Dear colleague, we are epidemiologists of the Italian National Research Council interested in exploring the potentiality of INTERNET for performing some epidemiological investigations at international level. As far as we know it is the first attemp of this type in epidemiological research. If you are interested in joining, you are kindly requested to fill in the following questionnaire for one day (at your choice) in the week 27 March - 1 April 1995 and send it back to (EPID@CNUCE.CNR.IT). We will pleased to answer any questions concerning the results of the investigation (a gopher named "EPID.CNUCE.CNR.IT" will be available at the IP port =7000). Thank you very much for your co-operation Yours sincerely Fabio Mariani Fabrizio Bianchi Departement of Epidemiology Institute of Clinical Physiology National Research Council - ITALY e-mail: marifa@nsifc.ifc.pi.cnr.it +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++ QUESTIONNAIRE What country do you work in? !______________________________! How many people live in the town where you work? !__! Up to 100,000 !__! From 100,000 to 500,000 !__! From 500,000 to 1,000,000 !__! Greater than 1,000,000 Sex? Male !__! Female !__! When were you born? Year: !__!__!__!__! What is the highest level of schooling that you have completed? !__! Completed primary school or less !__! Secondary school !__! Completed secondary school !__! College or university !__! completed college or university !__! Don't know, or does not apply How long have you been working with a video terminal (VDT) or a personal computer (PC)? (if less than 1 year code 1) (Years) !__!__! The next three questions require information abaut your habits during the last 30 days. How many hours have you worked weekly with a VDT or PC? (number of hours) !__!__! How many times (if any) have you staed up until the small hours working with a VDT or PC? (number of occasion) !__!__! Which of the following best describes your average distance from the screen? !__! Up to 15 inches !__! 15-30 inches !__! greater tan 30 inches On how many occasions (if any) have you ever had any of the following problems for which you have taken medicine or consulted a physician? Number of occasions in your lifetime Never 1-2 3-5 6-9 10 or more pain in the lower back !__! !__! !__! !__! !__! pain in the neck !__! !__! !__! !__! !__! pain in the shoulder !__! !__! !__! !__! !__! puffy eyes !__! !__! !__! !__! !__! weak eyesight !__! !__! !__! !__! !__! a severe headache !__! !__! !__! !__! !__! Number of occasions during the last 12 months Never 1-2 3-5 6-9 10 or more pain in the lower back !__! !__! !__! !__! !__! pain in the neck !__! !__! !__! !__! !__! pain in the shoulder !__! !__! !__! !__! !__! puffy eyes !__! !__! !__! !__! !__! weak eyesight !__! !__! !__! !__! !__! a severe headache !__! !__! !__! !__! !__! Number of accasions during the last 30 days Never 1-2 3-5 6-9 10 or more pain in the lower back !__! !__! !__! !__! !__! pain in the neck !__! !__! !__! !__! !__! pain in the shoulder !__! !__! !__! !__! !__! puffy eyes !__! !__! !__! !__! !__! weak eyesight !__! !__! !__! !__! !__! a severe headache !__! !__! !__! !__! !__! +++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++++