This survey asks respondents to indicate their level of agreement with statements about the effects of pollution on human health. It addresses how pollution can negatively impact the heart, skin, respiratory system, and risk of diseases like malaria. It contains statements about how pollution contributes to problems like heart disease, skin issues, lung cancer, and the spread of mosquito-borne illnesses. The survey also gauges awareness and concern about pollution issues as well as perceptions of responsibilities to address pollution.
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Effects of pollution on Human Health-Questionnaire
1. “SURVEY ON EFFECTS OF
POLLUTION ON HUMAN HEALTH”
Name: Qualification:
Age: Designation:
Contact #: Area:
“
STRONGLY
AGREE
AGREE NEUTRAL DISAGREE STRONGLY
DISAGREE
1. Pollutionparticles in the air can lead to big problems
for your heart.
2. Worried about you risk of heart disease due to
pollution.
3. Air pollution tend to strike people more who are
elderlyor already struggling with heart disease.
4. Pollutionis also believed to inflammatory effects on
the heart, causing cardiovascular problems.
5. We are struggling to avoid situations where we are
exposed to a high level of air pollution.
6. Breathing in pollutant stuff all the time seem to
increase rate of heart attack or stroke.
7. People who live near road intersections or factories
or who direct traffic are highly on risk of heart
disease.
8. Heart disease is increasing the rate of death effecting
from pollution.
9. It is harder to safe from ultrafine dust while working
in pollutant exposure.
10. Eating a healthy, balance diet protects us from
negative impacts of pollution on heart.
11. You are worried about the risk of skin rashes due to
pollution.
12. The increase of air pollution over the years have
major effect on the human skin.
13. Ultraviolet rays (UVR) effect human skin badly.
14. Pollutionis the reason of skin cancer.
15. There are many problems caused by pollution all
around the world.
16. Pollutionleads to smog which causes ageing of the
skin.
17. Due to pollution we suffer a lot of skin problem like
skin ageing, wrinkles and a lot of skin elasticity.
2. STRONGLY
AGREE
AGREE NEUTRAL DISAGREE STRONGLY
DISAGREE
18. Exposure to smog can increase you risk of likelyto
have an eczema and other skin issues such as acne,
dryness and rashes.
19. Children are more susceptible to get skin rashes than
adults due to pollution.
20. Cigarette smoke contributes to premature ageing
and increase in the incidence of psoriasis, acne and
skin cancer.
21. How strongly you believe that pollution can cause
respiratory problems.
22. Do you get out of breath in polluted areas?
23. Do you cough several times most of the days?
24. It is difficult for you to breath in smoky areas
25. Outdoor pollution is a cause of lung cancer.
26. Indoor pollution (domestic cooking fuel) cause lung
cancer
27. Children die due to respiratory problems attributable
indoor and outdoor air pollution.
28. Smoking can cause respiratory problems.
29. Due to frequent exposure to outdoor air, children are
more susceptible to airways toxicants than adults.
30. Poor air quality due to high level of ozone can cause
asthma problems.
31. Have you, or a member of your immediate family,
ever been diagnosed with Malaria.
32. People who live near polluted areas are highly on risk
of having Malaria
33. The death rate by Malaria is increasing day by day.
34. It's hard to keep our self safe from mosquito's
35. Increase in the number of Malaria mosquito can be
an alarming situation for the society.
36. Malaria mosquito generallybreed in pools of water
leftafter the rains.
37. Children are more susceptible to get Malaria than
adults due to outdoor activities.
38. You are worried about the risk of Malaria due to
pollution.
39. How strongly you believe that pollution can cause
Malaria disease.
40. Stagnant water on the road due to bad sewerage
system increase Malaria mosquitoes.
41. You're contracted any disease transmitted by insects
bites due to pollution.
3. STRONGLY
AGREE
AGREE NEUTRAL DISAGREE STRONGLY
DISAGREE
42. There are a lot of insects and bees in pollutedareas
43. Dengue/malaria is caused by pollution.
44. Dengue can be spread through person to person
45. Increase in mosquitoes and bees causes skin cancer.
46. Mosquito bitescan cause serious issues or might
cause death.
47. Dengue can be caused by contaminated water.
48. Dengue disease is common now a days.
49. The yellowfevermosquito that cause jaundice is also
the principal dengue carrying value
50. There is a rapid increase in insects and bees due to
pollution.
51. Polluting companies should be finedeven if it puts
some jobs at risk.
52. Power stations & factories should switch to cleaner
processor evenif consumer bills & prices go up.
53. Government should do more to promote and
encourage a better environment.
54. Police should stop and check car emissions more
frequently evenif causes traffic delays.
55. Improving environment is the duty of every citizen.
56. Recycling programs should be put in place and
promoted across the whole city.
57. I am actively involved in cleaning the environment.
58. The pollutionis out of my control and I can do
anything to change it.
59. I do not see the pollutionas a problem.
60. If I knew how to better contribute to a cleaner
environment, I would take action.
61. I live in area where pollutionis the issue
62. Personal health is affected by pollution.
63. Air pollution is now the world's largest single
environment health issue.
64. Dirty air and water is life threatening.
65. Clean atmosphere is necessary to sustain life
66. For both children and adults, the air indoors can be
just as dangerous as air outdoors.
67. Where i live can affect my and my family's health.
68. I trust the government about improving pollution
issues.
69. Combustion products from traffic affect children's
health.
70. Contaminated water badly affects our health.