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Scientific Data Documentation
Hematology And Biochemistry (1976-1980)
DSN: CC37.HANES2.HEMBIO HEMATOLOGY and BIOCHEMISTRY DATA Catalog Number 5411 DESCRIPTION OF SURVEY Description of Survey: A detailed description of the design, content,ques- tionnaires, and operation of NHANES II is provided in the following report: Plan and Operation of the Second Health and Nutrition Examination Survey, 1976-1980, DHHS Pub. No. (PHS) 81-1317 Series 1, No. 15, Public Health Service, Superintendent of Documents, U.S. Government Printing Office, Washington, D.C. 20402. The stock number is 017-022-00752-5 and the cost is $5.50. One copy is provided with the documentation herein, and a general summary of the data collection techniques and content is given in Appendix A. DESCRIPTION OF POPULATION Target Population:NHANES II was conducted on a nationwide probability sample of approximately 28,000 persons, ages 6 months-74 years, from the civilian, noninstitutionalized population of the United States. The survey started in February 1976 and was completed in February 1980. The NHANES II sample was selected so that certain population groups thought to be at high risk of malnutrition (persons with low incomes, preschool children and the elderly) were oversampled. Adjusted sampling weights were then computed for 76 age, sex,and race categories in order to inflate the sample in such a manner as to closely reflect the estimated civilian noninstitutionalized U.S. population ages 6 months-74 years at the midpoint of the survey (March 1, 1978). DATA COLLECTION TECHNIQUES AND CONTENT The plan developed with respect to the content of NHANES II called for the following: A. Questionnaires completed in the household: (1) Household questionnaire: For each household member, questions referred to family relationships;certain demographic items such as age, sex, and race; selected housing information;occupation, income, education, veteran status; and an indication of participation in food stamp programs. (2) Medical history questionnaires: (a) For each sample person ages 6 months-11 years The questionnaire included items on birth weight, prematurity,congenital conditions, medication, neurological conditions, lead poisoning, accidents, hospital care, disability, diarrhea, pica, vision, and a variety of chronic conditions. In addition, data were collected on allergies, kidney and bladder disease, anemia, speech and hearing, lung and chest conditions, and participation in food programs. (b) For each sample person ages 12-74 years The questionnaire included items on medication; hospital care; tuberculosis; a variety of acute and chronic diseases; tobacco usage, physical activity; weight; height; vision disability, exposure to pesticides; gastrointestinal problems; and for females; a menstrual and pregnancy history. In addition, data were collected on anemia, diabetes, respiratory condition, hearing and speech, liver and gallbladder conditions, kidney and bladder disease, allergies, hypertension, cardiovascular conditions, stroke, arthritis (stressing middle and upper back and neck problems), and participation in food programs. Questionnaires and tests administered in the mobile examination center: (3) Dietary Questionnaires (a) For each examined person, a 24-Hour Recall was administered by trained dietary interviewers. Specific and quantitative detail of every food or drink consumed during the previous day was recorded and calculated, thus providing estimates of calories, protein, carbohydrates, fat, unsaturated fats, cholesterol, and specific vitamins and minerals consumed. (b) For each examined person, a Food Frequency interview was administered to ascertain usual patterns of food consumption. Daily and/or weekly consumption of foods within 26 subgroups were recorded. In addition, data were collected on usual vitamin-mineral supplement usage. (c) For each person ages 12-74 years, a Dietary Supplement form was self-administered and reviewed. This form provided information on special diets, recent medications and barriers to purchasing groceries or eating foods; it does not provide information on vitamin/mineral or other supplements to the diet. (4) Medication/Vitamin Usage Form provided information on the past week's usage of any medicines; vitamins or minerals for al examined persons. (5) Behavior Questionnaire elicited data on behavior which may be associated with coronary heart disease for examined persons ages 25-74. B. Examination by physician A physician performed and recorded the results of a medical examination giving special attention to specified findings related to nutrition, to hearing, to the thyroid gland,and to the cardiovascular, respiratory, neurological and musculoskeletal systems. C. Special clinical procedures and tests A specially trained health technician carried out the following on examined persons in the designated age ranges: 1. Spirometry trials of examined persons ages 6-24 years, were digitized and recorded on magnetic tape. Various pulmonary function indicators such as FVC (forced vital capacity), FEV1 (forced expiratory volume in one second), and peak flow rate were subsequently derived from these data. 2. Electrocardiograms Electrocardiographic signals of examined persons ages 25-74 years were digitized and recorded on magnetic tape providing normative data of amplitude, duration, interval and axis measurements and permitting interpretations of heart disease according to the Minnesota classification code. 3. Body Measurements were made on all examinees and included standing height, body weight, triceps and subscapular skinfolds, and several other anthropometric measurements. 4. Puretone audiometry Tests were carried out on examined persons between the ages of 4 and 19 years, permitting determination of threshold levels of hearing for frequencies of 500, 1000, 2000, and 4000 Hertz for right and left ears. 5. Speech recording, involving use of tape recording of the subject's repetition of specially developed sentences,was carried out on examined persons between the ages of 4 and 6 years, permitting interpretations as an indication of problems with articulation and language development. 6. Allergy tests, involving skin tests (prick test) with eight common allergens (housedust, alternaria, cat fur, dog fur, ragweed, oak, rye grass, and Bermuda grass).The tests were made on examined persons between the ages of 6 and 74 years, to obtain degrees of skin reaction. D. X-Rays For examined persons ages 25-74 years, two x-rays were made. No x-rays were taken of pregnant women and no lumbar x-rays were taken on women under 50 years of age. 1. X-ray of cervical and lumbar spine, were taken to provide evidence of osteoarthritis and degenerative disc disease, and 2. X-ray of chest, to be used in the diagnosis of respiratory diseases and to serve as a measure of left ventricular enlargement. E. Urine tests Tests as follows were performed on casual samples of urine: 1. N-Multistix tests for qualitative protein, glucose, ketones, bilirubin, blood, urobilinogen, pH, and bacteriuria (nitrite test) were done for examined persons ages 6-74 years. 2. Urinary sediments, including red cells, white cells, and casts, were measured for a subsample of examined adults ages 20-74 years. 3. Gonorrhea cultures, of urinary sediments were performed for male and female examined persons ages 12-40 years. However, of those females who received the Glucose Tolerance Test (GTT) only those ages 20-24 years had the gonorrhea test performed. 4. Analyses for pesticide residue and metabolite levels,were carried out on a subsample of examined persons ages 12-74 years, including measures of the body burdens from exposure to alkyl phosphate residues and metabolites, carbamate residues, phenolic compound residues and malathion metabolites. F. Tests on blood samples Samples of blood provide a broad range of information related to health and nutrition. The particular tests performed varied with the specific target condition and age group as described in the Series 1, No.15 program description (page 39). 1. Glucose tolerance test (GTT) This test involved collection of blood specimens while in a fasting state, as well as at one and two hours after glucose challenge. The test was performed on a specified subsample of examined adults to provide estimates of the prevalence of diabetes. 2. Tests related to liver function (a) Post-prandial liver bile acid test. This test measures the ability of the liver to remove bile acids from the blood following consumption of a food preparation which induces eventual addition of bile acids to the blood via contraction of the gallbladder. (b) Liver biochemistries performed include bilirubin, SGOT, and alkaline phosphatase tests. 3. Anemia-related laboratory tests The tests made to characterize anemia consisted of protoporphyrin,iron,total iron binding capacity (TIBC), zinc, copper, red cell folates, serum folates, serum ferritin, B12, and the determination of abnormal hemoglobin. 4. Other nutritional biochemistries These tests include albumin,Vitamin A and Vitamin C. 5. Serum lipids Because of their important relevance to cardiovascular disease, determinations were made of cholesterol, triglycerides, and high density lipoprotein (HDL). 6. Biochemistries for body burden from environmental exposures Determinations were made of body burden levels of lead and pesticide residues and metabolites.Tests were also performed for carboxyhemoglobin which reflects environmental exposure to carbon monoxide and the individual's smoking habits. 7. Hematology The hematology included determinations of hemoglobin, hematocrit,red blood cell count,white blood cell count and differential leukocyte analysis, and red blood cell morphology and hemoglobin phenotyping. 8. Kidney function The only quantitative test for kidney function performed on blood samples was the serum creatinine test. 9. Syphilis The serology determinations for syphilis included qualitative and quantitative ART, a FTA-ABS and MHA-TP. USE OF NHANES DATA NCHS requests the cooperation of recipients of data tapes in certain actions related to their use: 1. Any publication based on the data should acknowledge the National Center for Health Statistics (NCHS) as the original source.It should include a disclaimer which credits the authors for any analyses, interpretations, or conclusions, and not NCHS, which is responsible only for the data. 2. Consumers who wish to publish a technical description of the data should make a reasonable effort to ensure that the description is not inconsistent with that published by NCHS.This does not mean, however, that NCHS will review such descriptions. 3. The National Center for Health Statistics would appreciate receiving reprints of journal articles or other publications based upon find- ings from the NHANES II survey. Please forward copies to: Division of Health Examination Statistics National Center for Health Statistics Center Building, Room 2-58, 3700 East-West Highway Hyattsville, Maryland 20782 EDITING OF THE DATA SETS The data users' tapes have been subjected to a great deal of careful editing. Some of the continuous data items have extremely high or low values and it has been verified that they do in fact appear that way on the original inter- view documents; that is, it has been verified that the values have not been incorrectly keyed.Within each data tape numerous consistency checks have been performed. However, due to the large volume of data collected in the survey, it is likely that a small number of errors or discrepancies remain undetected. The Division of Health Examination Statistics, NCHS would appreciate if any such errors are detected that they be brought to our attention so that errata sheets can be issued to previous purchasers and corrections made if new data tapes are created. USE OF SAMPLE WEIGHTS NHANES II uses a multistage sample designed to represent the civilian noninstitutionalized population of the United States,6 months-74 years of age. Since the sample is not a simple random one, it is necessary to incorporate the person's sample weight for proper analysis of the data.The sample weight is a composite of the individual selection probability, adjustments for nonresponese, and poststratification adjustments. NHANES II provides information on 20,322 interviewed and examined individuals. In addition to the general examination components, several more examinations were performed on subsamples of the population. Therefore, instead of there being one sample weight per person,there are several sample weights for each person. If a person was not selected for a particular subsample, their associated subsample weight is zero. When analyzing the special subsamples, the analyst must be careful to select the appropriate sampling weight from the weights found in tape locations 282-317. For a more complete description of how the sample weights are calculated, see the detailed note section of this