hemorrhoids?
    Description

    hemorrhoids

    Data type

    boolean

    36 Dou you have varices?
    Description

    varices

    Data type

    boolean

    37 Do you have back pain?
    Description

    back pain

    Data type

    boolean

    37 If yes, where? - 1 cervical spine/neck
    Description

    cervical spine or neck pain

    Data type

    text

    37 If yes, where? - 2 thoracic spine
    Description

    thoracic spine pain

    Data type

    text

    37 If yes, where? - 3 lumbar spine/lower back
    Description

    lumbar spine or lower back pain

    Data type

    text

    38 Do you suffer from lumbago (sciatica)?
    Description

    lumbago

    Data type

    boolean

    39 Did you have a herniated disk?
    Description

    herniated disk

    Data type

    boolean

    40 Do you have pain in any joints or limbs?
    Description

    joint pain/limb pain

    Data type

    boolean

    41 Do you have a seizure disorder?
    Description

    seizure disorder

    Data type

    boolean

    42 Do you have a neurological/psychiatric disease?
    Description

    neurological/psychiatric disease

    Data type

    boolean

    43 Are you prone to dermatoses?
    Description

    dermatosis

    Data type

    boolean

    44 Do you suffer from allergies?
    Description

    Allergies

    Data type

    boolean

    45 Do you have hay fever?
    Description

    hay fever

    Data type

    boolean

    46 Did you have any bone fractures?
    Description

    bone fractures

    Data type

    boolean

    47 Did you have an accident that led to any permanent damage?
    Description

    permanent damage due to accident

    Data type

    boolean

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Surgeries
    Description

    Surgeries

    48. Did you ever undergo surgery?
    Description

    Surgery

    Data type

    boolean

    1 Heart
    Description

    Heart surgery

    Data type

    boolean

    2 Kidney
    Description

    Kidney surgery

    Data type

    boolean

    3 Gallbladder
    Description

    Gallbladder surgery

    Data type

    boolean

    4 Hernia
    Description

    hernia surgery

    Data type

    boolean

    5 Stomach
    Description

    stomach surgery

    Data type

    boolean

    7 Bone
    Description

    bone surgery

    Data type

    boolean

    8 Other surgery
    Description

    other surgery

    Data type

    boolean

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Dental/medical treatment
    Description

    Dental/medical treatment

    49. Are you currently under dental/medical treatment?
    Description

    dental/medical treatment

    Data type

    boolean

    49. If yes, why?
    Description

    dental/medical treatment reason

    Data type

    text

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Vaccination
    Description

    Vaccination

    50. Are you vaccinated against tetanus?
    Description

    tetanus vaccination

    Data type

    boolean

    50. When?
    Description

    year

    Data type

    integer

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Current medication
    Description

    Current medication

    51. Are you taking any medication of at least one of the following types (mutiple selections possible)?
    Description

    Current medication

    Data type

    boolean

    1 Medication for headache
    Description

    medication for headache

    Data type

    boolean

    2 Pain medication
    Description

    pain medication

    Data type

    boolean

    3 Cardiovascular agents
    Description

    Cardiovascular agents

    Data type

    boolean

    4 Laxatives
    Description

    laxatives

    Data type

    boolean

    5 Tranquilizer
    Description

    Tranquilizer

    Data type

    boolean

    6 Sleeping pills
    Description

    sleeping pills

    Data type

    boolean

    7 Stomachic
    Description

    stomachic

    Data type

    boolean

    8 Bronchial medication
    Description

    Bronchial medication

    Data type

    boolean

    9 Other medication
    Description

    other medication

    Data type

    boolean

    9 Which other medication?
    Description

    other medicaton specification

    Data type

    text

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    Miscellaneous
    Description

