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Instruction Manual Data Collection, Part PART 15C Examination Staff Procedures Manual for the Health Examination Survey, 1974-1975 ~LTH. Ebb +,, %+ & Ho : U.S. DEPARTMENT OF .2 .U1 : HEALTH, EDUCATION, AND WELFARE z -s Public HealdI Service 2A @ . ~> v+ %.. Health ResourcesAdministration Q “’& @ u.s.A- CONTENTS PART I. INTRODUCTION CHAPTER 1. THE HEALTH EXAMINATION SURVEY General ------ ------ ------ ------ ------ ------- _----- ------ _----- --- 1-1 Description of the Examination ------ ------ ------ ------ ------ -- ”--- - 1-2 CHAPTER 2. QUALITY CONTROL IN DATA COLLECTION General ------- ------- ------- --.---- ------- --”---- ------- ------- - 2-1 Recording -------- -------- -----e”- -“------ .------- -------- “-- ”---- 2-2 Replicate Data ------- ------- ------- ------- --.---- --e-.-- ------- -. 2-3 CHAPTER 3. RESPONSIBILITIES OF EXAMINATION STAFF MEMBERS Medical Policy Regarding the Examination ------- ------- ----”-- ---.- 3-1 Responsibilities of All Staff Members ------- ------- ------- ------- --- 3-2 Responsibilities for Completing the Control Record ------------------ 3-20 Responsibilities for Completing the Report of Findings to Physician- --- 3-21 Responsibilities for Checking HES Documents in the Field ------------ 3-22 CHAPTER 4. EMERGENCY MEDICAL PROCEDURES Procedure ------- ---.--- ------- ---”--- ------- ------- -----”- ---- 4-1 ‘ART 11. PROCEDURES CHAPTER 5. COORDINATOR General ------ ------ ------ ------ ------ ------ ------ ------ ------ --- 5-1 Beginning of Stand ------------------------------------------------ 5-1 Before the Examination Session ------- ------- ------- ------- ------- - 5-1 During the Examination Session ------- ------- ------- ------- ------- - 5-2 After the Examination Session ------. ------- ------- ------- ------- -. 5-5 End of Stand ----------------------------------------------------- 5-5 Communication Between FOM and Examination Staff --------- --------- 5-5 iii Page CHAPTER 6. PHYSICIAN’S EXAMINATION General ------- ------- ------- ------- ------- ------- ------- ------- - 6-1 Format for the Examination ------- -. --”-- ------- --- ..-” “------ ---- 6-1 Examination Procedure -----”- ------- ------- ------- ------- -----”- . 6-3 Recording of Findings -----.- ------- ------- ------- --- .--” ------- -- 16-4 Criteria and Definitions ------- -. ”--.,- ---.---- ------- ------- ------- . 16-5 CHAPTER 7. BLOOD PRESSURE Equipment ------ ------ “----- ------ ------ ------ --- ”-- ------ ------ 7-1 Procedure ------- ------- “------ ---- ”-- ----”-- -.----- ------- ----- ‘7-1 CHAPTER 8. VENIPUNCTURE Equipment ------- ------- ------- ---”--- ------- --.--”. ------- ----- 8-1 Venipuncture Procedure ------- ------- ------- ------- ------- ------- 8-1 T3 and Tq Handling ------ ------ ------ ------ ------ ------ ----”. --”- 18-2 Hematology ------- -- m---- ------- ------- ““------ ------m ------- ---- 8-2 Clinical and Nutritional Biochemistries ----------------------------- 8-3 CHAPTER 9. CASUAL URINE COLLECTION Procedure ------ ------- ------ ------ ------ ------ ------ ------ -----m CHAPTER 10. ELECTROCARDIOGRAPHY AND SPIROMETRY Equipment ------ ------ -----” ------ .---” - ------ ---, --- ------ ------ 10-1 Code Interpretation-------------------------------"--------------- 10-1 Codes ------ ------ ------ ------ ------ ------ ------ ------- ------ ---- 10-2 Digicorder Computer Tape ------- ------- ------- -------- ------- ----- 10-3 EI<G-Spiro Data Book------------------------------"--------------- 10-4 Electrocardiogram ------- “------ --- ”--- ------- -------- ------- ----- 10-4 Spirometer ------ ------ -----” ------ ------- ------ “------ ------ ------ 10-9 Calibration Procedures ------ ----”- “----- ------ ------- ------ ------ - 101-15 Sterilization Procedure ---- =-- -------- -------- e------ ..-----” ------- - l(JI-21 CHAPTER 11. SINGLE-BREATH DIFFUSING CAPACITY Equipment --------------: --------" ------------------------------- 11-1 General --- ””-- ------- ------- ------- ---”--- ------- ..--””-- ------- - 11-1 Machine Maintenance and Calibration ------- -------- -“------ ------- --- 11-2 Criteria for an Acceptable Exam ------- -- ”---- -------- --- ”--- --- ”--- 11-4 Examination Procedure ------- ------- -. -”--- ------- -------- ------- - 11-5 Recording of Temperatures and Pressure ------- -------- ------- ------ 11-11 Interpretation of Spirogram -“----- ------- ------- --------- ------- m--- 11-11 Optional Check Procedures ---”------” ----. ---= --------------------- 11.13 iv . ~age CHAPTER 12. X-RAY Restrictions -------- -- . ------- ”------------- -------- ----- ”-- ----- 12-1 Radiation Badges ------- ------- ------- ------- ------- ------- ------ 12-1 X-Ray Exposures -------- -------- -------- ------------------------ 12-2 Procedure ------- ------- ------- ------- ------- ------- ------- ----- 12-3 Processing ------- ------- ------- ------- ------- ------- --- ”--- ----- 12-6 Field Checks and Calibrations ------------------------ -------- ----- 12-7 CHAPTER 13. AUDIOMETRY Equipment and Field Check Forms -------- -------- -------- -------- - 13-1 Pure Tone Air Conduction Testing-- ---------------- -------- ------- 13-2 Speech Discrimination Testing - . ---- ”--- ”------------- -------- ----- 13-14 CHAPTER 14. BODY MEASUREMENTS Equipment ------------------------ ---------------- -------- ------ 14-1 General -----.