documentation. SAMPLE DESIGN, VARIANCE ESTIMATION, AND HYPOTHESIS TESTING The data collected in the Second National Health and Nutrition Examination Survey (NHANES II) were obtained through a complex sample design involving both clustering and stratification.Because of the complex design and the ratio adjustments applied to the sample weights (see previous section on use of sample weights), the direct application of standard statistical analysis methods for variance estimation and hypothesis testing may be very misleading. The modification of statistical analysis procedures to incorporate the effects of complex survey designs is an important area of research;however, the current methodologies appropriate for the analysis of data from such surveys have not been made readily available in the standard packaged statistical software. There are computer programs available which do provide the capability of variance estimation for complex sample designs. The balanced repeated replication approach 1/ is utilized in &REPERR-&PSALMS-OSIRIS.IV 2/ to calculate the variance-covariance matrix.SESUDAAN, SURREGR 3/ and SUPERCARP 4/ are programs that calculate the variance-covariance matrix using the linearization approach 5/ (Taylor series expansion). In order to provide the user with the capability of estimating the complex sample variances in the NHANES II data using the above procedures, we have provided Strata and Pseudo Primary Sampling Unit (PSU) codes on all data tapes in positions 324-326. These variables and the sample weights are necessary for the calculation of variances. Even though the overall number of examined persons in this survey is quite large for statistical inference purposes, subclass analyses can lead to estimaters that are unstable, particularly estimates of variances. Consequently, analyses of subclasses require that the user pay particular attention to the coefficient of variation for the estimates of means, proportions and totals.In addition, small sample sizes, or a small number of PSU's used in the variance calculations may produce unstable estimates of the variances using the above computer programs. An NCHS Series 2 publication discussing these issues is in publication.6/ REFERENCES 1 National Center for Health Statistics: Replication an Approach to the Analysis of Data from Complex Surveys by P.J. McCarthy. Vital and Health Statistics Series 2-No. 14. DHEW Pub. No.(PHS) 79-1269. Public Health Service. Washington, D.C. U.S. Government Printing Office, 1966. 2 Survey Research Center Computer Support Group, OSIRIS IV User's Manual, Institute for Social Research, 1979. 3 Holt, M.M.: SURREGR: Standard errors of regression coefficients from sample survey data. (unpublished) Research Triangle Institute, NC, 1977. 4 Hidiruglou, M.A.,Fuller,W.A.,Hickman, R.D.:(SUPERCARP) Survey Section, Statistical Laboratory,Iowa State University. Ames, Iowa. Sixth Edition. October 1980. 5 Woodruff, R.S.: A simple method for approximating the variance of a complicated estimate. JASA 66:411-414, 1971. 6 National Center for Health Statistics: A General Statistical Methodology for the Analysis of Data from a Complex Survey: NHANES I by J.R. Landis, J.H. Lepkowski, S.A. Stehouwer, and S.A. Eklund. Vital and Health Statistics, Series 2. (In publication) GENERAL NOTES, DEMOGRAPHIC INFORMATION, NHANES II An advance letter, announcing the forthcoming arrival of an interviewer from the U.S.Bureau of the Census,was mailed to each household that fell into the NHANES II probability sample. The interviewer subsequently visited the household to ascertain its composition and to administer a questionnaire,the primary purpose of which was to obtain demographic information. The questionnaire was administered to each potential sample person in each household that was available and competent enough to respond to questions.In the event that a potential sample person was not at home at the time of interview, any responsible adult in the household was asked to respond to the questions for the absent person. DEMOGRAPHIC DATA SUMMARY - NHANES II Tape Positions Sample Sequence Number 1- 5 Catalog Number (5371-for Demographic Data only) 6- 9 Data user work area 10 Size of place 11 SMSA-not SMSA 12 Data user work area 13-23 Type of living quarters 24 Land usage 25 If rural, asked does this place have 10 acres or more? 26 If 10 acres or more, asked if in the last 12 months did sales of farm produce and livestock amount to $50 or more? 27 If 10 acres or more, asked to $250 or more? 28 Data user work area 29 Total number of persons in household 30-31 Total Number of Sample Persons in Household SAMPLE PERSON DATA Data user work area 34 Family relationship 35 Data user work area 36 Family unit number 37-41 Data user work area 42-44 Age-months (at interview) 45-46 Age-years (at interview) 47-48 Data user work area 49-50 Date of birth-month 51-52 Date of birth-year 53-54 Sex 55 Race 56 In what state was he/she born? 57-58 Is he/she married, widowed, divorced, separated or never married? 59 Natural origin or ancestry 60-61 Education level 62-63 Grade completed 64 What was he/she doing during most of the past 12 months? 65 What was he/she doing? 66 Did he/she work at a job or business at any time during the past three months? 67 Did he/she work full or part-time when working? 68 Was he/she working within last two weeks not counting work around the house? 69 Even though he/she did not work, does he/she have a job or business? 70 Was he/she looking for work or on layoff from a job? 71 Which, looking for work or on layoff from a job? 72 What kind of industry or business is this? 73- 75 What kind of work was he/she doing? 76- 78 Was he/she in private company or business or individual for wages, salary or commission? 79 Did he/she ever serve in the armed forces of the U.S.? 80 When did he/she serve? 81 Data user work area 82- 90 Household Data How many rooms are in this...? Count the kitchen, but not the bath 91 How many bedrooms are in this...? 92 Ask only of unrelated household members. Do you have complete kitchen facilities in your living quarters, that is a kitchen sink with piped water, a refrigerator and a range or cookstove? 93 Do you have access to complete kitchen facilities in this house? 94 Do you have access to a range or cookstove? 95 Do you have access to a refrigerator? 96 Do you have access to a sink with piped water? 97 Is there piped water in this house (these living quarters)? 98 Is there both hot and cold water? 99 Are these kitchen facilities used by anyone not living in this household? 100 What is the main type of heating system you have? 101-102 Do you have air conditioning? 103 How many motor vehicles are owned or regularly used for transportation by members of your family? 104 Is any language other than English spoken by family members living here? 105 What language? 106 Which of these income groups represents your total combined family income for the past 12 months? 107-108 During the past 12 months, how much money did you and all members of your family receive in wages or salaries before deductions (under $7,000 only)? 109-112 Social security or railroad retirement? 113 Data user work area 114 If yes, how much? 115-118 Welfare payments or other public assistance? 119 Data user work area 120 If yes, how much? 121-124 Unemployment compensation or workmen's compensation? 125 Data user work area 126 If yes, how much? 127-130 Government employee pension or private pensions? 131 Data user work area 132 If yes, how much? 133-136 Dividends, interest or rent? 137 Data user work area 138 If yes, how much? 139-142 Net income from their own business (nonfarm) professional practice, or partnership? 143 Data user work area 144 If yes, how much? 145-148 Net income from a farm? 149 Data user work area 150 If yes, how much? 151-154 Veteran's payments? 155 Data user work area 156 If yes, how much? 157-160 Alimony, child support or other support from persons not in household? 161 Data user work area 162 If yes, how much? 163-166 Any other income? 167 Data user work area 168 If yes, how much? 169-172 Total amount 173-176 Check Item B 177 Are you certified to participate in the food stamp program? 178 Are you buying food stamps now? 179 What is the main reason you are not participating in the program? 180 Are you certified for commodity distribution program? 181 Are you receiving commodity foods now for your family? 182 Why aren't you participating in the program? 183 Date of exam 184-189 Age in years (at examination) 190-191 Data user work area 192-205 Race-sex recode for sample persons 206 Farm, nonfarm recode for sample person 207 Interview status 208 Region 209 Poverty index 210-212 Data user work area 213-246 Head of Household Data Age in years 247-248 Data user work area 249-250 Date of birth-month 251-252 Date of birth-year 253-254 Sex 255 Race 256 In what state was he/she born? 257-258 Is he/she married, widowed, divorced, separated or never married? 259 Natural origin or ancestry? 260-261 Education level 262-263 Grade completed 264 What was he/she doing during most of the past 12 months? 265 What was he/she doing? 266 Did he/she work at a job or business at any time during the past three months? 267 Did he/she work full or part-time when working? 268 Was he/she working within last two weeks not counting work around the house? 269 Even though he/she did not work, does he/she have a job or business? 270 Was he/she looking for work or on layoff from a job? 271 Which?, looking for work or on layoff from a job? 272 Type of industry or business 273-275 What kind of work was he/she doing? 276-278 Was he/she in private company or business or individual for wages, salary or commission? 279 Did he/she ever serve in the armed forces of the U.S.? 280 When did he/she serve? 281 Sample Weights Examined final weight 282-287 Medical history interview final weight 288-293 Glucose Tolerance Test final examined weight 294-299 Lead final examined weight 300-305 Carboxyhemoglobin final examined weight 306-311 Bile acids final examined weight 312-317 Data user work area 318-323 Strata code 324-325 Pseudo PSU code 326 Poverty, Nonpoverty segments 327 (Not coded on Intake, Recall, Anthro and Glucose tapes) Serum ferritin final examined weight 328-333 Folates, Vitain B 12 and differential counts final 334-339 examined weight Unused positions 340-350 USE OF SPECIAL TERMS, DEMOGRAPHIC DATA, NHANES II The term "data user work area" refers to blank areas in the data tape which are reserved for the user as needed. The term "blank, but applicable",is used to indicate a data item that was to have a response for a sample person but none was given. The terms "blank" and "Not applicable"refer to data items where the sample person was not supposed to respond to the question or receive the examination component. To more fully understand the questionnaire skip patterns and the categorizations used,see the Plan and Operation of the Second National Health and Nutrition Examination Survey document included with this documentation. All the questionnaires are included in this document. RECORD LAYOUT, DEMOGRAPHIC DATA NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY - NHANES II DEMOGRAPHIC DATA TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 001- Sample Sequence Number 005 00001-27796 006- Catalog Number 009 5371 010 Data User Work Area 011 Size of Place See Detailed Notes 1 - Urbanized area with 3,000,000 or more 2 - Urbanized area 1,000,000 to 2,999,999 3 - Urbanized area with 250,000 to 999,999 4 - Urbanized area under 250,000 5 - Urban place 25,000 or more outside urbanized area 6 - Urban place 10,000-24,999 outside urbanized area 7 - Urban place 2,500 to 9,999 outside urbanized area 8 - Rural 012 SMSA-Not SMSA See Detailed Notes 1 - In SMSA, in central city 2 - In SMSA, not in central city 4 - Not in SMSA 013- Data User Work Area 023 024 Type of living quarters 1 - Housing unit 2 - Other unit 025 Land Usage 1 - Urban 2 - Rural 026 If rural, asked does this place have 10 acres or more? 1 - Yes 2 - No 9 - Not Applicable 027 If 10 acres or more, asked if in the last 12 months did sales of farm produce and livestock amount to $50 or more? 1 - Yes 2 - No 9 - Not Applicable 028 If less than 10 acres, asked if in the last 12 months did sales of farm produce and livestock amount to $250 or more? 1 - Yes 2 - No 9 - Not Applicable 029 Data User Work Area 030- Total Number Of Persons In Household 031 01 - 15 - As given 032- Total Number Of Sample Persons In Household 033 01 - 06 - As Given Sample Person Data 034 Data User Work Area 035 Family Relationship 1 - Head one person living alone or with non-relatives 2 - Head 2 or more related persons in family 3 - Wife 4 - Child 5 - Other relative 6 - Foster child 7 - Husband 036 Examination Status 1 - Examined 037- Family Unit Code See Detailed Notes 041 00001-21050 - As Given 042- Data User Work Area 044 045- Age-Months At Interview 046 06-11 Months Blank, if greater than 11 months 047- Age-Years At Interview 048 01 - 74 Years 00, If less than 12 months 049- Data User Work Area 050 TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 051- Date-Of-Birth-Month 052 01 - 12 Month 053- Date-Of-Birth-Year 054 01 - 79 Year 055 Sex 1 - Male 2 - Female 056 Race See Detailed Notes 1 - White 2 - Black 3 - Other 057- In what state was he/she born? See Detailed Notes 058 01 - 97 88 - Blank, but applicable 059 Is he/she married, widowed, divorced, separated, or never married? 