Scientific Data DocumentationAllergy Skin Testing (1976-1980)DSN: CC37.HANES2.SKINTEST ABSTRACT DESCRIPTION OF SURVEY A detailed description of the design, content,questionnaires, 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 NHANES II was conducted on a nationwide probability sample of approximately 28,000 persons, ages 6 months-74 years, from the civilian, noninstitutional- ized 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 20782EDITING 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 detailed 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 1-33 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 32-33 Tape Positions 34-90 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 Tape Positions 91-246 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 Tape Positions 247-281 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 Tape Positions 282-350 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) Data user work area 328-350 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 Tape Locations 1-50 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 or 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 033 Household 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 Locations 51-100 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 See Detailed Notes 075 this? 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 Locations 101-150 TAPE NHANES II DATA SOURCE LOC. ITEM DESCRIPTION & CODES OR NOTES 101- What is the main type of heating system 102 you have? 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 Locations 151-205 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 Locations 206-250 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 Locations 251-305 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 Locations 306-350 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,Puert Ricans and other persons of Latin American descent in "White", unless definitely Black, American Indian, or of other non-white race. Tape Positions 57-58 and 257-258 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 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.). Table 15 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-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 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 17 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-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. DATA SET DESCRIPTION This data tape contains demographic and allergy skin testing data for all examined persons 6 through 74 years of age. Skin tests were given to determine the number of positive reactions to eight allergens, one diluent and one histamine. For positive reactions, the type and size of the reaction were recorded. ALLERGY SKIN TESTING DATA COLLECTION Allergy skin testing was conducted at the time of the medical examination. Skin tests were given to sample persons ages 6 through 74 years who consented - see Appendix B for details. The examiner was instructed to record the length and width of the wheal and of the flare at 10 minutes (first reading) and 20 minutes (second reading) after innoculation with the allergen. The "wheal" is distinguished as a raised area in the middle of the reaction and the "flare" is the reddish area, or erythema, around the wheal. Sometimes there can be a wheal without a flare and vise versa. Skin tests were conducted under standardized conditions with care for the stability of the allergens throughout the four-year survey period. Tape users are referred to a NCHS publication which examined reactivity found in this study and problems associated with the data collection for further details--Series 11-No. 235 Percutaneous Immediate Hypersensi- tivity to Eight Selected Allergens in the Civilian Noninstitutionalized Population Ages 6-74 Years, United States, 1976-80.8 Another NCHS publication describes the complete operational protocol including a copy of the allergy skin testing recording form used during the survey.9 DATA EDITING Preliminary editing of the allergy testing forms was done by the Bureau of Biologics, Food and Drug Administration, which then delivered the data to NCHS on punched cards. NCHS personnel verified and corrected, to the extent possible, problematic data and did further edits for consistency, completeness, and accuracy of the data against microfilm records of the original questionnaire where needed. ALLERGY SKIN TESTING DATA SUMMARY Catalog Number.................................................. 401-404 Dummy Records Flag.............................................. 405 Unused positions................................................ 406-408 Examiner Number................................................. 409-410 Allergen Manufacturer........................................... 411 Unused positions................................................ 