    Miscellaneous

    52. Other complaints
    Description

    Other complaints

    Data type

    text

    53. Are you pregnant?
    Description

    Pregnancy

    Data type

    integer

    54. Do you undergo gynecological screenings regularly?
    Description

    Gynecological screening

    Data type

    integer

    Comments of physician
    Description

    Comments of physician

    Data type

    text

    General comments
    Description

    General comments

    Data type

    text

    Similar models

    MEDITUEV Occupational health check

    Name
    Type
    Description | Question | Decode (Coded Value)
    Data type
    Alias
    Item Group
    Personal data
    Name
    Item
    Name
    text
    C0027365 (UMLS CUI [1])
    First Name
    Item
    First Name
    text
    C1443235 (UMLS CUI [1])
    Date of birth
    Item
    Date of birth
    date
    C0421451 (UMLS CUI [1])
    birth name
    Item
    Birth name
    text
    C1549652 (UMLS CUI [1])
    street address
    Item
    Street address (street/number)
    text
    C1301826 (UMLS CUI [1,1])
    C0421449 (UMLS CUI [1,2])
    postal code code and place of residence
    Item
    Postal code code/place of residence
    text
    telephone number
    Item
    Telephone number
    text
    C1515258 (UMLS CUI [1])
    Item
    Sex
    text
    C0150831 (UMLS CUI [1])
    Code List
    Sex
    CL Item
    female (female)
    (Comment:en)
    CL Item
    male (male)
    (Comment:en)
    Date of employment
    Item
    Date of employment (month/year)
    text
    Nationality
    Item
    Nationality
    text
    C0027473 (UMLS CUI [1])
    Employer
    Item
    Employer
    text
    C1274022 (UMLS CUI [1])
    Health insurance
    Item
    Health insurance
    text
    C0021682 (UMLS CUI [1])
    General practitioner
    Item
    General practitioner
    text
    C0017319 (UMLS CUI [1])
    Item Group
    Work history
    Professional training
    Item
    1. Profession you were trained in?
    text
    C2698884 (UMLS CUI [1])
    Comments of physician
    Item
    Comments of physician
    text
    C0947611 (UMLS CUI [1])
    Item Group
    Former occupations
    Previous occupations
    Item
    2. Please state any former occupations (incl. military service) that you pursued for more than one year.
    text
    C0028811 (UMLS CUI [1])
    Beginning year
    Item
    2. Beginning (year)
    integer
    C0439659 (UMLS CUI [1])
    End year
    Item
    2. End (year)
    integer
    C0806020 (UMLS CUI [1])
    Comments of physician
    Item
    Comments of physician
    text
    C0947611 (UMLS CUI [1,1])
    C0031831 (UMLS CUI [1,2])
    Item Group
    Current occupation
    Current occupation
    Item
    3. Which occupation/function are you supposed to take up?
    text
    C0421456 (UMLS CUI [1])
    Beginning year
    Item
    3. Since when? (year)
    integer
    C0439659 (UMLS CUI [1])
    Comments of physician
    Item
    Comments of physician
    text
    C0947611 (UMLS CUI [1])
    Item Group
    Working conditions
    Workplace
    Item
    4. What is your usual work place (e.g. office, workshop, warehouse, vehicle fleet, forge, foundry)?
    text
    C0162579 (UMLS CUI [1])
    Working material
    Item
    5. Which kind of materials do you work with regularly? (e.g. metal, cement, paint, thinner, gases or other)
    text
    C0520510 (UMLS CUI [1,1])
    C0520510 (UMLS CUI [1,2])
    Work equipment
    Item
    6. Which work equipment do you use? (e.g. tools, screen, vehicle or other)
    text
    C0220824 (UMLS CUI [1])
    Protection
    Item
    7. Which means of protection do you use (e.g. protective helmet, ear protection, safety shoes, protective clothing)?
    text
    C0262668 (UMLS CUI [1])
    Item
    8. Working hours
    integer
    C2135639 (UMLS CUI [1])
    Code List
    8. Working hours
    CL Item
    normal (1)
    CL Item
    part-time (2)
    CL Item
    often overtime (3)
    CL Item
    hours per week (4)
    Item
    9. Do you do shift work?
    integer
    C1658633 (UMLS CUI [1])
    Code List
    9. Do you do shift work?
    CL Item
    no (1)
    C1298908 (UMLS CUI-1)
    (Comment:de)
    CL Item
    early shift and late shift (2)
    C0425104 (UMLS CUI-1)
    (Comment:de)
    CL Item
    alternate shift incl. night shift (3)
    C1660631 (UMLS CUI-1)
    (Comment:de)
    CL Item
    night shift only (4)
    C1660631 (UMLS CUI-1)