1 - Under 17 2 - Married 3 - Widowed 4 - Divorced 5 - Separated 6 - Never married 8 - Blank, but applicable 060- Natural Origin or Ancestry 061 01 - Countries of Central or South America 02 - Chicano 03 - Cuban 04 - Mexican 05 - Mexicano 06 - Mexican-American 07 - Puerto Rican 08 - Other Spanish 09 - Other European, such as German, French, English, Irish 10 - Black, Negro or Afro-American 11 - American Indian or Alaskan Native 12 - Asian or Pacific Islander Such as Chinese, Japanese, Korean, Philippino, Samoan 13 - Another Group Not Listed 88 - Blank, but applicable 062- Highest Grade Of School Attended 063 00 - None (regardless of age) 21 - 28 - Elementary Grades (1-8) 31 - 34 - High School (1-4) 41 - 45 - College (1-5+) 88 - Blank, but applicable 064 Grade Completed 1 - Yes 2 - No 8 - Blank, but applicable Blank 065 What was he/she doing during most of the past 12 months? 1 - Working 2 - Keeping house 3 - Something else 8 - Blank, but applicable Blank 066 What was he/she doing? 1 - Layoff 2 - Retired 3 - Student 4 - Ill 5 - Staying home 6 - Looking for work 7 - Unable to work 8 - Blank, but applicable 0 - Other Blank 067 Did he/she work at a job or business at any time during the past three months? 1 - Yes 2 - No 8 - Blank, but applicable Blank 068 Did he/she work full or part-time when working? 1 - Full time 2 - Part time 8 - Blank, but applicable Blank 069 Was he/she working within last two weeks not counting work around the house? 1 - Yes 2 - No 8 - Blank, but applicable Blank 070 Even though he/she did not work does he/she have a job or business? 1 - Yes 2 - No 8 - Blank, but applicable Blank 071 Was he/she looking for work or on layoff from a job? 1 - Yes 2 - No 8 - Blank, but applicable Blank 072 Which looking for work or on layoff from a job? 1 - Looking 2 - Layoff 3 - Both 8 - Blank, but applicable Blank 073- What kind of industry or business is this? See Detailed Notes 075 017 - 998 (last digit 7, 8, 9) 000 - Blank, but applicable Blank 076- What kind of work was he/she doing? See Detailed Notes 078 001 - 992 - Occupation (last digit 0-6) 000 - Blank, but applicable Blank 079 Was he/she in private company or business or working for individual for wages, salary or commission? 1 - Private 2 - A Federal government employee 3 - A State government employee 4 - A local government employee 5 - Incorporated-Own 6 - Self-employed (or farm) 7 - Working without pay in family business or farm 8 - Never worked 0 - Blank, but applicable Blank 080 Did he/she ever serve in the armed forces of the U.S.? 1 - Yes 2 - No 8 - Blank, but applicable Blank 081 When did he/she serve? 1 - Vietnam 2 - Korean War 3 - World War II 4 - World War I 5 - Post Vietnam 6 - Other Service 8 - Blank, but applicable 9 - Do not know Blank 082- Data User Work Area 090 Household Data 091 How many rooms are in this..? Count the kitchen, but not the bath. 1 - 8 Rooms 9 - 9 Or More Rooms 092 How many bedrooms are in this - ? 0 - 7 Bedrooms - More than 7 bedrooms coded as 7 093 Ask only of unrelated household members. Do you have complete kitchen facilities in your living quarters, that is a kitchen sink with piped water, a refrigerator and a range or cookstove? 1 - Yes 2 - No Blank 094 Do you have access to complete kitchen facilities in this house? 1 - Yes 2 - No 8 - Blank, but applicable Blank 095 Do you have access to a range or cookstove? 1 - Yes 2 - No 8 - Blank, but applicable Blank 096 Do you have access to a refrigerator? 1 - Yes 2 - No 8 - Blank, but applicable Blank 097 Do you have access to a sink with piped water? 1 - Yes 2 - No 8 - Blank, but applicable Blank 098 Is there piped water in this house (these living quarters)? 1 - Yes 2 - No 8 - Blank, but applicable Blank 099 Is there both hot and cold water? 1 - Yes 2 - No 8 - Blank, but applicable Blank 100 Are these kitchen facilities used by anyone not living in this household? 1 - Yes 2 - No 8 - Blank, but applicable Blank TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 101- What is the main type of heating system you have? 102 11 - Steam or hot water system 12 - Central warm air furnace with ducts to individual rooms or central heat pump (forced air) 13 - Built in electric units (permanently installed in wall, ceiling or baseboard) 14 - Floor, wall or pipeless furnace 15 - Circulating, radiant or room heaters, with flue or vent, burning gas, oil, or kerosene 16 - Circulating, radiant, or room heaters (not portable) without flue or vent burning gas, oil or kerosene 17 - Fireplace or stoves burning coal, wood or coke 18 - Portable room heaters of any kind 19 - Some other type 20 - None, unit is not heated 88 - Blank, but applicable 103 Do you have air conditioning? 1 - Yes, individual room unit 2 - Yes, central air conditioning 3 - No 8 - Blank, but applicable 104 How many motor vehicles are owned or regularly used for transportation by members of your family? 0 - None 1 - 8 Vehicles (more than 8 coded as 8) 9 - Blank, but applicable 105 Is any language other than English spoken by family members living here? 1 - Yes 2 - No 8 - Blank, but applicable 106 What language? 0 - German 1 - Italian 2 - French 3 - Polish 4 - Russian 5 - Spanish 6 - Chinese 7 - Other language 8 - Blank, but applicable 9 - Not applicable 107- Which of these income groups represents See Detailed Notes 108 your total combined family income for the past 12 months? 11 - Under $1,000 12 - $1,000-1,999 13 - $2,000-2,999 14 - $3,000-3,999 15 - $4,000-4,999 16 - $5,000-5,999 17 - $6,000-6,999 18 - $7,000-9,999 19 - $10,000-14,999 20 - $15,000-19,999 21 - $20,000-24,999 22 - $25,000 and over 88 - Blank, but applicable 109- During the past 12 months, how much 112 money did you and all members of your family receive in wages or salaries before deductions? 0000 - 6999 Amount 8888 - Blank, but applicable Blank 113 Social security or railroad retirement? 1 - Yes 2 - No 8 - Blank, but applicable Blank 114 Data User Work Area 115- If yes, how much? 118 0038 - 6828 Amount 8888 - Blank, but applicable Blank 119 Welfare payments or other public assistance? 1 - Yes 2 - No 8 - Blank, but applicable Blank 120 Data User Work Area 121- If yes, how much? 124 0012 - 6800 Amount 8888 - Blank, but applicable Blank 125 Unemployment Compensation or Workman's Compensation 1 - Yes 2 - No 8 - Blank, but applicable Blank 126 Data User Work Area 127- If yes, how much? 130 0015 - 5640 Amount 8888 - Blank, but applicable Blank 131 Government Employee Pension or Private Pensions? 1 - Yes 2 - No 8 - Blank, but applicable Blank 132 Data User Work Area 133- If yes, how much? 136 0036 - 6000 Amount 8888 - Blank, but applicable Blank 137 Dividends, Interest or Rent? 1 - Yes 2 - No 8 - Blank, but applicable Blank 138 Data User Work Area 139- If yes, how much? 142 0001 - 5200 Amount 8888 - Blank, but applicable Blank 143 Net income from their own business (nonfarm) professional practice, or partnership? 1 - Yes 2 - No 3 - Loss 8 - Blank, but applicable Blank 144 Data User Work Area 145- If yes, how much? 148 0001 - 6800 Amount 8888 - Blank, but applicable Blank 149 Net income from a farm? 1 - Yes 2 - No 3 - Loss 8 - Blank, but applicable Blank 150 Data User Work Area TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 151- If yes, how much? 154 0000 - 6500 Amount 8888 - Blank, but applicable Blank 155 Veterans payments? 1 - Yes 2 - No 8 - Blank, but applicable Blank 156 Data User Work Area 157- If yes, how much? 160 0060 - 6000 Amount 8888 - Blank, but applicable Blank 161 Alimony, child support or other support from persons not in household? 1 - Yes 2 - No 8 - Blank, but applicable Blank 162 Data User Work Area 163- If yes, how much? 166 0020 - 6900 Amount 8888 - Blank, but applicable Blank 167 Any other income? 1 - Yes 2 - No 8 - Blank, but applicable Blank 168 Data User Work Area 169- If yes, how much? 172 0003 - 6403 Amount 8888 - Blank, but applicable Blank 173- Total Amount Q 21 & 22 176 0000 - 6999 Amount 8888 - Blank, but applicable Blank 177 Check Item B 2 - Food stamps available 4 - Both - Food Stamps and commodities 178 Are you certified to participate in the food stamp program? 1 - Yes 2 - No 8 - Blank, but applicable Don't know 179 Are you buying food stamps now? 1 - Yes, Regularly 2 - Yes, Occasionally 3 - No 8 - Blank, but applicable Blank 180 What is the main reason you are not participating in the program? 1 - No need 2 - Not enough money at the time 3 - No transportation 4 - Pride 5 - Other 8 - Blank, but applicable Blank 181 Are you certified for commodity distribution program? 1 - Yes 2 - No 9 - Do not know Blank 182 Are you receiving commodity foods now for your family? 1 - Yes, regularly 2 - Yes, occasionally 3 - No Blank 183 Why aren't you participating in the program? 1 - No need 2 - No transportation 3 - Pride 4 - Other 8 - Blank, but applicable Blank 184- Date of Exam Month Control Record 185 01 - 12 186- Date of Exam Day Control Record 187 00 - 31 188- Date of Exam Year Control Record 189 76 - 80 190- Age Years At Examination 191 01 - 75 Years 00 - If less than 12 months or non- examined 192- Data User Work Area 205 TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 206 Race Sex Recode For Sample Person See Detailed Notes 1 - Male, White 2 - Male, Black 3 - Male, Other 4 - Female, White 5 - Female, Black 6 - Female, Other 207 Farm, Non-Farm Recode For Sample Person See Detailed Notes 1 - Farm 2 - Non-Farm 208 Interview Status 1 - Interviewed 209 Region See Detailed Noted 1 - Northeast 2 - Midwest 3 - South 4 - West 210- Poverty Index (x.xx) See Detailed Notes 212 001 - 880 - As Given 999 - Unknown 213- Data User Work Area 246 Head of Household Data 247- Age Years 248 15 - 99 Years (more than 100 coded as 99) 249- Data User Work Area 250 TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 251- Date-Of-Birth-Month 252 01 - 12 Month 88 - Blank, but applicable 253- Date-Of-Birth-Year 254 00 - 99 Year 255 Sex 1 - Male 2 - Female 256 Race See Detailed Notes 1 - White 2 - Black 3 - Other 257- In what state was he/she born? See Detailed Notes 258 01 - 97 88 - Blank, but applicable 259 Is he/she married, widowed, divorced, separated, or never married? 1 - Under 17 2 - Married 3 - Widowed 4 - Divorced 5 - Separated 6 - Never married 8 - Blank, but applicable 260- Natural Origin or Ancestry? 261 01 - Countries of Central or South America 02 - Chicano 03 - Cuban 04 - Mexican 05 - Mexicano 06 - Mexican-American 07 - Puerto Rican 08 - Other Spanish 09 - Other European, such as German, French, English, Irish 10 - Black, Negro or Afro-American 11 - American Indian or Alaskan Native 12 - Asian or Pacific Islander Such as Chinese, Japanese, Korean, Philippino, Samoan 13 - Another Group Not Listed 88 - Blank, but applicable 262- Highest Grade Attended 263 00 - None (regardless of age) 21 - 28 - Elementary Grades (1-8) 31 - 34 - High School (1-4) 41 - 45 - College (1-5+) 88 - Blank, but applicable 264 Grade Completed 1 - Yes 2 - No 8 - Blank, but applicable Blank 265 What was he/she doing during most of the past 12 months? 1 - Working 2 - Keeping house 3 - Something else 8 - Blank, but applicable Blank 266 What was he/she doing? 1 - Layoff 2 - Retired 3 - Student 4 - Ill 5 - Staying home 6 - Looking for work 7 - Unable to work 8 - Blank, but applicable 0 - Other Blank 267 Did he/she work at job or business during past three months? 1 - Yes 2 - No 8 - Blank, but applicable Blank 268 Did he/she work full or part-time when working? 1 - Full time 2 - Part time 8 - Blank, but applicable Blank 269 Did he/she work at any time the last two weeks not counting work around the house? 1 - Yes 2 - No 8 - Blank, but applicable Blank 270 Even though he/she did not work, does he/she have a job or business? 1 - Yes 2 - No 8 - Blank, but applicable Blank 271 Was he/she looking for work or on layoff from a job? 1 - Yes 2 - No 8 - Blank, but applicable Blank 272 Which, looking for work or on layoff from a job? 1 - Looking 2 - Layoff 3 - Both 8 - Blank, but applicable Blank 273- Type of industry or business? See Detailed Notes 275 017 - 998 (last digit 7, 8, 9) 000 - Blank, but applicable Blank 276- What kind of work was he/she doing? See Detailed Notes 278 001 - 992 - Occupation (last digit 0-6) 000 - Blank, but applicable Blank 279 Was he/she in private company or business or working for individual for wages, salary or commission? 1 - Private 2 - A Federal government employee 3 - A State government employee 4 - A local government employee 5 - Incorporated-Own 6 - Self-employed (or farm) 7 - Working without pay in family business or farm 8 - Never worked 0 - Blank, but applicable Blank 280 Did he/she ever serve in the armed forces of the U.S.? 1 - Yes 2 - No 8 - Blank, but applicable Blank 281 When did he/she serve? 