412-413 Allergens House Dust................................................. 414-439 Alternaria................................................. 440-465 Cat........................................................ 466-491 Dog........................................................ 492-517 Ragweed.................................................... 518-543 Oak........................................................ 544-569 Rye Grass.................................................. 570-595 Bermuda Grass.............................................. 596-621 Control (Diluent)............................................... 622-647 Histamine....................................................... 648-673 Unused position................................................. 674 Valid Test Codes but Missing Measurement Data Allergens House Dust................................................. 675-676 Alternaria................................................. 677-678 Cat........................................................ 679-680 Dog........................................................ 681-682 Ragweed.................................................... 683-684 Oak........................................................ 685-686 Rye Grass.................................................. 687-688 Bermuda Grass.............................................. 689-690 Diluent.................................................... 691-692 Histamine.................................................. 693-694 RECORD LAYOUT, ALLERGY SKIN TESTING DATA Tape Positions 401-450 ALLERGY TESTING DATA AGES 6-74 YEARS TAPE CONTROL NHANES-II DATA POSITIONS ITEM DESCRIPTION AND CODES COUNTS SOURCE OR NOTES 401-404 CATALOG NUMBER: 5309 16,204 Allergy Testing Ages 6-74 years 405 Dummy Records Flag (See Detailed Note) 1 - Yes 193 2 - No 16,011 406-408 Unused Positions 409-410 Examiner Number (See Detailed Note) 1-79 15,887 88 - Blank, but applicable 316 91 1 411 Nelco versus Greer Antigen (See Detailed Note) 1 Nelco-Dual Use Stands 2,964 2 Greer-Dual Use Stands 3,024 3 Nelco-Single Use Stands 9,032 4 Greer-Single use Stands 1,184 412-413 Unused Positions House Dust-First Reading 414-415 Wheal Length (mm) 00 14,284 01-15 1,244 88 - Blank, but applicable 676 416-417 Wheal Width (mm) 00 14,284 01-12 1,244 88 - Blank, but applicable 676 418 Confluent 1 - Yes 75 2 - No 15,405 8 - Blank, but applicable 724 419-420 Flare Length (mm) 00 14,252 01-76 1,259 88 - Blank, but applicable 693 421-422 Flare Width (mm) 00 14,251 01-60 1,251 88 - Blank, but applicable 702 423-424 Minutes 4-8 Minutes 9 10 Minutes 15,536 13-14 Minutes 2 88 - Blank, but applicable 657 419-420 Flare Length (mm) 00 14,252 01-76 1,259 88 - Blank, but applicable 693 421-422 Flare Width (mm) 00 14,251 01-60 1,251 88 - Blank, but applicable 702 423-424 Minutes 4-8 Minutes 9 10 Minutes 15,536 13-14 Minutes 2 88 - Blank, but applicable 657 425-426 Test Results (See Detailed Note) 10-20 15,964 88 - Blank, but applicable 240 House Dust-Second Reading 427-428 Wheal Length (mm) 00 14,063 01-15 1,432 88 - Blank, but applicable 709 429-430 Wheal Width (mm) 00 14,063 01-14 1,432 88 - Blank, but applicable 709 431 Confluent 1 - Yes 64 2 - No 15,342 8 - Blank, but applicable 798 432-433 Flare Length (mm) 00 13,999 01-62 1,473 88 - Blank, but applicable 732 434-435 Flare Width (mm) 00 13,999 01-55 1,468 88 - Blank, but applicable 737 436-437 Minutes 13 Minutes 1 20 Minutes 15,520 30 Minutes 2 88 - Blank, but applicable 681 438-439 Test Results (See Detailed Note) 10-20 15,946 88 - Blank, but applicable 258 Alternaria-First Reading 440-441 Wheal Length (mm) 00 14,983 01-27 565 88 - Blank, but applicable 656 442-443 Wheal Width (mm) 00 14,983 01-15 545 88 - Blank, but applicable 656 444 Confluent 1 - Yes 37 2 - No 15,481 8 - Blank, but applicable 686 445-446 Flare Length (mm) 00 14,977 01-56 562 88 - Blank, but applicable 665 447-448 Flare Width (mm) 00 14,977 01-53 562 88 - Blank, but applicable 665 449-450 Minutes 4-8 Minutes 4 10 Minutes 15,547 13 Minutes 2 88 - Blank, but applicable 651 Tape Positions 451-500 TAPE CONTROL NHANES-II DATA POSITIONS ITEM DESCRIPTION AND CODES COUNTS SOURCE OR NOTES 451-452 Test Results (See Detailed Note) 10-20 15,961 88 - Blank, but applicable 243 Alternaria-Second Reading 453-454 Wheal Length (mm) 00 14,854 01-20 685 88 - Blank, but applicable 665 455-456 Wheal Width (mm) 00 14,854 01-15 685 88 - Blank, but applicable 665 457 Confluent 1 - Yes 41 2 - No 15,429 8 - Blank, but applicable 734 458-459 Flare Length (mm) 00 14,838 01-60 684 88 - Blank, but applicable 682 460-461 Flare Width (mm) 00 14,838 01-55 682 88 - Blank, but applicable 684 462-463 Minutes 15 Minutes 1 20 Minutes 15,544 30 Minutes 1 88 - Blank, but applicable 658 464-465 Test Results (See Detailed Note) 10-20 15,960 88 - Blank, but applicable 244 Cat-First Reading 466-467 Wheal Length (mm) 00 15,000 01-15 487 88 - Blank, but