EPIDEMIOLOGY STANDARDIZATION PROJECT 23
ATS-DLD-78-A 13
For Office Use
FAMILY HISTORY
28. Were either of your natural parents ever told by a doctor that they had a
chronic lung condition such as:
FATHER MOTHER
1. YES 2. NO 3. DON'T 1. YES 2. NO 3. DON'T
KNOW KNOW
A. Chronic
bronchitis? (63) (64)
B. Emphysema? (65) (66)
C. Asthma? (67) (68)
D. Lung cancer? (69) (70)
E. Other chest
conditions? (71) (72)
29A. Is parent currently alive?
(73) (74)
B. Please Specify
Age if living Age if living (75) (76)
Age at death Age at death (77) (78)
8. Don't know 8. Don't know
C. Please specify cause of death.
(79) (80)