1 - Vietnam 2 - Korean War 3 - World War II 4 - World War I 5 - Post Vietnam 6 - Other Service 8 - Blank, but applicable 9 - Do not know Blank SEE DETAILED NOTES FOR POSITIONS 282-326 282- Examined Final Weight 287 001218 - 079634 288- Medical History Interview Final Weight 293 001171 - 071969 294- Glucose Tolerance Test Final Examined 299 Weight 003502 - 084477 000000 300- Lead Final Examined Weight 305 001218 - 084115 000000 TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 306- Carboxyhemoglobin Final Examined Weight 311 002546 - 110759 000000 312- Bile Acids Final Examined Weight 317 003519 - 087638 000000 318- Data User Work Area 323 324- STRATA 325 01 - 32 326 PSEUDO Primary Sampling Unit 1 OR 2 328 Poverty/Non-Poverty Segments 1-Non-Poverty 2-Poverty 328- Data User Work Area 350 DETAILED NOTES, DEMOGRAPHIC DATA Size of Place Size of place classification was derived from the 1970 census. According to the definition used in the 1970 census, the urban population was comprised of all persons living in (a) places of 2,500 inhabitants or more incorporated as cities, boroughs (except Alaska),villages and towns (except towns in New York, New England States,and Wisconsin),but excluding those persons living in the rural portions of extended cities; (b) unincorporated places of 2,500 inhabitants or more; and (c) other territories included in urbanized areas. the remaining population was classified as rural. Urban areas are further classified by population size for places within urbanized areas and other places outside urbanized areas. SMSA Except in New England,a standard metropolitan statistical area is basically a county or a group of contiguous counties which contains at least one city of 50,000 inhabitants or more, or "twin cities" with a combined population of at least 50,000. In addition to the county or counties containing such a city or cities, contiguous counties are included in an SMSA if, according to the 1970 census, they are socially and economically integrated with the central city. Each SMSA must include at least one central city,and the complete title of an SMSA identifies the central city or cities. In New England, SMSA's consist of towns and cities, rather than counties. Family Unit Code All related sample persons in the same family unit have the same computer generated family unit code. This will enable analysis of individual family units. Race The race of the respondent was marked by observation and the interviewers were instructed to assume the race of all related persons was the same as the respondent unless otherwise learned.The race categories were "White","Black" or "Other". If the appropriate category could not be marked by observation, then race was asked. Interviewers were instructed to record persons who responded with something other than White or Black,such as Japanese,Chinese, American Indian, Korean, Hindu, Eskimo, etc., as "Other"; and to include Mexicans,Puerto Ricans and other persons of Latin American descent in "White", unless definitely Black, American Indian, or of other non-white race. United States Name of Place Code Alabama 01 Alaska 02 Arizona 04 Arkansas 05 California 06 Colorado 08 Connecticut 09 Delaware 10 District of Columbia 11 Florida 12 Georgia 13 Hawaii 15 Idaho 16 Illinois 17 Indiana 18 Iowa 19 Kansas 20 Kentucky 21 Louisiana 22 Maine 23 Maryland 24 Massachusetts 25 Michigan 26 Minnesota 27 Mississippi 28 Missouri 29 Montana 30 Nebraska 31 Nevada 32 New Hampshire 33 New Jersey 34 New Mexico 35 New York 36 North Carolina 37 North Dakota 38 Ohio 39 Oklahoma 40 Oregon 41 Pennsylvania 42 Rhode Island 44 South Carolina 45 South Dakota 46 Tennessee 47 Texas 48 Utah 49 Vermont 50 Virginia 51 Washington 53 West Virginia 54 Wisconsin 55 Wyoming 56 Outlying Areas of the United States Name of Place Code Description American Samoa 60 U.S. territory in the Pacific Canal Zone 61 Territory in Panama leased by U.S. Canton and Enderbury Islands 62 Under common US-UK administration Guam 66 U.S. territory in the Pacific Johnston Atoll U.S. territory in the Pacific, includes Sand Island Midway Islands 71 U.S. territory in the Pacific Puerto Rico 72 Commonwealth associated with the U.S. Swan Islands 74 U.S. territory in the Caribbean Trust Territories of the Pacific 75 U.S. administered, includes Islands Caroline, Mariana, and Marshall Island Groups U.S. Miscellaneous Caribbean 76 Includes Navassa Islands, Quito Islands Sueno Bank, Roncador Cay, Serrana Bank, Serranilla Bank U.S. Miscellaneous Pacific 77 Includes Kingman Reef, Howland, Islands Baker and Jarvis Islands, Palmyra Atoll Virgin Islands 78 U.S. territory in the Caribbean Wake Island 79 U.S. territory in the Pacific Foreign Countries North America 91 South America 92 Europe 93 Africa 94 Asia 95 Australasia 96 Pacific Islands 97 Industry and Occupation Codes A person's occupation may be defined as his principal job or business. For this survey purpose, the principal job or business of a respondent is defined in one of the following ways: If the person worked during the two-week interview period or had a job or business, the question concerning his occupation (or work) applies to his job during that period.If the respondent held more than one job, the question is directed to the one at which he spent the most time. It refers to the one he considers most important when equal time is spent at each job. A person who has not begun work at a new job, is looking for work, or is on layoff from work is questioned about his last full-time civilian job.A full-time job is defined as one at which the person spent 35 or more hours per week and which lasted two consecutive weeks or more. A person who has a job to which he has not yet reported and has never had a previous job or business is classified as a "new worker". The 1970 census of population Alphabetical Index of Industries and Occupa- tion was used in the coding of both the industry and occupation. Library of Congress Number 74-612012. For sale by the Superintendent of Documents,U.S. Government Printing Office, Washington, D.C. 20402. $3.00. Stock Number 0301-2283. Family Income Group The respondent was handed a card with 12 income ranges listed as Group A to Group L and asked "Which of these income groups represents your total com- bined family income for the past 12 months,that is,yours, your ...'s, etc? include income from all sources such as wages,salaries,social security or retirement benefits, help from relatives, rent from property and so forth." If the respondent answered Group A through G,that is with an income less than $7,000,then questions 21 and 22 detailing exact sources and amounts of income were asked; otherwise, these questions were skipped. No effort was made to reconcile amounts reported in detailed questions 21 and 22 with the categorical response to the family income group question. During the survey time period, no adjustments to the income groups or $7,000 value were made to account for inflation. Land used for farming purposes (Code 1 in Tape Position 207) was identified as being rural land (Code 2 in Tape Position 25) consisting of 10 or more acres (Code 1 in Tape Position 26) with crop sales amounting to $50 or more (Code 1 in Tape Position 27), or rural land (Code 2 in Tape Position 25) consisting of less than 10 acres(Code 2 in Tape Position 26)with crop sales amounting to $250 or more (Code 1 in Tape Position 28).All other land is classified as nonfarm (Code 2 in Tape Position 207). Region The United States was divided into four broad geographic regions of approximately equal population. Those regions, which deviate somewhat from the groups used by the Bureau of Census, are as follows: Region States Included Northeast Maine, Vermont, New Hampshire, Massachusetts, Connecticut, Rhode Island, New York, New Jersey, and Pennsylvania South Delaware, Maryland, District of Columbia, West Virginia, Virginia, Kentucky, Tennessee, North Carolina, South Carolina, Georgia, Florida, Alabama, Mississippi, Louisiana, and Arkansas Midwest Ohio, Illinois, Indiana, Michigan, Wisconsin, Minnesota, Iowa, Missouri West Washington, Oregon, California, Nevada, New Mexico, Arizona, Texas, Oklahoma, Kansas, Nebraska, North Dakota, South Dakota, Idaho, Utah, Colorado, Montana, Wyoming, Alaska, Hawaii Poverty Index Income status was determined by the Poverty Income Ratio (PIR). Poverty statistics published in the Census Bureau reports 1-5 were based on the poverty index developed by the Social Security Administration (SSA) in 1964. (For a detailed discussion of the SSA poverty standards, see reference 6.) Modifications in the definition of poverty were adopted in 1969.7 The stand- ard data series in poverty for statistical use by all executive departments and establishments has been established.8 The two components of the PIR are the total income of the household (numera- tors the median of the income group for incomes $7,000 and above; the sum of the porponent parts of the income questions for incomes under $7,000) and a multiple of the total income necessary to maintain a family with given characteristics on a nutritionally adequate food plan3 (denominator). The dollar value of the denominator of the PIR is constructed from a food plan (economy plan) necessary to maintain minimum recommended daily nutritional requirements.The economy plan is designated by the Department of Agriculture for "emergency or temporary use when funds are low." For families of three or more persons,the poverty level was set at three times the cost of the economy food plan.For smaller families and persons living alone,the cost of the economy food plan was adjusted by the relatively higher fixed expenses of these smaller households. The denominator or poverty income cutoff adjusts the family poverty income maintenance requirements by the family size, the sex of the family head, the age of the family head in families with one or two members, and the place of residence (farm, nonfarm).Annual revisions of the poverty income cutoffs are based on the changes in the average cost of living as reflected in the Consumer Price Index. As shown in the tables, the annual income considered to be the poverty level increases as the family size increases. A family with any combination of characteristics and with the same income as shown in the table has been designated as having a PIR or poverty level of 1.0. The same family with twice the income found in the table would have a PIR of 2.0. Ratios of less than 1.0 can be described as "below poverty",ratios greater than or equal to 1.0, as "at or above poverty". Poverty thresholds are computed on a national basis only. No attempt has been made to adjust these thresholds for regional,state,or other variations in the cost of living (except for the farm, nonfarm difference).None of the noncash public welfare benefits such as food stamp bonuses are included in the income of the low income families receiving these benefits.PIR has been adjusted by year (see tables) and accounts in some part for inflation. 1 U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 107, "Money Income and Poverty Status of Families and Persons in the United States: 1976" (Advance Report) U.S. Government Printing Office, Washington, D.C., 1977. 2 U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 116, "Money Income and Poverty Status of Families and Persons in the United States: 1977" (Advance Report) U.S. Government Printing Office, Washington, D.C., 1978. 3 U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 120, "Money Income and Poverty Status of Families and Persons in the United States: 1978" (Advance Report), U.S. Government Printing Office, Washington, D.C., 1979. 4 U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 125, "Money Income and Poverty Status of Families and Persons in the United States: 1979" (Advance Report), U.S. Government Printing Office, Washington, D.C., 1980. 5 U.S. Bureau of the Census, Current Population Reports, Series P-60, No. 127, "MoneyIncome and Poverty Status of Families and Persons in the United States: 1980"(Advance Data from the March 1981 Current Population Survey), U.S. Government Printing Office, Washington, D.C., 1981. 6 Orshansky, M.: "Counting the Poor: Another Look at the Poverty Profile", Social Security Bulletin, January 1965; "Who's Who Among the Poor: A demographic View of Poverty", Social Security Bulletin, July 1965. 7 U.S. Bureau of the Census, Current Population Reports, Series P-23, No. 28 "Special Studies", U.S. Government Printing Office, Washington, D.C., August 12, 1969. 8 Circular No. A-46,Transmitted Memorandum No. 9,Executive Office of the President, Bureau of the Budget, August 29, 1969, and Exhibit L (rev.). 9 Centers for Disease Control, E.W. Gunter, W.E. Turner, J.W. Neese, and D.D. Bayse: Laboratory Procedures Used by the Clinical Chemistry Division, Centers for Disease Control, for the Second National Health and Nutrition Examination Survey (HANES II) 1976-1980. Public Health Service. Atlanta, 1981. 