applicable 717 468-469 Wheal Width (mm) 00 15,000 01-20 487 88 - Blank, but applicable 717 470 Confluent 1 - Yes 32 2 - No 15,428 8 - Blank, but applicable 744 471-472 Flare Length (mm) 00 15,025 01-65 441 88 - Blank, but applicable 738 473-474 Flare Width (mm) 00 15,024 01-52 441 88 - Blank, but applicable 739 475-476 Minutes 4-8 Minutes 6 10 Minutes 15,484 13 Minutes 1 88 - Blank, but applicable 713 477-478 Test Results (See Detailed Note) 10-20 15,954 88 - Blank, but applicable 250 Cat-Second Reading 479-480 Wheal Length (mm) 00 14,887 01-15 578 88 - Blank, but applicable 739 481-482 Wheal Width (mm) 00 14,887 01-12 578 88 - Blank, but applicable 739 483 Confluent 1 - Yes 32 2 - No 15,389 8 - Blank, but applicable 783 484-485 Flare Length (mm) 00 14,886 01-55 561 88 - Blank, but applicable 757 486-487 Flare Width (mm) 00 14,885 01-41 560 88 - Blank, but applicable 759 488-489 Minutes 20 Minutes 15,477 30 Minutes 1 88 - Blank, but applicable 726 490-491 Test Results (See Detailed Note) 10-20 15,946 88 - Blank, but applicable 258 Dog-First Reading 492-493 Wheal Length (mm) 00 14,987 01-15 502 88 - Blank, but applicable 715 494-495 Wheal Width (mm) 00 14,987 01-15 502 88 - Blank, but applicable 715 496 Confluent 1 - Yes 37 2 - No 15,421 8 - Blank, but applicable 746 497-498 Flare Length (mm) 00 15,006 01-40 455 88 - Blank, but applicable 743 499-500 Flare Width (mm) 00 15,006 01-42 453 88 - Blank, but applicable 745 Tape Positions 501-550 TAPE CONTROL NHANES-II DATA POSITIONS ITEM DESCRIPTION AND CODES COUNTS SOURCE OR NOTES 501-502 Minutes 4-8 Minutes 6 10 Minutes 15,488 13 Minutes 1 88 - Blank, but applicable 709 503-504 Test Results (See Detailed Note) 10-20 15,949 88 - Blank, but applicable 255 Dog-Second Reading 505-506 Wheal Length (mm) 00 14,858 01-15 597 88 - Blank, but applicable 749 507-508 Wheal Width (mm) 00 14,858 01-15 596 88 - Blank, but applicable 750 509 Confluent 1 - Yes 39 2 - No 15,359 8 - Blank, but applicable 806 510-511 Flare Length (mm) 00 14,860 01-40 576 88 - Blank, but applicable 768 512-513 Flare Width (mm) 00 14,860 01-40 575 88 - Blank, but applicable 769 514-515 Minutes 20 Minutes 15,471 30 Minutes 1 88 - Blank, but applicable 732 516-517 Test Results (See Detailed Note) 10-20 15,931 88 - Blank, but applicable 273 Ragweed-First Reading 518-519 Wheal Length (mm) 00 13,843 01-31 1,644 88 - Blank, but applicable 717 520-521 Wheal Width (mm) 00 13,843 01-23 1,644 88 - Blank, but applicable 717 522 Confluent 1 - Yes 125 2 - No 15,276 8 - Blank, but applicable 803 523-524 Flare Length (mm) 00 13,830 01-74 1,612 88 - Blank, but applicable 762 525-526 Flare Width (mm) 00 13,830 01-66 1,600 88 - Blank, but applicable 774 527-528 Minutes 4-8 Minutes 11 10 Minutes 15,487 13-14 Minutes 2 88 - Blank, but applicable 704 529-530 Test Results (See Detailed Note) 10-20 15,958 88 - Blank, but applicable 246 Ragweed-Second Reading 531-532 Wheal Length (mm) 00 13,506 01-30 1,926 88 - Blank, but applicable 772 533-534 Wheal Width (mm) 00 13,506 01-30 1,925 88 - Blank, but applicable 773 535 Confluent 1 - Yes 153 2 - No 15,078 8 - Blank, but applicable 973 536-537 Flare Length (mm) 00 13,501 01-72 1,898 88 - Blank, but applicable 803 99 - Greater than 100 mm 2 538-539 Flare Width (mm) 00 13,501 01-70 1,877 88 - Blank, but applicable 826 540-541 Minutes 20 Minutes 15,453 30 Minutes 2 88 - Blank, but applicable 749 542-543 Test Results (See Detailed Note) 10-20 15,919 88 - Blank, but applicable 285 Oak-First Reading 544-545 Wheal Length (mm) 00 14,615 01-22 919 88 - Blank, but applicable 670 546-547 Wheal Width (mm) 00 14,615 01-20 919 88 - Blank, but applicable 670 548 Confluent 1 - Yes 110 2 - No 15,383 8 - Blank, but applicable 711 549-550 Flare Length (mm) 00 14,620 01-59 884 88 - Blank, but applicable 700 Tape Positions 551-600 TAPE CONTROL NHANES-II DATA POSITIONS ITEM DESCRIPTION AND CODES COUNTS SOURCE OR NOTES 551-552 Flare Width (mm) 00 14,619 01-65 883 88 - Blank, but applicable 702 553-554 Minutes 4-8 Minutes 7 10 Minutes 15,540 13-15 Minutes 2 88 - Blank, but applicable 655 555-556 Test Results (See Detailed Note) 10-20 15,956 88 - Blank, but applicable 248 Oak-Second Reading 557-558 Wheal Length (mm) 00 14,448 01-22 1,036 88 - Blank, but applicable 720 559-560 Wheal Width (mm) 00 14,448 01-23 1,036 88 - Blank, but applicable 720 561 Confluent 1 - Yes 136 2 - No 15,273 8 - Blank, but applicable 795 562-563 Flare Length (mm) 00 14,416 01-78 1,052 88 - Blank, but applicable 736 564-565 Flare Width (mm) 00 14,416 01-64 1,049 88 - Blank, but applicable 739 566-567 Minutes 15 Minutes 1 20 Minutes 15,511 30-35 Minutes 2 88 - Blank, but applicable 690 568-569 Test Results (See Detailed Note) 10-20 15,928 88 - Blank, but applicable 276 Rye Grass-First Reading 570-571 Wheal Length (mm) 00 14,056 01-35 1,461 88 - Blank, but applicable 687 572-573 Wheal Width (mm) 00 14,056 01-34 1,458 88 - Blank, but applicable 