-- “------- -- ”------------- -------- -------- -------- - 14-1 Measuring and Recording ------------------------ ---------------- . 14-2 Procedure ------------------------ ------------------------ ------ 14-3 Field Checks -------- .------- ---------------- -------- -------- ---- 14-7 Replicates ------- ------- ------- ------- ------- ------- ------- ---”- 14-9 CHAPTER 15. QUESTIONNAIRES General ---------------- “------- -------- ------------------------ - 15-1 Health Care Needs Questionnaire -------- ---------------- ---------- 15-1 General Well-Being Questionnaire -----.-- -------- -------- -------- - 15-5 CHAPTER 16. DISTANCE VISION TESTING Equipment -------- -------- ---------------- ---------------- ------ 16-1 Procedure ------- ------- ------- ---.--- -“----- ------- ------- ----- 16-1 CHAPTER 17. NEAR VISION TESTING Equipment -------- -------- -------- ----.-”- -------- - . ---- ”------- 17-1 General -------- -------- -------- -------- ------------------------ - 17-1 Procedure ------------------------------------------------------ 17-1 Special Cases -------- -------- -------- -------- ---.---- -------- --- 17-4 v PART L INTRODUCTION CHAPTER 1 THE HEALTH EXAMINATION SURVEY General Congress in 1956 authorized the Public Health Service to conduct continuing U.S. national health surveys to collect information about the Nation’s health. This information is used by Federal, State, and local health agencies, medical researchers, educators, physicians, dentists, and many other public and private agencies. One part of these national health surveys is the Health Examination Survey which collects data on scientifically de- signed samples of the U.S. population through a series of consecutive pro- grams. The National Health Survey obtains information in several ways. People are asked questions about themselves and their health. Records of hospitals and nursing homes where people receive health care are studied. Actual health examinations are administered to get information which can only be obtained by this means. This latter method is being employed in the current Health Examination Survey (HES), a major part of the National Health Survey. Over the past 15 years, 38,000 American children, adolescents, and adults have participated voluntarily in four different surveys involving special health examinations. When the present survey is completed in 1975, an additional 7,000 persons will have received examinations. In HES data are collected by actual examinations of and tests on the individuals in the sample. Such examinations and tests can yield morbidity information that is unobtainable through other programs of the National Health Survey. They can provide information about diagnosed conditions including those which persons may fail to report or may be incapable of 1-1 reporting in a survey based upon individual interviews. They can also reveal previously undiagnosed, unattended, and nonmanifested chr”onic diseases. In addition to serving this primary purpose c)f determining prev- alence of specified diseases, the examinations are intended to obtain base- line data on certain nutritional, physical, psychological, and physiological measurements. Such measurement data on a defined pc)pulation are needed for understanding departures from the norms, as well as for assisting in planning certain specific programs dependent upon human engineering in- format ion. The individuals entering these examinations are selected through the use of a nationwide probability sample of the civilian, noninstitutionalized population of the United States. The use of such a procedure makes it pos- sible to obtain the desired statistics efficiently, economically, and in such a manner that the statistical reliability of results is determinable. The most recently completed program, the Health and Nutrition Exam- ination Survey, was designed to measure the nutritional status of the popu- lation. A broader age range (persons aged 1 to 74) was covered for the nu- trition examination part of this survey which began on April 2, 1971, and was completed on June 10, 1974. In this same survey about one-fifth of the sample persons (adults aged 25- 74) also received a more detailed examination designed to detect certain chronic diseases and to c)btain
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