10 National Center for Health Statistics: McCarthy, P.J.: Replication: An approach to the Analysis of Data from Complex Surveys. Vital and Health Statistics. Series 2, No 14. DHEW Pub. No. (PHS) 79-1269. Public Health Service. Washington, D.C. U.S. Government Printing Office. Apr., 1966. 11 National Center for Health Statistics: Landis, J.R.,J.M. Lepkowski, S.A. Stehouwer and S.A. Eklund. A Statistical Methodology for Analyzing Data from a Complex Survey: The First National Health and Nutrition Examination Survey. Vital and Health Statistics. Series 2, No. 92. DHHS Pub. No. (PHS) 82-1366. Public Health Service. Washington, D.C. U.S. Government Printing Office. Sept., 1982. 12 National Center for Health Statistics: McDowell, A., A. Engel, J.T. Massey and K. Maurer: Plan and Operation of the Second National Health and Nutrition Examination Survey, 1976-1980. Vital and Health Statistics. Series 1, No. 15. DHHS Pub. No. (PHS) 81-1317. Public Health Service. Washington, D.C. U.S. Government Printing Office. July, 1981. 13 National Center for Health Statistics: Percutaneous Immediate Hypersensitivity to Eight Selected Allergens in the Civilian Nonnstitutionalized Population Ages 6-74 Years: United States, 1976-1980. Series 11, No. 235. DHHS Pub. No. (PHS) 86-1685. Public Health Service. Washington, D.C. U.S. Government Printing Office. In Publication. 14 Survey Research Center Computer Support Group, OSIRIS IV User's Manual, Institute for Social Research, University of Michigan, Ann Arbor, Michigan, 1979. 15 Holt, M.M.: SURREGR: Standard Errors of Regression Coefficients from Sample Survey Data. Research Triangle Institute, Research Triangle Park, N.C., 1977. (Revised Apr., 1982 by B.V. Shah). 16 Hidiroglou, M.A., Fuller, W.A., Hickman, R.D.: SUPERCARP. Sixth Edition. Survey Section, Statistical Laboratory, Iowa State University, Ames, Iowa. Oct., 1980. 17 Woodruff, R.S.: A Sample Method for Approximating the Variance of a Complicated Estimate. Journal of the American Statistical Association, 66:411-414, 1971. 18 Shah, B.V.: SESUDAAN: Standard Errors Program for Computing of Standardized Rates form Sample Survey Data. Research Triangle Institute, Research Triangle Park, N.C., RTI/5250/00-01s, Apr., 1981. Table 15. Weighted Average Thresholds, 1976 WEIGHTED AVERAGE THRESHOLDS--POVERTY CUTOFFS IN 1976, BY SIZE OF FAMILY AND SEX OF HEAD, BY FARM-NONFARM RESIDENCE NONFARM SIZE OF FAMILY UNIT Total Total Male Head Female Head (Dollars) (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . . . . . 2 877 2 884 3 016 2 788 14 to 64 Years . . . . . . . 2 954 2 959 3 069 2 840 65 Years And Over. . . . . . 2 720 2 730 2 758 2 722 2 Persons. . . . . . . . . . . 3 688 3 711 3 721 3 660 Head 14 to 64 Years. . . . . 3 806 3 826 3 846 3 733 Head 65 Years and Over . . . 3 417 3 445 3 447 3 428 3 Persons. . . . . . . . . . . 4 515 4 540 4 565 4 414 4 Persons. . . . . . . . . . . 5 786 5 815 5 818 5 790 5 Persons. . . . . . . . . . . 6 838 6 876 6 884 6 799 6 Persons. . . . . . . . . . . 7 706 7 760 7 766 7 709 7 Persons Or More. . . . . . . 9 505 9 588 9 622 9 375 FARM SIZE OF FAMILY UNIT Total Male Head Female Head (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . 2 438 2 532 2 348 14 to 64 Years . . . . . . . . . . . . 2 542 2 608 2 413 65 Years And Over. . . . . . . . . . . 2 322 2 344 2 313 2 Persons. . . . . . . . . . . . . . . . 3 128 3 133 3 033 Head 14 to 64 Years. . . . . . . . . . 3 267 3 271 3 159 Head 65 Years and Over . . . . . . . . 2 928 2 928 2 922 3 Persons. . . . . . . . . . . . . . . . 3 858 3 864 3 734 4 Persons. . . . . . . . . . . . . . . . 4 950 4 953 4 840 5 Persons. . . . . . . . . . . . . . . . 5 870 5 871 5 847 6 Persons. . . . . . . . . . . . . . . . 6 585 6 584 6 607 7 Persons Or More. . . . . . . . . . . . 8 072 8 068 8 428 Table 15. Weighted Average Thresholds, 1977 WEIGHTED AVERAGE THRESHOLDS--POVERTY CUTOFFS IN 1977, BY SIZE OF FAMILY AND SEX OF HEAD, BY FARM-NONFARM RESIDENCE NONFARM SIZE OF FAMILY UNIT Total Total Male Head Female Head (Dollars) (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . . . . . 3 067 3 075 3 214 2 969 14 to 64 Years . . . . . . . 3 147 3 152 3 267 3 023 65 Years And Over. . . . . . 2 895 2 906 2 936 2 898 2 Persons. . . . . . . . . . . 3 928 3 951 3 961 3 907 Head 14 to 64 Years. . . . . 4 054 4 072 4 095 3 981 Head 65 Years and Over . . . 3 637 3 666 3 670 3 646 3 Persons. . . . . . . . . . . 4 806 4 833 4 860 4 708 4 Persons. . . . . . . . . . . 6 157 6 191 6 195 6 162 5 Persons. . . . . . . . . . . 7 279 7 320 7 329 7 238 6 Persons. . . . . . . . . . . 8 208 8 261 8 268 8 197 7 Persons Or More. . . . . . . 10 137 10 216 10 249 9 995 FARM SIZE OF FAMILY UNIT Total Male Head Female Head (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . 2 588 2 672 2 498 14 to 64 Years . . . . . . . . . . . . 2 709 2 776 2 569 65 Years And Over. . . . . . . . . . . 2 475 2 495 2 563 2 Persons. . . . . . . . . . . . . . . . 3 318 3 325 3 176 Head 14 to 64 Years. . . . . . . . . . 3 466 3 474 3 278 Head 65 Years and Over . . . . . . . . 3 128 3 131 3 079 3 Persons. . . . . . . . . . . . . . . . 4 093 4 110 3 893 4 Persons. . . . . . . . . . . . . . . . 5 273 5 274 5 213 5 Persons. . . . . . . . . . . . . . . . 6 247 6 247 6 237 6 Persons. . . . . . . . . . . . . . . . 7 026 7 026 7 040 7 Persons Or More. . . . . . . . . . . . 8 708 8 706 8 738 Table A-3. Weighted Average Thresholds, 1978 WEIGHTED AVERAGE THRESHOLDS AT THE POVERTY LEVEL IN 1978, BY SIZE OF FAMILY AND SEX OF HEAD, BY FARM-NONFARM RESIDENCE NONFARM SIZE OF FAMILY UNIT Male Female Total Total Head1 Head1 1 Person (Unrelated Individual). . . . . . . . . $3,302 $3,311 $3,460 $3,196 14 to 64 Years . . . . . . . 3,386 3,392 3,516 3,253 65 Years And Over. . . . . . 3,116 3,127 3,159 3,118 2 Persons. . . . . . . . . . . 4,225 4,249 4,258 4,206 Head 14 to 64 Years. . . . . 4,363 4,383 4,407 4,286 Head 65 Years and Over . . . 3,917 3,944 3,948 3,923 3 Persons. . . . . . . . . . . 5,178 5,201 5,231 5,065 4 Persons. . . . . . . . . . . 6,628 6,662 6,665 6,632 5 Persons. . . . . . . . . . . 7,833 7,880 7,888 7,806 6 Persons. . . . . . . . . . . 8,825 8,891 8,895 8,852 7 Persons Or More. . . . . . . 10,926 11,002 11,038 10,765 FARM SIZE OF FAMILY UNIT Male Female Total Head1 Head1 1 Person (Unrelated Individual). . . . . $2,795 $2,898 $2,690 14 to 64 Years . . . . . . . . . . . . 2,913 2,987 2,764 65 Years And Over. . . . . . . . . . . 2,661 2,685 2,650 2 Persons. . . . . . . . . . . . . . . . 3,578 3,582 3,497 Head 14 to 64 Years. . . . . . . . . . 3,731 3,737 3,614 Head 65 Years and Over . . . . . . . . 3,352 3,354 3,313 3 Persons. . . . . . . . . . . . . . . . 4,413 4,430 4,216 4 Persons. . . . . . . . . . . . . . . . 5,681 5,683 5,622 5 Persons. . . . . . . . . . . . . . . . 6,714 6,714 6,700 6 Persons. . . . . . . . . . . . . . . . 7,541 7,543 7,462 7 Persons Or More. . . . . . . . . . . . 9,373 9,386 8,813 1 For one person (i.e., unrelated individual), sex of the individual. Table A-3. Weighted Average Thresholds, 1979 WEIGHTED AVERAGE THRESHOLDS--POVERTY CUTOFFS IN 1979, BY SIZE AND TYPE OF FAMILY, BY FARM-NONFARM RESIDENCE NONFARM Families With SIZE OF FAMILY UNIT Total Total Female HHLDR, No Husband1 All Other Present Families2 (Dollars) (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . . . . . 3 683 3 689 3 556 3 855 14 to 64 Years . . . . . . . 3 773 3 778 3 619 3 912 65 Years And Over. . . . . . 3 472 3 479 3 469 3 515 2 Persons. . . . . . . . . . . 4 702 4 725 4 669 4 737 Head 14 to 64 Years. . . . . 4 858 4 878 4 762 4 905 Head 65 Years and Over . . . 4 364 4 390 4 362 4 394 3 Persons. . . . . . . . . . . 5 763 5 784 5 624 5 820 4 Persons. . . . . . . . . . . 7 386 7 412 7 381 7 416 5 Persons. . . . . . . . . . . 8 736 8 775 8 690 8 785 6 Persons. . . . . . . . . . . 9 849 9 914 9 843 9 922 7 Persons Or More. . . . . . . 12 212 12 280 12 037 12 322 FARM Families With Female HHLDR, No Husband All Other SIZE OF FAMILY UNIT Total Present1 Families2 (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . 3 138 3 001 3 236 14 to 64 Years . . . . . . . . . . . . 3 254 3 076 3 324 65 Years And Over. . . . . . . . . . . 2 963 2 948 2 988 2 Persons. . . . . . . . . . . . . . . . 3 987 3 917 3 991 Head 14 to 64 Years. . . . . . . . . . 4 156 4 027 4 163 Head 65 Years and Over . . . . . . . . 3 730 3 686 3 732 3 Persons. . . . . . . . . . . . . . . . 4 917 4 680 4 928 4 Persons. . . . . . . . . . . . . . . . 6 329 6 261 6 332 5 Persons. . . . . . . . . . . . . . . . 7 492 7 509 7 492 6 Persons. . . . . . . . . . . . . . . . 8 424 8 309 8 428 7 Persons Or More. . . . . . . . . . . . 10 533 10 178 10 547 1 Includes female unrelated individuals. 2 Includes male unrelated individuals. Table 17. Weighted Average Thresholds, 1980 WEIGHTED AVERAGE THRESHOLDS--POVERTY CUTOFFS IN 1980, BY SIZE AND TYPE OF FAMILY, BY FARM-NONFARM RESIDENCE NONFARM Families With SIZE OF FAMILY UNIT Total Total Female HHLDR, No Husband1 All Other Present Families2 (Dollars) (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . . . . . 4 184 4 190 4 037 4 379 14 to 64 Years . . . . . . . 4 286 4 290 4 109 4 441 65 Years And Over. . . . . . 3 941 3 949 3 938 3 990 2 Persons. . . . . . . . . . . 5 338 5 363 5 316 5 373 Head 14 to 64 Years. . . . . 5 518 5 537 5 415 5 568 Head 65 Years and Over . . . 4 954 4 983 4 946 4 988 3 Persons. . . . . . . . . . . 6 539 6 565 6 388 6 605 4 Persons. . . . . . . . . . . 8 385 8 414 8 382 8 418 5 Persons. . . . . . . . . . . 9 923 9 966 9 878 9 976 6 Persons. . . . . . . . . . . 11 215 11 269 11 227 11 274 7 Persons Or More. . . . . . . 13 883 13 955 13 767 13 986 FARM Families With Female HHLDR, No Husband All Other SIZE OF FAMILY UNIT Total Present1 Families2 (Dollars) (Dollars) (Dollars) 1 Person (Unrelated Individual). . . . . 3 539 3 392 3 680 14 to 64 Years . . . . . . . . . . . . 3 693 3 492 3 773 65 Years And Over. . . . . . . . . . . 3 359 3 347 3 392 2 Persons. . . . . . . . . . . . . . . . 4 502 4 302 4 513 Head 14 to 64 Years. . . . . . . . . . 4 714 4 497 4 721 Head 65 Years and Over . . . . . . . . 4 233 4 185 4 237 3 Persons. . . . . . . . . . . . . . . . 5 573 5 271 5 587 4 Persons. . . . . . . . . . . . . . . . 7 170 7 152 7 170 5 Persons. . . . . . . . . . . . . . . . 8 472 8 373 8 474 6 Persons. . . . . . . . . . . . . . . . 9 613 9 168 9 625 7 Persons Or More. . . . . . . . . . . . 11 915 12 133 11 389 1 Includes female unrelated individuals. 2 Includes male unrelated individuals. Tape Positions 282-323 A multistage estimation procedure was used to calculate the various NHANES II subsample sample weights that are necessary to use in any analysis of the data.The procedure has three basic components:(1) inflation by reciprocals of the probabilities of selection, (2) adjustment for nonresponse, and (3) poststratification ratio adjustment by age-sex-race. A brief description of each component is as follows: Inflation by reciprocals of the sampling probabilities.Since the survey utilized a three-stage sample design, there were three probabilities of selection: (1) the probability of selecting the PSU,(2) the probability of selecting a segment (housing unit),and (3) the probability of select- ing a sample person. Adjustment for nonresponse. Estimates from the NHANES II data were adjusted to account for sample persons who were not examined. The estimates were inflated by a multiplication factor calculated within five selected income groups, three age groups, four regions, and standard metropolitan statistical area (SMSA) or non-SMSA. The numerator of these factors was the sum of the weights for sample persons resulting from the reciprocal of the probability of selection, and the denominator was the sum of the weights for examined persons also resulting from the reciprocals of the sampling probabilities. Poststratification by age-sex-race. The estimates were ratio adjusted within each of 76 age-sex-race cells to an independent estimate,provided by the U.S. Bureau of the Census, of the population of each cell as of March 1, 1978, (approximate mid-point of the survey). The ratio adjustment was a multiplication factor of which the numerator was the U.S.population and the denominator was the sum of the weights adjusted for nonresponse for examined persons. This ratio estimation process makes the sample more closely representative of the civilian, noninstitutionalized population of the U.S. Potential bias of nonresponse.Usually a sizeable number of sample persons who initially are willing to complete the household information and some of the medical history questionnaire subsequently will not participate in the examination.This creates the potential for bias if these persons differ from other sample persons with respect to the variables being studied. Intense efforts were undertaken during NHANES II to develop and implement standard procedures and inducements that would reduce the number of nonrespondents and thereby reduce the potential for bias. The user