690 574 Confluent 1 - Yes 201 2 - No 15,248 8 - Blank, but applicable 755 575-576 Flare Length (mm) 00 14,098 01-74 1,393 88 - Blank, but applicable 713 577-578 Flare Width (mm) 00 14,098 01-66 1,362 88 - Blank, but applicable 744 579-580 Minutes 4-8 Minutes 8 10 Minutes 15,527 12-13 Minutes 2 88 - Blank, but applicable 667 581-582 Test Results (See Detailed Note) 10-20 15,945 88 - Blank, but applicable 259 Rye Grass-Second Reading 583-584 Wheal Length (mm) 00 13,739 01-35 1,736 88 - Blank, but applicable 729 585-586 Wheal Width (mm) 00 13,739 01-43 1,734 88 - Blank, but applicable 731 587 Confluent 1 - Yes 246 2 - No 15,070 8 - Blank, but applicable 888 588-589 Flare Length (mm) 00 13,795 01-85 1,648 88 - Blank, but applicable 759 99 - Greater than 100 mm 2 590-591 Flare Width (mm) 00 13,793 01-87 1,601 88 - Blank, but applicable 810 592-593 Minutes 15 Minutes 1 20 Minutes 15,498 30 Minutes 1 88 - Blank, but applicable 704 594-595 Test Results (See Detailed Note) 10-20 15,915 88 - Blank, but applicable 289 Bermuda Grass-First Reading 596-597 Wheal Length (mm) 00 14,830 01-30 706 88 - Blank, but applicable 668 598-599 Wheal Width (mm) 00 14,830 01-25 706 88 - Blank, but applicable 668 600 Confluent 1 - Yes 114 2 - No 15,389 8 - Blank, but applicable 701 Tape Positions 601-651 TAPE CONTROL NHANES-II DATA POSITIONS ITEM DESCRIPTION AND CODES COUNTS SOURCE OR NOTES 601-602 Flare Length (mm) 00 14,829 01-60 693 88 - Blank, but applicable 682 603-604 Flare Width (mm) 00 14,828 01-64 689 88 - Blank, but applicable 687 605-606 Minutes 4-8 Minutes 4 10 Minutes 15,544 13 Minutes 1 88 - Blank, but applicable 655 607-608 Test Results (See Detailed Note) 10-20 15,957 88 - Blank, but applicable 247 Bermuda Grass-Second Reading 609-610 Wheal Length (mm) 00 14,625 01-30 884 88 - Blank, but applicable 695 611-612 Wheal Width (mm) 00 14,625 01-25 883 88 - Blank, but applicable 696 613 Confluent 1 - Yes 140 2 - No 15,307 8 - Blank, but applicable 757 614-615 Flare Length (mm) 00 14,643 01-72 857 88 - Blank, but applicable 704 616-617 Flare Width (mm) 00 14,644 01-64 850 88 - Blank, but applicable 710 618-619 Minutes 20 Minutes 15,526 30 Minutes 1 88 - Blank, but applicable 677 620-621 Test Results (See Detailed Note) 10-20 15,942 88 - Blank, but applicable 262 Control (diluent)-First Reading 622-623 Wheal Length (mm) 00 15,466 01-09 66 88 - Blank, but applicable 672 624-625 Wheal Width (mm) 00 15,466 01-10 65 88 - Blank, but applicable 673 626 Confluent 1 - Yes 7 2 - No 15,527 8 - Blank, but applicable 670 627-628 Flare Length (mm) 00 15,465 02-40 69 88 - Blank, but applicable 670 629-630 Flare Width (mm) 00 15,465 01-45 69 88 - Blank, but applicable 670 631-632 Minutes 4-8 Minutes 4 10 Minutes 15,535 13 Minutes 1 88 - Blank, but applicable 664 633-634 Test Results (See Detailed Note) 10-20 15,950 88 - Blank, but applicable 254 Control (diluent)-Second Reading 635-636 Wheal Length (mm) 00 15,425 01-08 97 88 - Blank,but applicable 682 637-638 Wheal Width (mm) 00 15,427 01-10 97 88 - Blank, but applicable 680 639 Confluent 1 - Yes 10 2 - No 15,506 8 - Blank, but applicable 688 640-641 Flare Length (mm) 00 15,419 01-42 103 88 - Blank, but applicable 682 642-643 Flare Width (mm) 00 15,419 01-39 103 88 - Blank, but applicable 682 644-645 Minutes 20 Minutes 15,535 30 Minutes 1 88 - Blank, but applicable 668 646-647 Test Results (See Detailed Note) 10-20 15,953 88 - Blank, but applicable 251 Histamine-First Reading 648-649 Wheal Length (mm) 00 4,423 01-35 10,463 88 - Blank, but applicable 1,318 650-651 Wheal Width (mm) 00 4,424 01-39 10,462 88 - Blank, but applicable 1,318 Tape Positions 652-700 TAPE CONTROL NHANES-II DATA POSITIONS ITEM DESCRIPTION AND CODES COUNTS SOURCE OR NOTES 652 Confluent 1 - Yes 114 2 - No 14,435 8 - Blank, but applicable 1,655 653-654 Flare Length (mm) 00 4,831 01-75 9,895 88 - Blank, but applicable 1,478 655-656 Flare Width (mm) 00 4,832 01-82 9,833 88 - Blank, but applicable 1,539 657-658 Minutes 2-9 Minutes 12 10 Minutes 15,176 11-14 Minutes 5 88 - Blank, but applicable 1,011 659-660 Test Results (See Detailed Note) 10-20 15,891 88 - Blank, but applicable 313 Histamine-Second Reading 661-662 Wheal Length (mm) 00 4,263 01-33 10,093 88 - Blank, but applicable 1,848 663-664 Wheal Width (mm) 00 4,249 01-38 10,095 88 - Blank, but applicable 1,860 665 Confluent 1 - Yes 99 2 - No 13,279 8 - Blank, but applicable 2,826 666-667 Flare Length (mm) 00 4,715 01-79 9,532 88 - Blank, but applicable 1,956 95 1 668-669 Flare Width (mm) 00 4,708 01-65 9,497 88 - Blank, but applicable 1,999 670-671 Minutes 10-19 Minutes 5 20 Minutes 14,854 30 Minutes 1 88 - Blank, but applicable 1,344 672-673 Test Results (See Detailed Note) 10-20 15,565 88 - Blank, but applicable 639 674 Unused Position 16,204 675 House Dust - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 3 0 - Other 16,201 676 House Dust - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 