    (Comment:de)
    Comments of physician
    Item
    Comments of physician
    text
    C0947611 (UMLS CUI [1])
    Item Group
    Working capacity
    Incapacity to work
    Item
    10. Have you ever been incapable to work for more than 14 consecutive days within the last 12 months?
    boolean
    C2984044 (UMLS CUI [1])
    Item
    11. Do you receive a pension?
    integer
    C0425022 (UMLS CUI [1])
    Code List
    11. Do you receive a pension?
    CL Item
    no (1)
    CL Item
    yes (2)
    CL Item
    requested (3)
    Item
    14. Do you have a certificate of disability?
    integer
    C0018576 (UMLS CUI [1])
    Code List
    14. Do you have a certificate of disability?
    CL Item
    no (1)
    CL Item
    yes (2)
    CL Item
    requested (3)
    degree of disability
    Item
    14. If yes, what is your degree of disability?
    integer
    C0231170 (UMLS CUI [1])
    health-related change of workplace
    Item
    15. Did you change your workplace due to health-related reasons?
    boolean
    C0162579 (UMLS CUI [1])
    Comments of physician
    Item
    Comments of physician
    text
    C0947611 (UMLS CUI [1])
    Item Group
    Medical examinations
    Occupational health check
    Item
    16. Did you ever undergo an occupational health check?
    boolean
    C2973270 (UMLS CUI [1])
    place of occupational health check
    Item
    16. If yes, where?
    text
    C2973270 (UMLS CUI [1,1])
    C2986042 (UMLS CUI [1,2])
    X-ray
    Item
    17. Have you been X-rayed in recent years?
    boolean
    C0043309 (UMLS CUI [1])
    X-ray body part
    Item
    17. If yes, which body parts?
    text
    C0043309 (UMLS CUI [1,1])
    C0229962 (UMLS CUI [1,2])
    Comments of physician
    Item
    Comments of physician
    text
    C0947611 (UMLS CUI [1])
    Item Group
    18. Which stress factors are/were you exposed to?
    Item
    1 Heat
    text
    C0018837 (UMLS CUI [1])
    Code List
    1 Heat
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    2 Cold, wetness, moisture
    text
    C0009264 (UMLS CUI [1])
    C1830752 (UMLS CUI [2])
    C0868994 (UMLS CUI [3])
    Code List
    2 Cold, wetness, moisture
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    3 Gas, fumes, dust, smell
    text
    Code List
    3 Gas, fumes, dust, smell
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    4 Noise [more than 85 dB(A)]
    text
    Code List
    4 Noise [more than 85 dB(A)]
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    5 Solvent
    text
    Code List
    5 Solvent
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    6 Cooling lubricant
    text
    Code List
    6 Cooling lubricant
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    8 Pressure of time
    text
    Code List
    8 Pressure of time
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    9 Bad posture
    text
    Code List
    9 Bad posture
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Item
    10 Hard work
    text
    Code List
    10 Hard work
    CL Item
    no (no)
    CL Item
    sometimes (sometimes)
    CL Item
    constantly (constantly)
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Work-related sources of irritation
    source of irritation
    Item
    19 Are there factors that irritate you at your workplace?
    text
    Comments of physician
    Item
    text
    Item Group
    Please answer the following questions about your personal living conditions
    Item
    20. Do you live together with other people?
    integer
    Code List
    20. Do you live together with other people?
    CL Item
    living in a familiy/community (1)
    CL Item
    living alone (2)
    CL Item
    Answer refused (3)
    Number of children
    Item
    21. How many children do you have that live with you?
    integer
    Age of children
    Item
    21. Age (years)
    text
    Item
    22. Do you smoke?
    integer
    Code List
    22. Do you smoke?
    CL Item
    no (1)
    CL Item
    yes (2)
    CL Item
    not anymore (3)
    Item
    23. Do you consume alcohol?
    integer
    Code List
    23. Do you consume alcohol?
    CL Item
    no (1)
    CL Item
    yes (2)
    CL Item
    sometimes (3)
    CL Item
    daily (4)
    Item
    24. Do you do sports?
    integer
    Code List
    24. Do you do sports?
    CL Item
    no (1)
    CL Item
    regularly (2)
    CL Item
    irregularly (3)