needs to be aware of and should explore the potential bias for nonresponse in any analysis of the NHANES II data. HEMATOLOGY AND BIOCHEMISTRY INFORMATION General Information Blood samples collected in NHANES II provided a broad range of information related to health and nutrition. The particular tests performed varied with specific age groups (Tables 1-2). A more complete discussion of the development of this analytic plan is provided in Series 1, No.15 as described on page 1 of this documentation. The anemia subsample determinations identified in Table 1 and other selected blood findings from NHANES II will be included in a later version of this date tape. These are: Red Cell Folate Serum Folate Serum Ferritin Serum Vitamin B12 Bile Salts Serum Cholesterol Triglyceride Pesticides Serum Creatinine Syphilis Serology The methods used in collecting the specimens, specimen handling, shipment, laboratory processing, and methods are described in the publication "Labora- tory Procedures used by the Clinical Chemistry Division, Centers for Disease Control,for the Second Health and Nutrition Examination Survey (HANES II) 1976-1980" and is provided with this documentation.A brief description of the methodologies used for the hematological and carboxyhemoglobin determinations is presented in the detailed notes section. Table 1 Analytical Protocol for Hanes II Specimens AGE GROUP A B C D E AGE (YRS) (3) (3-11) (12-19) (20-74) (20-74) COLOR Red Green Yellow Blue Orange WHOLE BLOOD Lead Lead Lead Lead Lead Carboxy- Carboxy- Carboxy- Carboxy- Hemo- Hemo- Hemo- Hemo- globin globin globin globin Proto- Proto- Proto- Proto- Proto- porphyrin porphyrin porphyrin porphyrin porphyrin Red Cell Red Cell Red Cell Red Cell Red Cell Folate * Folate * Folate * Folate* Folate* SERUM Ferritin* Ferritin* Ferritin* Ferritin* Bile Salts** Cholesterol Cholesterol Triglyceride Triglyceride Pesticides Pesticides Creatinine Creatinine Creatinine Syphilis Syphilis Syphilis Iron Iron Iron Iron Iron Total Iron Binding TIBC TIBC TIBC TIBC Capacity (TIBC) Folate* Folate* Folate* Folate* Folate* Vitamin B12 Vitamin B12 Vitamin B12 Vitamin B12 Vitamin B12 Vitamin A Copper Copper Copper Copper Zinc Zinc Zinc Zinc Albumin Albumin Albumin Albumin Vitamin C Vitamin C Vitamin C Vitamin C PLASMA Glucose Tolerance (Fasting 1,2 h) *Anemia Subgroup Only (See Table 3) for an explanation of the subgroup criteria.) **To be tested only on a subgroup 35-74 years old.Patients were administered X-NOGR, a high-fat eggnog drink with approximately 8.6% full milk cream and egg yolks (Syntex Laboratories, Palo Alto, CA). A blood specimen was collected 2 h later for bile salts analysis. CDC performed bilirubin, asparate aminotransferase, and alkaline phosphatase measurements on samples with elevated bile salts. 2 h glucose tolerance tests were performed on this age group. A fasting blood specimen was collected; the patient was given GlucolaR (#2604,Ames Diagnostics, Elkhart, IN), a 75-g carbohydrate-load cola solution. Addi- tional specimens were collected 1 and 2 h after cola ingestion. Table 2 CRITERIA FOR INCLUSION INTO THE ANEMIA SUBGROUP (On the basis of these hematological indices,a sample person was selected for the anemia subgroup; serum and red cell folate, vitamin B12, and ferritin assays and differential smear analyses were performed. A control group was composed of those normal sample persons whose identification numbers ended in 8.) VALUE ASSESSMENT/SEX-AGE Less Than Greater Than White Cell Count (All) 3.5 (X 109/L) 13.0 (X 109/L) Red Cell Count Males 15 yrs 4.0 (X 1012/L) 6.0 (X 1012/L) Females 15 yrs Children* 3.8 (X 1012/L) 6.0 (X 1012/L) Hemoglobin Males 15 yrs 13.5 g/dL 18.5 g/dL Females 15 years 11.5 g/dL 16.5 g/dL Children* 11.0 g/dL - Hematocrit Males 15 yrs 38.0 % 56.0 % Females 15 years 32.0 % 50.0 % Children* 31.0 % - Mean Corpuscular Volume Males 15 yrs 79.5 fL 105.0 fL Females 15 years Children* 74.5 fL 100.0 fL *Persons under 16. HEMATOLOGY AND BIOCHEMISTRY DATA SUMMARY Tape Positions Catalog Number 351-354 Specimen Collection 355 Session 356 Hematocrit 357-359 Hematocrit Imputation Code 360 Hemoglobin 361-363 Hemoglobin Imputation Code 364 Red Blood Cell Count 365-367 White Blood Cell Count 368-370 Mean Corpuscular Volume 371-374 Mean Corpuscular Hemoglobin 375-377 Mean Corpuscular Hemoglobin Concentration 378-380 Serum Iron 381-383 Serum Total Iron-Binding Capacity 384-386 Transferrin Saturation 387-389 Serum Albumin 390-392 Serum Vitamin C 393-395 Serum Zinc 396-398 Serum Copper 399-401 Serum Vitamin A 402-404 Erthyrocyte Protoporphyrin 405-408 Lead 409-411 Carboxyhemoglobin 412-415 Methemoglobin 416-419 Carboxyhemoglobin Imputation Code 420 Serum lipids, lipoprotein and related data 421-439 Oral glucose tolerance related data 440-464 Oral glucose challenge results 465-474 Serum ferritin 475-478 RBC folate 479-482 Serum folate 483-486 Serum B 12 487-490 Differential counts 491-510 Serum creatinine 511-513 Urine multistix test results 514-521 Bile acid data 522-527 Unused positions 528-530 USE OF SPECIAL TERMS, HEMATOLOGY AND BIOCHEMISTRY DATA HEMATOLOGY AND BIOCHEMISTRY DATA Use of Special Terms The term "data user work area" refers to blank areas in the data tape which are reserved for the user as needed. The term "blank,but applicable",is used to indicate a data item that was to have a response for a sample person but none was given.The terms "blank" and "Not applicable" refer to data items where the sample person was not supposed to respond to the question or receive the examination component or blood test. To more fully understand the "blank" and "not applicable" categorizations see the Lab Manual - and Refer to the Test number with it's priorities, etc. RECORD LAYOUT, HEMATOLOGY AND BIOCHEMISTRY DATA NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES II - 1976 - 1980) HEMATOLOGY AND BIOCHEMISTRY DATA The blood and urine assessments from tape positions 421-530 are not available in Version 1 of this data tape. Each one of these assessments had some type of data quality issue that needed to be resolved before the data could be released for general use. These issues ranged from laboratory quality control concerns to large amounts of missing data. Many of these assessments have special sample weights that need to be used to analyze the data. The user is strongly encouraged to read the detailed notes for each assess- ment. The interpretation of the results for many of these blood and urine variables should be made with caution. Any analysis should include a complete description of the laboratory methodology and an in-depth study of nonresponse bias. Tape Positions 328-420 TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 328- Serum Ferritin Final Examined Weight 333 001977 - 351679 000000 334- Folates, Vitamin B12 and Differential 339 Counts Final Examined Weight 001606 - 579093 000000 340- Unused positions 350 351- CATALOG NUMBER: 5411 354 355 Specimen Collection 1 - Venipuncture See Detailed Notes 2 - Capillary 8 - Blank, but applicable 356 Session 1 - AM 2 - PM 3 - Night 8 - Unknown 357- Hematocrit (Percent) See Detailed Notes 359 (xx.x - decimal not shown on tape) 145 - 617 - As given 888 - Blnk, but applicable 360 Hematocrit Imputation Code See Detailed Notes 1 - Not imputed 2 - Imputed 361- Hemoglobin (grams per deciliter) (g/dL) 363 (xx.x - decimal not shown on tape) See Detailed Notes 037 - 202 - As given 888 - Blank, but applicable 364 Hemoglobin Imputation Code See Detailed Notes 1 - Not imputed 2 - Imputed 365- Red Blood Cell Count (x1012/liter) 367 (x.x - decimal not shown on tape) See Detailed Notes 225 - 798 - As given 888 - Blank, but applicable 368- White Blood Cell Count (x109/liter) 370 (xx.x - decimal not shown on tape) See Detailed Notes 021 - 735 - As given 888 - Blank, but applicable 371- Mean Corpuscular Volume Computer Generated 374 (femtoliters) (fL) (xxx.x - decimal not shown on tape) 0507 - 1263 - As given 8888 - Blank but applicable 375- Mean Corpuscular Hemoglobin Computer Generated 377 (picograms (pg) (xx.x - decimal not shown on tape) 124 - 435 - As given 888 - Blank but applicable 378- Mean Corpuscular Hemoglobin Computer Generated 380 Concentration (g/dL) (xx.x - decimal not shown on tape) 237 - 446 - As given 888 - Blank, but applicable 381- Serum Iron (micrograms per deciliter) 383 (ug/dL) (xxx.x - decimal not shown on tape) 007 - 343 - As given 888 - Blank, but applicable 384- Serum Total Iron - Binding Capacity 386 (ug/dL) (xxx. - decimal not shown on tape) 157 - 792 - As given 999 - Blank, but applicable 387- Transferrin Saturation (Percent) Computer Generated 389 (xx.x - decimal not shown on tape) 031 - 943 - As given 000 - Blank, but applicable 390- Serum Albumin (g/dL) Ages 3-74 years 392 (xx.x - decimal not shown on tape) 020 - 059 - As given 888 - Blank, but applicable 999 - Not applicable 393- Serum Vitamin C (milligrams/deciliter) Ages 3-74 years 395 (mg/dL) (xx.x - decimal not shown on tape) 001 - 181 - As given 888 - Blank, but applicable 999 - Not applicable 396- Serum Zinc (ug/dL) Ages 3-74 years 398 (xxx. - decimal not shown on tape) 042 - 240 - As given 888 - Blank, but applicable 999 - Not applicable 399- Serum Copper (ug/dL) Ages 3-74 years 401 (xxx. - decimal not shown on tape) 011 - 346 - As given 888 - Blank, but applicable 999 - Not applicable 402- Serum Vitamin A (ug/dL) Ages 3-11 years 404 (xxx. - decimal not shown on tape) 003 - 208 - As given 888 - Blank, but applicable 999 - Not applicable 405- Erythrocyte Protoporphyrin (ug/dL RBC) 408 (xxxx. - decimal not shown on tape) 0020 - 1307 - As given 8888 - Blank, but applicable 409- Lead (ug/dL) Important: 411 (xxx. - decimal not shown on tape) Special Subsample See Detailed Notes 002 - 116 - As given Use sample weight in 888 - Blank, but applicable positions 300-305 999 - Not applicable 412- Carboxyhemoglobin (percent) Important: 415 (xx.xx - decimal not shown on tape) Special Subsample See Detailed Notes 0000 - 1729 - As given Use sample weight in 9999 - Not applicable positions 306-311 416- Methemoglobin (percent) Important: 419 (xx.xx - decimal not shown on tape) Special subsample See Detailed Notes 0000 - 1448 - As given Use sample weight in 9999 - Not applicable positions 306-311 420 Carboxyhemoglobin and Methemglobin See Detailed Notes Imputation Code 0 - Imputed 1 - Not imputed 9 - Not applicable SERUM LIPIDS, LIPOPROTEIN AND RELATED DATA TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 421- Serum Cholesterol (milligrams per See Detailed Notes 423 deciliter) (mg/dL) Ages 20-74 years (XXX. - decimal not shown on tape) 080 - 828 - As given 999 - Not applicable 424 Imputation Code 1 - imputed 2 - not imputed 9 - Not applicable 425 Birth Control Pill Usage Have you taken birth control pills in the last six months and are taking them now? 1 - yes See Detailed Notes 2 - no 9 - Not applicable 426- Serum Triglyceride (milligrams per Important: 429 deciliter) (mg/dL) Special subsample (XXXX. - decimal not shown on tape) See Detailed Notes 0016 - 2604 - As given Use sample weight in 8888 - Blank but applicable positions 294-299 9999 - Not applicable 430- Fasting Time (Hours) See Detailed Notes 431 00 - 48 - As given 88 - Blank but applicable 99 - Not applicable 432 Fasting Time Recode 1 = 00-09 Hours 2 = 10-11 Hours 3 = 12+ Hours 4 = Blank but applicable 9 = Not applicable 433 Session of Examination 1 - Morning 2 - Afternoon 3 - Evening 8 - Blank but applicable 9 = Not applicable 434- HDL Cholesterol (milligrams per 436 deciliter) (mg/dL) (XXX. - decimal not shown on tape) 015 - 187 - As given See Detailed Notes 888 - Blank but applicable Ages 20-74 years 999 - Not applicable 437 HDL Serum 1 - Frozen 2 - Refrozen 8 - Blank but applicable 9 - Not applicable 438- Strata - HDL Cholesterol 439 01 - 31 - As given See Detailed Notes 88 - Blank but applicable 99 - Not applicable ORAL GLUCOSE TOLERANCE TEST TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 440- How many hours ago did you IMPORTANT: 441 have your last meal? Special Subsample See Detailed Notes 01 - 48 - As given Use sample weight 88 - Blank but applicable in position 294-299 99 - Not applicable 442 Have you had anything to eat or drink, except water, since that meal? 1 - Yes 2 - No 8 - Blank but applicable 9 - Not applicable 443- How many hours ago did you have it? 00 - 17 - As given 88 - Blank but applicable 99 - Not applicable 445- Number of hours fasted Computer generated 00 - 48 - As given 87 - Blank 88 - Blank but applicable 89 - Blank 99 - Not applicable 447 Amount of time between glucola given Computer generated and one-hour specimen drawn 1 - Under 50 minutes 2 - 50 to 54 minutes 3 - 55 to 59 minutes 4 - 60 minutes 5 - 61 to 65 minutes 6 - 66 to 70 minutes 7 - 71 to 75 minutes 8 - Over 75 minutes 9 - Blank but applicable 448- Time glucola given 451 0805 - 1115 - As given 8888 - Blank but applicable 9999 - Not applicable 452 Imputed or unknown time between glucola Computer generated given and one-hour specimen drawn 3 - Time imputed 8 - Not calculated 9 - Not applicable 453- Time one-hour specimen drawn 456 0906 - 1218 - As given 8888 - Blank, but applicable 9999 - Not applicable 457 Imputed or unknown time between glucola Computer generated given and two-hour specimen drawn 3 - Time imputed 8 - Not calculated 9 - Not applicable 458 Amount of time between glucola given Computer generated and two-hour specimen drawn 1 - Under 110 minutes 2 - 110 - 114 minutes 3 - 115 - 119 minutes 4 - 120 minutes 5 - 121 - 125 minutes 6 - 126 - 130 minutes 7 - 131 - 135 minutes 8 - Over 135 minutes 9 - Not Applicable 459- Time two-hour specimen drawn 462 1004 - 1310 - As given 8888 - Blank, but applicable 9999 - Not applicable 463 Partial data - reason test incomplete Computer generated 1 - Sample person became ill 3 - Technical error 6 - Sample person refused to continue 7 - Venipuncture unsuccessful 9 - Not applicable 464 Was test satisfactory? 