4 0 - Other 16,200 677 Alternaria - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 3 0 - Other 16,201 678 Alternaria - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 3 0 - Other 16,201 679 Cat - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 2 0 - Other 16,202 680 Cat - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 4 0 - Other 16,200 681 Dog - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 3 0 - Other 16,201 682 Dog - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 7 0 - Other 16,197 683 Ragweed - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 6 0 - Other 16,198 684 Ragweed - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 6 0 - Other 16,198 685 Oak - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 5 0 - Other 16,199 686 Oak - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 7 0 - Other 16,197 687 Rye Grass - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 4 0 - Other 16,200 688 Rye Grass - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 3 0 - Other 16,201 689 Bermuda Grass - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 5 0 - Other 16,199 690 Bermuda Grass - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 5 0 - Other 16,199 691 Diluent - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 3 0 - Other 16,201 692 Diluent - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 6 0 - Other 16,198 693 Histamine - First Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 204 0 - Other 16,000 694 Diluent - Second Reading - NUMBER WITH VALID TEST CODES BUT ALL MEASUREMENTS MISSING (See Detailed Note) 1 - Yes 340 0 - Other 15,864 695-700 Unused positions DETAILED NOTES, ALLERGY SKIN TESTING DATA Tape Position 405 The term "Dummy Record" refers to a tape record for a respondent who was included in the sample but for whom no allergy test data was received. Although demographic data are available for all respondents, positions 405-694 are filled with 8's for all dummy records. Tape Position 411 The allergens used in this study were purchased from two different manufacturers--Nelco and Greer. In single use stands only allergens of one manufacturer were used. In dual use stands, even numbered sample persons received Greer allergens and odd numbered sample persons received Nelco allergens. The comparability of the two batteries of allergens used in this study are fully discussed in Series 11-No. 235--Percutaneous Immediate Hypersensi- tivity to Eight Selected Allergens in the Civilian Noninstitutionalized Population Ages 6-74 Years: United States, 1976-80.8 In summary, the Greer allergens were found to have increased rates of reaction for house dust, oak, and bermuda grass. The Nelco allergen was found to have a higher rate of reactivity for dogs. No differences in reactivity were found for alternaria, cat, ragweed, and rye grass. Tape Positions 425-673 Tape Postitions 425-526, 438-439, 451-452, 464-465, 477-478, 490-491, 503-504, 516-517, 529-530, 542-543, 555-556, 568-569, 581-582, 594-595, 607-608, 620-621, 633-634, 646-647, 659-660, 672-673 Test Result Codes and Definitions: Code Definition 10 No Reaction 11 Erythema between 5 and 21 mm in diameter--no wheal 12 Erythema larger than 21 mm in diameter--no wheal 13 Wheal without erythema 14 Wheal and erythema 15 Test not given--history of allergies, history of previous allergy testing, history of previous allergy shots, or on allergy medicine 16 Test not given--no histamine 17 Test not given--no reason recorded 18 Test not given--patient refusal, allergic to aspirin, patient ill, dermatitis on arms, etc. 19 No reaction at 20 minutes, data imputed--no reaction to the allergen was recorded at the 10 minute reading but no data was recorded for the 20 minutes reading. We imputed the data for no reaction at 20 minutes 20 Erythema between 1 and 4 mm in diameter--no wheal 88 Blank but applicable Tape Positions 675-694 A small number of records were found to have a valid test code indicating a reaction to the particular allergen but no measurements for either the wheal or flair were recorded. The measurement fields for these reactions were coded with an eight indicating blank but applicable. APPENDIX A - DATA COLLECTION TECHNIQUES AND CONTENT 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 Household questIonnaire: This questionnaire included for each household member items on family relationships and certain demographic variables such as age, sex, race, education, occupation, and veteran status. Also obtained were information on selected housing characteristics,family income,and an indication of the family's participation in food stamp programs. 