Environmental Health Questionnaire

When should I use the environmental history questionnaire?

• Consider having each patient fill it out one time, especially if you live in area where people have concerns about the environment.
• When the presenting symptoms seem unusual; for instance, weight loss, irritability, and “gripe”, or flu-like symptoms, along with tremor – possibility of mercury poisoning.
• When an illness fails to respond to standard therapy; for instance, prolonged rhinorrhea which is non-allergic and non-infectious – consider indoor air pollution as a source of upper airway irritation.
• When environmental factors may exacerbate a common disease with a complex etiology; for instance, environmental asthma triggers such as dust mites, mold, and outdoor air pollution or headache triggered by inadequate ventilation indoors.

Environmental Health Questionnaires

There are a number of excellent sources of environmental health questionnaires. These include the following:

• The Agency for Toxic Substances and Disease Registry (ATSDR) has a case studies in environmental medicine series. The module on “Pediatric Environmental Health” covers the broad topic to include special susceptibilities of children, and environmental exposures common to children. “Taking a Pediatric Exposure History” discusses anticipatory guidance, inclusion of environmental factors in differential, and instruction on taking an environmental history, environmental illness testing, and referral.