0 - Satisfactory test 1 - Illness 2 - Diabetic on insulin 3 - Technical error 4 - Examined in afternoon 5 - Fasting criteria not met 6 - Refusal 7 - Venipuncture unsuccessful 8 - Partial data 9 - Not applicable ORAL GLUCOSE CHALLENGE TEST RESULTS TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 465 Result classification 1 - Normal result 2 - Impaired glucose tolerance 3 - Diabetes millitus 4 - Unclassifiable 8 - Test missing 9 - Not applicable 466- Fasting plasma glucose (milligrams per See Detailed Notes 468 deciliter) (mg/dL) Use sample weight (XXX. - decimal not shown on tape) in position 294-299 031 - 400 - As given 777 - Unacceptable data 888 - Blank but applicable 999 - Not applicable 469- One-hour plasma glucose (milligrams per See Detailed Notes 471 deciliter) (mg/dL) Use sample weight (XXX. - decimal not shown on tape) in position 294-299 028 - 617 - As given 777 - Unacceptable data 888 - Blank but applicable 999 - Not applicable 472- Two-hour plasma glucose (milligrams per See Detailed Notes 474 deciliter) (mg/dL) Use sample weight (XXX. - decimal not shown on tape) in position 294-299 026 - 703 - As given 777 - Unacceptable data 888 - Blank but applicable 999 - Not applicable FERRITIN, FOLATES, VITAMIN B12 AND DIFFERENTIAL COUNTS Important: Read Detailed Notes for these fields before beginning any analysis of the data TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 475- Serum Ferritin nanogram/milliliter (ng/mL) Important: 478 (XXXX. - decimal not shown on tape) Special subsample See Detailed Notes 0001 - 1596 - As given Use sample weight in 8888 - Blank but applicable positions 328-333 9999 - Not applicable 479- RBC Folate nanogram per milliliter of Red Important: 482 Blood Cell (ng/mL) Special subsample (XXXX. - decimal not shown on tape) See Detailed Notes Use sample weight in 0025 - 3089 - As given positions 334-339 8888 - Blank but applicable 9999 - Not applicable 483- Serum Folate nanogram per milliliter of Important: 486 serum (ng/mL) Special subsample (XXX.X - decimal not shown on tape) See Detailed Notes Use sample weight in 0002 - 0795 - As given positions 334-339 8888 - Blank but applicable 9999 - Not applicable 487- Serum B12 picograms per milliliter Important: 490 (pg/mL) Special subsample (XXX.X - decimal not shown on tape) See Detailed Notes Use sample weight in 0054 - 5553 - As given positions 334-339 8888 - Blank but applicable 9999 - Not applicable DIFFERENTIAL COUNTS 491- Blast Forms (percent of 100 cells) Important: 492 Special subsample 00 See Detailed Notes 03 Use sample weight in 88 - Blank but applicable positions 334-339 99 - Not applicable 493- Promyelocytes (percent of 100 cells) 494 00 01 88 - Blank but applicable 99 - Not applicable 495- Myelocytes (percent of 100 cells) 496 00 01 - 04 88 - Blank but applicable 99 - Not applicable 497- Metamyelocytes (percent of 100 cells) 498 00 01 - 05 88 - Blank but applicable 99 - Not applicable 499- Banded Neutrophils (percent of 100 cells) 500 00 01 - 25 88 - Blank but applicable 99 - Not applicable 501- Segmented Neutrophils (percent of 100 cells) 502 00 01 - 87 88 - Blank but applicable 99 - Not applicable 503- Eosinophils (percent of 100 cells) 504 00 01 - 51 88 - Blank but applicable 99 - Not applicable 505- Basophils (percent of 100 cells) 506 00 01 - 06 88 - Blank but applicable 99 - Not applicable 507- Lymphocytes (percent of 100 cells) 508 00 05 - 86, 89 - 95 88 - Blank but applicable 99 - Not applicable 509- Monocytes (percent of 100 cells) 510 00 01 - 29 88 - Blank but applicable 99 - Not applicable 511- Serum Creatinine (milligrams per deciliter) (mg/dL) Important: (XX.X decimal not shown on tape) Special Subsample See Detailed Notes 003 - 169 - As given Ages 12 - 74 years 888 - Blank but applicable 999 - Not applicable URINE MULTISTIX TEST RESULTS See Detailed Notes Ages 6-74 years TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 514 Urine pH Number 5 - 9 - As given 1 - Blank but applicable 2 - Not applicable 515 Protein 0 - Negative 1 - 30+ 2 - 100++ 3 - 300+++ 4 - 1000++++ 5 - Trace 8 - Blank but applicable 9 - Not applicable 516 Glucose 0 - Negative 1 - Light+ 2 - Medium++ 3 - Dark+++ 4 - Very dark++++ 5 - Trace 8 - Blank but applicable 9 - Not applicable 517 Ketones 0 - Negative 1 - Small+ 2 - Moderate++ 3 - Large+++ 4 - Very large++++ 5 - Trace 8 - Blank but applicable 9 - Not applicable 518 Bilirubin 0 - Negative 1 - Small+ 2 - Moderate++ 3 - Large+++ 4 - Very large++++ 5 - Trace 8 - Blank but applicable 9 - Not applicable 519 Blood (Hematest) 0 - Negative 1 - Small+ 2 - Moderate++ 3 - Large+++ 4 - Very large++++ 5 - Trace 8 - Blank but applicable 9 - Not applicable 520 Nitrite 0 - Negative 1 - Small+ 2 - Moderate++ 3 - Large+++ 4 - Very large++++ 5 - Trace 8 - Blank but applicable 9 - Not applicable 521 Urobilinogen (Ehrlich units/ 100 milliliters of Urine) 1 - Normal 2 - 4 3 - 8 4 - 12 8 - Blank but applicable 9 - Not applicable BILE ACID RESULTS Important: Special Subsample Use sample weight in positions 312-317 See Detailed Notes Ages 35-47 years TAPE NHANES II DATA SOURCE POS. ITEM DESCRIPTION & CODES OR NOTES 522- Postprandial Serum Bile Acid 525 (Micromoles per liter) (mmol/l) (XXX.X - decimal not shown on tape) 0016 - 2050 - As given 8888 - Blank but applicable 9999 - Not applicable 526 Allergy to Eggs 1 - Yes 2 - No 8 - Blank but applicable 9 - Not applicable 527 Challenge given 1 - X-nog 2 - Substitute 8 - Blank but applicable 9 - Not applicable 528- Unused Positions 530 DETAILED NOTES, HEMATOLOGY AND BIOCHEMISTRY DATA Poverty, Non-Poverty Segments In order to oversample persons with low incomes,enumeration districts (ED's) were sorted into poverty or non-poverty strata as follows:the poverty strata contained ED's with 13 percent or more of persons below the poverty level, and the non-poverty strata contained ED's with less than 13 percent of per- sons below the poverty level as determined by the 1970 census.Thus, segments (cluster of housing units) within ED's were classified as either poverty or non-poverty. Special Subsample Weights Two special subsample weights are found in the tape positions. A procedure similar to that explained in the detailed note for tape positions 282-317 was used to calculate these sample weights. See the detailed note for tape positions 475-510 for the appropriate use of these subsample weights in analysis of the data for serum ferritin, serum vitamin B 12, serus folate, red blood cell folate, and differential leukocyte counts. Specimen Collection In NHANES II, there were 1,337 sample persons for which there is no blood or urine data. These were persons who either refused the veni- puncture, or were excused for some special circumstances. The hematology measurements were done in the mobile examination center.The hemoglobins were performed on a Coulter hemoglobinometer. Hematocrits were performed by the spun microhematocrit method. Cell counts were performed on a Coulter Model FN.The hematologic indices (MCV, MCH, MCHC) were computer generated using the spun microhematocrit value and, the following formulas: MCV (in femtoliters) = Hematocrit (percent) ____________________ RBC per liter x 100 MCH (in picograms) = Hemoglobin (g/dL) x 10 ______________________ RBC per liter MCHC (in g/dL) = Hemoglobin (g/dL) x 100 _______________________ Hematocrit (percent) If either hemoglobin or hematocrit values were missing but not both, then an imputed value was calculated for the missing item using the other known value. This was done for 30 hematocrit values and 535 hemoglobin values. No imputations were done if both items were missing. The following mathematical formulas were used in the imputation procedure: (1) Hemoglobin missing: Hemoglobin = 0.3448 x Hematocrit (2) Hematocrit missing: Hematocrit = 2.9 x Hemoglobin The NHANES II Lead subsample consisted of all sample persons ages 6 months- 6 years and one-half of all sample persons ages 7-74 years. Those sample persons not in the Lead subsample have a value of 999 in tape positions 408-411. The NHANES II carboxyhemoglobin subsample consisted of one-half of all sample persons ages 3-74 years.Those persons not in the carboxyhemoglobin subsample have "9999" in each of these two tape locations. Carboxyhemoglobin and methemoglobin level measurements were made by the spectrophotometric method of Small et al.1 1Small, K. A., Radford, E. P., Frazier, J. M., and others:A rapid method for simultaneous measurement of carboxy-and-methemoglobin in blood. J. Appl. Physiol. 31: 154-160, 1971. The carboxyhemoglobin imputation code identifies those cases where an absent or unacceptable carboxyhemoglobin value (pos. 412-415) was replaced by an acceptable value from a demographically similar examinee. Whenever a carboxyhemoglobin value was imputed, the corresponding methemoglobin value (pos. 416-419) was also imputed. A "0" in this position indicates imputed values while a "1" indicates nonimputed values. A "9" indicates that this examinee was not selected to receive a carboxyhemoglobin evaluation.In a few cases, a valid carboxyhemoglobin value did not have any methemoglobin value recorded with it; in these cases, the methemoglobin value was not imputed. Serum Lipid Determinations Blood samples were obtained by veniupunture from both fasting and non- fasting subjects. The cells were allowed to clot and the samples were then centrifuged. The serum was recovered, an aliquot was placed in a plastic screw-capped vial and placed in a freezer within three hours of collection. At approximately two-week intervals, serum specimens collected over the preceding period were placed in a styrofoam shipping container containing dry ice and shipped to George Washington University Lipid Research Clinic Laboratory for analysis of serum cholesterol, triglyceride and high density lipoprotein (HDL) cholesterol. Samples received in the laboratory were placed in a freezer at -15 degrees until they were analyzed; usually within two weeks of receipt. Specimens were allowed to thaw at room temperature and then mixed thoroughly by vortexing. All measurements were performed according to the protocol described for the Lipid Research Clinics (LRC) program. (1) Total Serum Cholesterol and Serum Triglycerides Analyses were performed on zeolite-treated isopropanol extracts using a Technicon Auto-Analyzer II (AAII) which used a Lieberman-Burchard reagent for cholesterol and a flourimetric measurement of triglycerides.Instrumental process was established at the beginning of each analytical run with cholesterol/triglycercide standards in isopropanol (100/50, 200/100, 300/200 and 400/300 mg/dl) provided by the Clinical Chemistry Standardization Section of the Centers for Disease Control (CDC). A serum calibrator was used to automatically adjust instrumental response to reference Abell-Kendall values. (2) Extracts of a high or low serum cholesterol/triglyceride internal pool were positioned in each tray; results from out of control analyses were rejected and the analyses repeated. The serum calibrator and internal control pools with assigned cholesterol/ triglyceride target values were provided by the CDC. High Density Lipoprotein Cholesterol HDL cholesterol was determined by the beta quantification procedure, which involves a combination of preparative ultracentrifugation and heparin- maganese precipitation. The determination was made on a supernatant fraction obtained after treatment of the sera with heparin and manganese chloride, to precipitate apo B containing lipoproteins. The precipitate was sedimented by centrifugation for 30 minutes at 1500 x g, and an aliquot of the clear supernatent was extracted with 9.5 volumes of 99 percent isoropanol. The extract was treated with a zeolite-containing mixture to remove interfering substances. The solids were sedimented by centrifuging for 30 minutes at 1500 x g, and the cholesterol content of the extract was measured on the AutoAnalyzer II (Technicon Instruments, Tarrytown, NY) as described in the LRC Program Operations Manual. (1) (1) Manual of Laboratory Operations, Volume 1, Lipid Research Clinics Program, Lipid and Lipoprotein Analysis. DHEW Publications No.