2Medical history questionnaires: a. For each sample person 6 months-11 years of age The questionnaire included items on birth weight, prematurlty, 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 12-74 years of age The questionnaire included Items on medication, hospital care, tuberculosiS, a variety of acute and chronic diseases, tobacco usage, physical activity, weight, height, vision disability, eating and gastrointestinal problems, and participation in food programs. Detailed data were collected on anemia, diabetes, respiratory conditions, hearing and speech, liver and gallbladder conditions, kidney and bladder disease, allergies, hypertension, cardiovascular conditions, stroke and arthritis (stressing middle and upper back and neck problems). 9. QUESTIONNAIRES ADMINISTERED IN THE MOBILE EXAMINATION CENTER 1. 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. h. For each examined Person, a Food Frequency Questionnaire 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 12-74 years of aqe, 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. 2. Health History Supplement, for persons 12 through 74 years of age, included questions on cardiovascular and respiratory conditions, kidney and bladder disease, and arthritis in addition to those asked in the household Medical History. Also included were questions on pesticide exposure, smoking for persons through 17 years of age, and a menstrual and pregnancy history for females. 3. Medications/Vitamin usaqe form collected information on the past week's usage of any medicines, vitamins or minerals for all examined persons. 4. Behavior Questionnaire elicited data on behavior which may be associated with coronary heart disease for examined persons 2S through 74 years of age. C. 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. D. 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 6 through 24 years of age 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. Electrocardioqrams were made on examined persons 25 through 74 years of age. Electrocardiographic signals were digitized and recorded on magnetic tape, providing normative data on 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 or recumbent length, depending on age; body weight; triceps and subscapular skinfolds; and several other anthropometric measurements. 4. Pure tone 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 recordinq, 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. Allerqy tests, involving skin tests (prick test) with eight common alleroens (house dust, 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 ohtain degrees of skin reaction. E. X-RAYS For examined persons 25 through 74 years of age, 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-rays of the cervical and lumbar spine were taken to provide evidence of osteoarthritis and degenerative disc disease, and an 2. X-ray of the chest was taken to be used in the diagnosis of respiratory diseases and to serve as a measure of left ventricular enlargement. F. 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 6 through 74 years of age. 2. Urinary sediments, including red cells, white cells, and casts, were measured for a subsample of examined adults 20 through 74 years of age. 3. Gonorrhea cultures of urinary sediments were performed for male and female examined persons 12 through 40 years of age. However, of those females who received the Glucose Tolerance Test (GTT), only those 20 through 24 years had the gonorrhea test performee. 4. Analyses for pesticide residue and metabolite levels were carried out on a subsample of examined persons 12 through 74 years of age, including measures of the body burdens from exposure to alkyl phosphate residues and metabolites, carbamate residues, phenolic compound residues and malathion metabolites. G. 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 on page 39 of the Series 1, No. 15 program description.8 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 subsample of examined adults 20 through 74 years of age to provide estimates of the prevalence of diabetes. 2. Tests related to liver function a. A post-prandial liver bile acid test was performed to measure the ability of the liver to remove bile acids from the blood. This Involved consumption of a food preparation, which induces eventual addition of bile acids to the blood via contraction of the gallbladder, and subsequent collection of blood specimens. 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 included 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 (HOL). 