Environmental Impact and Sensitivity Assessment Questionnaire (QEESI): Masking Index. Take a free online course without registration.

10

Do you smoke tobacco once a week or more often?

Yes No

9

Do you consume alcoholic beverages, beer, or wine once a week or more often?

Yes No

8

Do you consume caffeinated beverages once a week or more often?

Yes No

7

Do you regularly use (once a week or more) perfumes, hairspray, or other scented personal hygiene products?

Yes No

6

Has your home or workplace been treated for pests in the last year?

Yes No

5

In your current job or hobby, do you regularly (once a week or more) come into contact with any chemicals, smoke, or vapors?

Yes No

4

Does anyone else in your house smoke besides you?

Yes No

3

Do you use a gas or propane stove for cooking at home?

Yes No

2

Is scented fabric softener used for washing your clothes or bedding?

Yes No

1

Do you regularly take steroid medications (such as prednisone), pain relievers, medications for depression, anxiety, or mood disorders, sleep medications, or drugs?

Yes No