(NIH)75-1628, 1974. (2) Bachorik P.S., Wood PDS, William J., Kuchmak M., Ahmed S. et al: Automated determinations of total Plasma Cholesterol: A Serum Calibration technique. Clin. Chem. Acta. 96:145, 1979. Lipids Imputation Process The 272 missing serum cholesterol values were imputed using a "hot deck" procedure. The variables used in the imputation process were sex, age and, for women, hormone/birth control pill use. Since less than one percent of males in NHANES II were taking hormones, the hormone variable was not used for imputing the missing values for males. Consequently, the variables used in the imputation process for each sex are as follows: Males Females (a) age (a) age (b) birth control pill use The serum cholesterol file for males was sorted by age. The serum cholesterol file for females was divided into pill and non-pill users, then each file was sorted by age. When a missing cholesterol value was encount- ered, the preceding sample person's value of the same age was substituted. If there were consecutive missing values, an interative process was used to assure that the preceding value was substituted only once. No imputations were performed for serum triglycerides or HDL cholesterol. Birth Control Pill Usage The birth control bill question was worded as follows: (a) Have you taken birth control pills during the past six months? Only if the answer to this question was yes, was the sample person asked: (b) Are you taking them now? There were 533 females ages 20-74 years who were interviewed as part of the Health History Supplement of the Medical History for NHANES II that answered "yes" to both questions. Serum Triglyceride Serum triglyceride values in positions 426-429 are for the fasting sample only. The nonfasting sample values are indicated as 9999. There were 5903 sample persons in the fasting sample. The fasting time in hours were calculated from the Glucose Challange and Related Diabetes Data questionnaire and are recorded in positions 430-431 and recoded in position 432. The questions were as follows: a. How many hours ago did you have your last meal? b. Have you had anything to eat or drink, except water, since that meal? c. How many hours ago did you have it? Note: Question "c" was only asked of those sample persons who answered "yes" to question "b". If the answer to question (b) was "yes", then the fasting time was recorded from the answer to question (c); otherwise, the number of fasting time was recorded from the answer to question (a). The analyst should use the information on actual fasting time (positions 430-431 or 432) and information on time of examination, morning, afternoon or evening (position 433) to determine legitimate triglyceride values since ther are sample persons who have fasting times less than 10 hours or who were examined in the afternoon or evening. HDL Cholesterol Strata Code for Variance Calculation The strata codes in positions 438-439 should be used when calculating complex sample variance estimates for HDL cholesterol only. For other variables on this tape, use strata codes as recorded in positions 324-325. OGTT and Blood Glucose Analysis OGTT's were administered according to ,ational Diabetes Data Group (NDDG) recommendations, which require the following: Subjects fast overnight for 10-16 hours; OGTT's are performed in the morning; a fasting blood sample is taken; subjects drink flavored water containing 75 grams of glucose or carbohydrate equivalent; and additional blood samples are taken. The drink used in NHANES II was Glucola,(a) a cola-flavored prep- aration containing a carbohydrate equivalent of 75 grams of glucose. Although the NDDG recommends that blood samples be taken at one-half hour intervals up to the final 2-hour sample, in this voluntary survey NHANES II fields staff did not attempt to obtain multiple midtest venipunctures.(The test recommended by the World Health Organization requires only fasting and 2-hour blood samples.) They did obtain fasting, single midtest, and 2-hour blood samples in 98 percent of OGTT's in compliance with NDDG guidelines. More than 95 percent of all midtest and 2-hour samples were obtained within 5 minutes of the specified times, and 99 percent were within 10 minutes. Venous blood samples were obtained in each venipuncture. Plasma was separated from blood, frozen, and shipped in dry ice to the Centers for Disease Control for analysis. There, glucose determinations were made by the Clinical Trials Section, Metabolic Biochemistry Branch, Clinical Chemistry Division, using a micradapation of the national glucose reference method. This method has been shown to have several desirable properties including reliability, transferability, specificity, and precision. It has an average bias of less than 2 percent. Further information on processing of blood samples and the classification and diagnosis of diabetes mellitus is presented in Series 11 Number 237, available from the National Center for Health Statistics. This report also presents an indepth analysis of the possible effects (bias) due to the large amount of missing data for this topic area. (a) Mention of brand names is for the purpose of specific identification of the equipment or product used in the survey and does not imply endorsement by the U.S. Department of Health and Human Services. Ferritin, Folate, B 12, and Differential Count Subsamples In NHANES II, the following assessments were done on a special subsample of persons ages 3-74 years from the total examined sample; serum ferritin, serum vitamin B 12, serum folate, red blood cell folate, and differential leukocyte counts. This subsample, (sometimes referred to as the "anemia" sample), was defined as a random ten percent sample of all examined sample persons plus all persons who had a predetermined "high" or "low" value for one or more of the following hematologic assessments: hemoglobin, hematocrit, red cell count, white cell count and mean corpuscular volume. The number of examined sample persons in this subsample was 3,909. For each assessment there were a number of persons who do not have a known value (for numerous reasons) and these are designated by blank but applicable codes. Because the sample size was relatively small to begin with and because of larger numbers of missing values for these assessments, extra caution needs to be used when any analyses of these data are done. A special sample weight was calculated for use in analysis of these data (except ferritin, see below). It is located in tape positions 334-339. Because this sample weight is based on relatively few people, the population point estimates and standard errors will be much more variable and unstable. This will often limit the presentation and interpretation of the data. Do not use the sample weight found in tape positions 282-287. This latter sample weight is appropriate to use for other blood and urine assessments on this data tape. For serum ferritin, and additional subsample of persons were selected and analyzed in the laboratory. Therefore ther were 5,833 examined sample persons in the "ferritin subsample." Of these, 5157 have a known result. A separate sample weight was calculated for this special subsample and is found in tape positions 328-333. Again, this is the only appropriate sample weight to use when analyzing the serum ferritin data. The original protocol stated that all of the above assessments (except ferritin) were to be done for all age groups. Because of the difficulty in drawing blood from young children, thes subsample assessments were only reported for ages 3074 years. In addition to the sample size issue, missing data and methodological issues are significant for each of the assessments listed above. Examples of these issues for the folate and iron assessments have been published(1,2) and should be reviewed by users before conducting analyses using these measures. (1) Expert Scientific Working Group. Summary of a report on assessment of iron nutritional status of the United States population. Am J Clin Nutr 1985:42:1318-30. (2) Senti FR and Pilch SM, editors. Analyses of folate data from the second National Health and Nutrition Examination Survey (NHANES II). J. Nutr. 1985:115:1398-1402 Serum Creatinine Serum creatinine determinations were performed by Western Laboratories (Jaffe Reaction Smac Technicon). All specimens of serum yielding creatinine values for 1.4 mg/100 ml or greater had an immediate repeat determination. The two values were then averaged, with odd identificator numbers rounded up and even identification numbers rounded down. Records showing individual values for the quality control standards were available only for part of the survey. The time period of September 1977 to December 1978 was used to evaluate the overall quality of the data since it contained the greatest number and most consistent coverage of the available quality control determinations. There were no values of the quality control standards run during this period that fell outside the designated range of 1.3 to 1.8. The overall mean of the quality control standards (Monitrol) during that period was 1.58 as compared to an expected mean of 1.55. After the survey was completed the creatinine data were subjected to further editing to eliminate erratic laboratory runs. The editing procedure used a technique involving truncated means adjusted for age and sex to detect out of range laboratory runs. This resulted in an elimination of 249 serum creatinine values from those collected on the 18-74 year age group. The nonresponse rate for serum creatinine was 28.3 percent. The reasons for item nonresponse for serum creatinine included: refusal to give blood and technical failures in blood drawing and handling of the specimens (3%), low priority given to this determination resulting in lack of serum (10-11%), and editing exclusion of erratic laboratory runs (2%). The remainder of the item nonresponse for serum creatinine can be attributed to loss of specimens in shipping (13%). A large part of this shipping loss resulted from misdirection by the post office of serum from CDC to Western Laboratories. Because of the large amount of missing data and the lack of quality control data for part of the laboratory analyses, users are urged to be extremely cautious in analyzing and interpreting the findings for serum creatinine. N - Multistix Test Results Urinalysis Ames Reagent Strip were used to test for the presence of glucose, bilirubin, ketone, blood, ph, protein, nitrite and urobilinogen in the urine. These test results may provide information regarding the status of carbohydrate metabolism, kidney and liver function, acid-based balance, and urinary tract infection. Procedure used for testing urine 1. Fresh urine specimen was collected in a clean, dry container. The urine was mixed well immediately before testing. 2. A reagent strip was replaced immediately. Reagent areas of the strip were completely immersed in the fresh urine and removed immediately to avoid dissolving out the reagents. 3. Excess urine was removed from the strip by running the edge of the strip against the rim of the urine container. The strip was held in a horizontal position to prevent possible areas and/or contaminating the hands with urine. 4. The reagent areas were compared to the corresponding color chart on the bottle label at the time specified. THE STRIP WAS HELD CLOSE TO THE COLOR BLOCKS AND MATCHED CAREFULLY. Care was taken so that the strip was not laid on the color chart because this would result in the urine soiling the chart. For more information on the specific procedure for each test, users may contact the National Center for Health Statistics or The Ames Division, Miles Laboratories, Inc., P.O. Box 70, Elkhart, Indiana 46515 Serum Bile Acid Information Two hour postprandial serum bile acids (SBA) were measured on a subsample of adults ages 36-74 years in NHANES II. Sample persons were administered X-NOG, a high fat eggnog drink containing approximately 8.6 percent full milk cream and egg yolks (manufactured by Syntex Lab, Palo Alto, CA), or the substitute (peanut butter cups) if an egg allergy was present. Two hours (plus or minus 30 minutes) after ingestion of the challenge, the blood sample was taken. The blood samples were analyzed at the Division of Gastroenterology's laboratory at the New York Hospital- Cornell Medical Center in New York City. Postprandial SBA were measured fluorometrically by means of an enzymatic technique with strict quality control. Of the 4,089 adults in the bile acids sample, 3261 (80 percent) had a SBA value available for analysis. About half of the missing data was due to a loss of blood shipment for the first five locations in the survey. The rest of the missing data was due to a variety of reasons including: refusal to have the blood drawn, an allergy to the challenge drink, insufficient amount of sera, etc. Users should be cognizant of the potential bias these missing data may have on the analysis and presentation of serum bile acids results.