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. Hematoloqy 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-ARS and MHA-TP. APPENDIX B - ALLERGY SKIN TEST PROCEDURES ALLERGY TEST Equipment Sponge wipes Needles, 25 gauge, 5/8" Allergens Alternaria Bermuda grass Cat Dog House dust Mixed long and short ragweed Oak Perennial rye grass Histamine base Phosphate buffered saline (control) General The allergy test administered by the health technicians is designed so that constitutional reactions that would necessitate the use of emergency medical procedures will be kept to a minimum. The allergens most likely to cause constitutional reactions are cat, dog, and to a lesser extent ragweed. Procedure 1. Before testing Ask the examinee whether or not he: o Has ever had even a small positive reaction to a skin test for cat, dog, or ragweed. o Has a history of allergy to cat, dog, or ragweed. Write in the examinee's age on the right side of box c, "Sex." Questions 22-24 on the Medical history for ages 6 months to 11 years and questions 58-60 on the medical history for ages 12-74 years pertain to the examinee's allergy history. If there is no indication that the examinee is allergic to cats, dogs, or ragweed or that he is highly sensitive to certain other types of materials, then administer the tests according to the instructions in this chapter. If the examinee has a history of allergy to cats, dogs, or ragweed, has had a positive reaction to any one of the three, or is known according to the Medical istory to be a highly sensitive person, do the allergy test as usual with the following exception. DO NOT administer the cat, dog, or ragweed allergens. After the 10-minute reading ask the physician to review the examinee's allergy history along with the results of the 10-minute reading for the allergens administered. The physician will decide whether to proceed with the cat, dog, and ragweed testing in total or in part based on either of the following: o The history of allergy to cats, dogs, and ragweed and the overall sensitivity of the person based on the appropriate items in the medical history. o The reactions at 10 minutes to the other allergens administered: o If less than three of the other allergens show positive reactions, (codes 12, 13, 14) then cat, dog, and ragweed allergens should be administered in the regular fashion in the other arm. (A HISTAMINE REACTION IS NOT TO BE COUNTED AS A POSITIVE). o If three or more of the other allergens show positive reactions (12, 13, 14) then cat and dog allergens will not be administered. Ragweed may be administered in the other arm, but with caution. If a wheal (the flat, edematous elevation of the skin) of at least 6 mm in diameter appears, wipe the site immediately and make a reading. Record the time the reading was made under "Minutes" if the reading was made before 10 minutes after the allergen was applied. Read again at 20 minutes even though the wheal area was wiped. If a wheal of at least 6 mm in diameter does not appear before 10 minutes after application, do the usual 10-minute and 20-minute readings. 2. Administration of the allergy test a. Sponge the inside of either forearm with alcohol and let the arm air-dry. b. Use a black marking pen to mark 10 dots, two rows of five each, for the skin pricks. Avoid the vascular areas near the elbows and wrists. c. Put a drop of allergen solution next to each dot until all ten solution have been used. Use small drops of allergens so that they won't run. d. Prick the skin under the drops by lifting the skin lightly with a 25 gauge BD needle. e. Set the timer for the 10-minute reading as soon as the first prick is made. f. When the timer goes off at 10 minutes, immediately reset it for the 20-minute reading and then read the reactions and record the results of the readings for the allergens administered according to the instructions in the next section. g. 20 minutes after the first prick read the reactions and record the results for all the allergens administered. 3. Reading the reactions and recording the results For all tests administered complete the Allergy Testing form, Deck No. 309, as follows: a. First Reading (1) Time Normally the first reading is taken 10 minutes after first prick is made. However, in the case of an extreme reaction, safety precautions, the examinee's needing to leave the exam center, or some other reason, measurements of reactions may have to be done at a time other than the standard time of 10 minutes after the prick. If there is a deviation from 10 minutes, record the time of the reading under "Minutes" and record the reason why across the bottom of the form. (2) Recording results (a) For each allergen whose wheal at 10 minutes is 6 mm or more in diameter, record the wheal's exact measurements under "Wheal Length" and "Wheal Width." Check under "Confluent" whether or not the reaction from the allergens has run into that of any other allergen. Record also the exact measurements of the flare or erythema (area of redness) surrounding the wheal under "Flare Length" and "Flare Width." Write in under "Test Results" the code that best describes the reaction from that allergen according to the code definitions given at the bottom of the Allergy Testing form. Blot the test areas after the 10-minute reading. (b) For each allergen whose wheal at 10 minutes is less than 6 mm in diameter, record whether the reaction is confluent or not, measure and record the wheal and flare