    actions to benefit health
    Item
    25. What do you do to benefit your health?
    text
    Item
    26. Do you go to cancer screenings?
    integer
    Code List
    26. Do you go to cancer screenings?
    CL Item
    no (1)
    CL Item
    yes (2)
    latest cancer screening
    Item
    26. When was the last time?
    integer
    Item
    27.Have you ever undergone a treatment at a health resort?
    integer
    Code List
    27.Have you ever undergone a treatment at a health resort?
    CL Item
    no (1)
    CL Item
    yes (2)
    latest treatment at a health resort
    Item
    27. When was the last time?
    integer
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Are/were there any diseases in your family?
    Diabetes
    Item
    Diabetes
    boolean
    Hypertension
    Item
    Hypertension
    boolean
    Stroke
    Item
    Stroke
    boolean
    C0038454 (UMLS CUI [1])
    Myocardial infarction
    Item
    Myocardial infarction
    boolean
    Allergies
    Item
    Allergies/Hypersensitivity to substances, food, etc.
    boolean
    Respiratory diseases
    Item
    Respiratory diseases
    boolean
    Gout
    Item
    Gout
    boolean
    Deformities
    Item
    Deformities
    boolean
    cancer
    Item
    Cancer
    boolean
    Other disease
    Item
    Other diseases
    boolean
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Please answer the following questions about your diseases and health problems
    heachaches
    Item
    1 Do you suffer from headaches frequently?
    boolean
    Lack of appetite
    Item
    2 Do you suffer from lack of appetite?
    boolean
    thirst
    Item
    3 Do you suffer from increased thirst?
    boolean
    sleep disturbances
    Item
    4 Do you have sleep disturbances?
    boolean
    difficulty falling asleep
    Item
    4 If yes, do you have difficulties falling asleep?
    boolean
    waking during the night
    Item
    4 If yes, do you wake during the night?
    boolean
    irregular bowel movements
    Item
    5 Do you have irregular bowel movements?
    boolean
    glasses/contact lenses
    Item
    6 Do you wear glasses/contact lenses?
    boolean
    Eye complaint
    Item
    7 Do you have an eye complaint?
    boolean
    impaired hearing
    Item
    8 Is your hearing impaired?
    boolean
    Ear problems
    Item
    9 Do you have ear problems?
    boolean
    diseases of frontal sinus and maxillary sinus, throat
    Item
    12 Are you prone to diseases of the frontal sinus and the maxillary sinus of the throat?
    boolean
    common cold
    Item
    13 Do/did you have a common cold multiple times a year?
    boolean
    Cough
    Item
    14 Do you cough frequently (regularly every day)?
    boolean
    bronchial asthma/bronchitis
    Item
    15 Are you prone to bronchial asthma/bronchitis?
    boolean
    pneumonia, pleurisy, tuberculosis
    Item
    17 Did you ever have pneumonia/pleurisy/tuberculosis?
    boolean
    Hypertension
    Item
    18 Have you ever been diagnosed with hypertension?
    boolean
    dyspnea
    Item
    19 Do you suffer from dyspnea?
    boolean
    Chest tightness
    Item
    20 Do you feel a tightness in the chest (chest pain) during physical stress?
    boolean
    myocardial infarction
    Item
    21 Did you ever have a myocardial infarction?
    boolean
    other cardiovascular problems
    Item
    22 Do you have other cardiovascular problems?
    boolean
    dizziness, disturbed balance
    Item
    23 Are you prone to dizziness/disturbed balance?
    boolean
    Diabetes
    Item
    24 Have you been diagnosed with diabetes?
    boolean
    elevated blood lipid levels
    Item
    25 Were your blood lipid levels ever found to be elevated?
    boolean
    elevated uric acid levels
    Item
    26 Were your uric acid levels ever found to be elevated (gout)?
    boolean
    thyroid disease
    Item
    27 Have you ever been diagnosed with a thyroid disease?
    boolean
    gastro-intestinal problems, heartburn
    Item
    28 Do you have gastro-intestinal problems/heartburn?
    boolean
    Bilious complaints
    Item
    30 Do you have bilious complaints?
    boolean
    jaundice
    Item
    31 Did you ever have jaundice?
    boolean
    liver disease
    Item
    32 Have you been diagnosed with a liver disease?
    boolean
    uropathy
    Item
    33 Are you prone to uropathies (kidney, bladder)?
    boolean
