Published March 10, 2023 | Version V3 22.10.2021

EPOCHAL (Effects of Pollen on Cardiorespiratory Health and Allergic symptoms): Intake questionnaire (English and German)

  • 1. Swiss Tropical and Public Health Institute

Description

This questionnaire was developed for the EPOCHAL study (Effects of Pollen on Cardiorespiratory Health and Allergic symptoms). The study was sponsored and led by Swiss TPH in Basel, Switzerland and approved by the local ethics committee (Ethikkomission Nordwest- und Zentralschweiz EKNZ, project ID 2021-00151). Written informed consent was obtained from every participant prior to study inclusion. 

This is the "intake questionnaire" which was administered once for each participant upon starting the study. It includes questions about the following topics:
1) Education
2) Employment
3) Allergy history: including allergies, previous testing, treatments and typical symptoms
4) Residential history
5) Medical history: including asthma, lung conditions, cardiac conditions, Covid-19, neurologic and psychiatric conditions, sleep conditions, recent surgeries and medication intake
6) Lifestyle: including physical activity, smoking habits, alcohol and caffeine intake, sleep habits

The questionnaire is also available in German under the same DOI.

Please note that this questionnaire was administered electronically on a tablet, and contains:

  • Form logic, which determines the relevance of some questions based on previous answers. Affected questions are typically shown in grey color.
  • Warnings (in large red font) and directions (in large grey font) to warn nurses against performance of spirometry measurements if contraindications were present. For example, when recent surgery was indicated in Topic #5.

Notes

The rationale and study design for the EPOCHAL project are published here: https://doi.org/10.3389/fpubh.2021.689248

Files

EPOCHAL_Intake Questionnaire_v3_EN_22.10.2021.pdf

Files (13.9 MB)

Additional details

Funding

European Commission
EPOCHAL - Beyond seasonal suffering: Effects of Pollen on Cardiorespiratory Health and Allergies 853568
Swiss National Science Foundation
Effects of airborne pollen on cardiorespiratory health and allergic symptoms PZ00P3_185864