length and width, and write in the code number which best describes the test results. (c) Erythema boundary -- The distinguishing of the erythema boundary is easy in most cases. Wiping with an alcohol sponge will help in the determination. In the case of a dark skinned person the boundary is harder to determine. A bright light will help with this problem. Either a 75 watt incandescent or fluorescent bulb can be used. Bright sunlight will help if a lamp is not available. In all cases, before reading wipe with an alcohol sponge. b. Second Reading (1) Time Normally the second reading is taken 20 minutes after the first prick is made. However, in the case of extreme reaction, safety precautions, an examinee's needing to leave the exam center, or some other reason, measurements of reactions may have to be done at a time other than the standard time of 20 minutes after the prick. If there is a deviation from 20 minutes, record the time of the reading under "Minutes" and record the reason why across the bottom of the form. (2) Recording results Measure the length and width of each wheal and flare and record the measurements in the appropriate spaces. Also, record whether or not the reaction was confluent with another reaction. Write in the appropriate test result according to the codes at the bottom of the form. If there is no reaction for an allergen, leave every space blank except the space for "Test Results;" record "10" in that space. c. After the second reading (1) Wipe the arm clean with alcohol. (2) Check on the form whether the test was satisfactory or unsatisfactory. If it was unsatisfactory, give reason why. (3) Don't let the examinee leave the examination center before 30 minutes after the administration of the allergens. d. Physician's report of findings In transferring the results of the allergy test to the report of findings use the following translations to make the test result codes correspondent to the codes from the "Notes on Tests and Procedures." Allergy form Report of findings test result code code 10, 20 0 11 1 12 2 13 3 14 4 15-18 5 19 6 Emergency Procedure Generalized reactions to the skin tests are not expected. However, if one does occur it may be sudden and sometimes serious. Do not wait for full development of an adverse reaction. If the examinee says he feels funny, faint, dizzy, or weak, that is the signal to immediately notify the physician who will take appropriate action. The recommended treatment is indicated below and has been excerpted from an article by Sheldon C. Siegel, M.D., as a contribution to "Current Pediatric Therapy." "At the first sign of an impending anaphylactic reaction, the following drugs should be promptly administered and the described additional measures taken as indicated: Epinephrine 1:1000, 0.3 to 0.5ml, should be administered either subcutaneously or intramuscularly. If no response is noted within 5 minutes, the dose may be repeated. In the event of severe shock with vascular collapse, 1 ml of 1:1000 epinephrine diluted in 10 ml of saline solution should be administered by slow intravenous injection. "If the anaphylaxis has been caused by a therapeutic agent injected into an extremity, a tourniquet should be placed proximal to the site to delay absorption, and an additional 0.25 ml of epinephrine injected directly into the previous injection site. "The administration of epinephrine should be followed immediately by an intramuscular or intravenous injection of an antihistaminic such as diphenhydramine (Benadryl). The dose for an older child should be comparable to that for an adult, 50 mg; for an infant or younger child, use 1 mg/kg, not exceeding 50 mg per dose or 150 mg per day." "Oxygen administered promptly will minimize the development of hypoxia, which may in itself contribute to vascular collapse and cerebral edema. Vigilance must be kept at all times to make certain the patient has adequate ventilation. Excess secretions should be removed by suction. If the airway becomes completely obstructed by angioedema, intubation or tracheostomy may be necessary." Antigen Care The test antigens should always be refrigerated to maintain their stability. To assure stability throughout a stand the following should be followed: 1. Since 4 fresh vials of each antigen are provided at the beginning of each stand, discard all opened vials midway through the stand and replace with fresh vials which have been refrigerated since the beginning of the stand. At the end of each stand, discard all opened and unopened vials of antigen. 2. During an examination session antigen vials should be kept in special containers at a temperature of between 2 and 4 C. 3. After the last session of each day and after the first session of a split session day, antigens are to be replaced in the refrigerator. Again, the ideal temperature is 2 to 4 C.
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