    problems when urinating
    Item
    34 Do you have problems when urinating?
    boolean
    hemorrhoids
    Item
    35 Do you have hemorrhoids?
    boolean
    varices
    Item
    36 Dou you have varices?
    boolean
    back pain
    Item
    37 Do you have back pain?
    boolean
    Item
    37 If yes, where? - 1 cervical spine/neck
    text
    Code List
    37 If yes, where? - 1 cervical spine/neck
    CL Item
    sometimes  (sometimes)
    CL Item
    frequently  (frequently)
    CL Item
    daily  (daily)
    Item
    37 If yes, where? - 2 thoracic spine
    text
    Code List
    37 If yes, where? - 2 thoracic spine
    CL Item
    sometimes  (sometimes)
    CL Item
    frequently  (frequently)
    CL Item
    daily  (daily)
    Item
    37 If yes, where? - 3 lumbar spine/lower back
    text
    Code List
    37 If yes, where? - 3 lumbar spine/lower back
    CL Item
    sometimes  (sometimes)
    CL Item
    frequently  (frequently)
    CL Item
    daily  (daily)
    lumbago
    Item
    38 Do you suffer from lumbago (sciatica)?
    boolean
    herniated disk
    Item
    39 Did you have a herniated disk?
    boolean
    joint pain/limb pain
    Item
    40 Do you have pain in any joints or limbs?
    boolean
    seizure disorder
    Item
    41 Do you have a seizure disorder?
    boolean
    neurological/psychiatric disease
    Item
    42 Do you have a neurological/psychiatric disease?
    boolean
    dermatosis
    Item
    43 Are you prone to dermatoses?
    boolean
    Allergies
    Item
    44 Do you suffer from allergies?
    boolean
    hay fever
    Item
    45 Do you have hay fever?
    boolean
    bone fractures
    Item
    46 Did you have any bone fractures?
    boolean
    permanent damage due to accident
    Item
    47 Did you have an accident that led to any permanent damage?
    boolean
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Surgeries
    Surgery
    Item
    48. Did you ever undergo surgery?
    boolean
    Heart surgery
    Item
    1 Heart
    boolean
    Kidney surgery
    Item
    2 Kidney
    boolean
    Gallbladder surgery
    Item
    3 Gallbladder
    boolean
    hernia surgery
    Item
    4 Hernia
    boolean
    stomach surgery
    Item
    5 Stomach
    boolean
    bone surgery
    Item
    7 Bone
    boolean
    other surgery
    Item
    8 Other surgery
    boolean
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Dental/medical treatment
    dental/medical treatment
    Item
    49. Are you currently under dental/medical treatment?
    boolean
    dental/medical treatment reason
    Item
    49. If yes, why?
    text
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Vaccination
    tetanus vaccination
    Item
    50. Are you vaccinated against tetanus?
    boolean
    time of tetanus vaccination
    Item
    50. When?
    integer
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Current medication
    Current medication
    Item
    51. Are you taking any medication of at least one of the following types (mutiple selections possible)?
    boolean
    medication for headache
    Item
    1 Medication for headache
    boolean
    pain medication
    Item
    2 Pain medication
    boolean
    Cardiovascular agents
    Item
    3 Cardiovascular agents
    boolean
    laxatives
    Item
    4 Laxatives
    boolean
    Tranquilizer
    Item
    5 Tranquilizer
    boolean
    sleeping pills
    Item
    6 Sleeping pills
    boolean
    stomachic
    Item
    7 Stomachic
    boolean
    Bronchial medication
    Item
    8 Bronchial medication
    boolean
    other medication
    Item
    9 Other medication
    boolean
    other medicaton specification
    Item
    9 Which other medication?
    text
    Comments of physician
    Item
    Comments of physician
    text
    Item Group
    Miscellaneous
    Other complaints
    Item
    52. Other complaints
    text
    Item
    53. Are you pregnant?
    integer
    Code List
    53. Are you pregnant?
    CL Item
    yes (1)
    CL Item
    no (2)
    Item
    54. Do you undergo gynecological screenings regularly?
    integer
    Code List
    54. Do you undergo gynecological screenings regularly?
    CL Item
    yes (1)
    CL Item
    no (2)
    Comments of physician
    Item
    Comments of physician
    text
    General comments
    Item
    General comments
    text

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