Scientific Data Documentation
Physician's Exam, Ages 6 months - 74 years (1976-1980)
DSN: CC37.HANES2.PHYSEXAM
ABSTRACT
Description of Survey
A detailed description of the design, content, questionnaires, and operation
of NHANES II is provided in the following report: Plan and Operation of the
Second Health and Nutrition Examination Survey, 1976-1980, DHHS Pub. No.
(PHS) 81-1317 Series 1, No. 15, Public Health Service, Superintendent of
Documents, U.S. Government Printing Office, Washington, D.C. 20402. The stock
number is 017-022-00752-5 and the cost is $5.50. One copy is provided with
the documentation herein, and a general summary of the data collection
techniques and content is given in Appendix A.
TARGET POPULATION
NHANES II was conducted on a nationwide probability sample of approximately
28,000 persons, ages 6 months-74 years, from the civilian, noninstitutional-
ized population of the United States. The survey started in February 1976 and
was completed in February 1980. The NHANES II sample was selected so that
certain population groups thought to be at high risk of malnutrition (persons
with low incomes, preschool children and the elderly) were oversampled.
Adjusted sampling weights were then computed for 76 age, sex,and race
categories in order to inflate the sample in such a manner as to closely
reflect the estimated civilian noninstitutionalized U.S. population ages 6
months-74 years at the midpoint of the survey (March 1, 1978).
DATA COLLECTION TECHNIQUES AND CONTENT
The plan developed with respect to the content of NHANES II called for the
following:
A. Questionnaires completed in the household:
(1) Household questionnaire: For each household member, questions
referred to family relationships;certain demographic items such
as age, sex, and race; selected housing information;occupation,
income, education, veteran status; and an indication of
participation in food stamp programs.
(2) Medical history questionnaires:
(a) For each sample person ages 6 months-11 years
The questionnaire included items on birth weight,
prematurity,congenital conditions, medication, neurological
conditions, lead poisoning, accidents, hospital care,
disability, diarrhea, pica, vision, and a variety of chronic
conditions. In addition, data were collected on allergies,
kidney and bladder disease, anemia, speech and hearing, lung
and chest conditions, and participation in food programs.
(b) For each sample person ages 12-74 years
The questionnaire included items on medication; hospital
care; tuberculosis; a variety of acute and chronic diseases;
tobacco usage, physical activity; weight; height; vision
disability, exposure to pesticides; gastrointestinal
problems; and for females; a menstrual and pregnancy
history. In addition, data were collected on anemia,
diabetes, respiratory condition, hearing and speech, liver
and gallbladder conditions, kidney and bladder disease,
allergies, hypertension, cardiovascular conditions, stroke,
arthritis (stressing middle and upper back and neck
problems), and participation in food programs.
Questionnaires and tests administered in the mobile examination
center:
(3) Dietary Questionnaires
(a) For each examined person, a 24-Hour Recall was administered
by trained dietary interviewers. Specific and quantitative
detail of every food or drink consumed during the previous
day was recorded and calculated, thus providing estimates of
calories, protein, carbohydrates, fat, unsaturated fats,
cholesterol, and specific vitamins and minerals consumed.
(b) For each examined person, a Food Frequency interview was
administered to ascertain usual patterns of food consumption.
Daily and/or weekly consumption of foods within 26 subgroups
were recorded. In addition, data were collected on usual
vitamin-mineral supplement usage.
(c) For each person ages 12-74 years, a Dietary Supplement form
was self-administered and reviewed. This form provided
information on special diets, recent medications and barriers
to purchasing groceries or eating foods; it does not provide
information on vitamin/mineral or other supplements to the
diet.
(4) Medication/Vitamin Usage Form provided information on the past
week's usage of any medicines; vitamins or minerals for al
examined persons.
(5) Behavior Questionnaire elicited data on behavior which may be
associated with coronary heart disease for examined persons
ages 25-74.
B. Examination by physician
A physician performed and recorded the results of a medical
examination giving special attention to specified findings
related to nutrition, to hearing, to the thyroid gland,and
to the cardiovascular, respiratory, neurological and
musculoskeletal systems.
C. Special clinical procedures and tests
A specially trained health technician carried out the
following on examined persons in the designated age ranges:
1. Spirometry trials of examined persons ages 6-24 years,
were digitized and recorded on magnetic tape. Various
pulmonary function indicators such as FVC (forced vital
capacity), FEV1 (forced expiratory volume in one second),
and peak flow rate were subsequently derived from these
data.
2. Electrocardiograms Electrocardiographic signals of
examined persons ages 25-74 years were digitized and
recorded on magnetic tape providing normative data of
amplitude, duration, interval and axis measurements and
permitting interpretations of heart disease according to
the Minnesota classification code.
3. Body Measurements were made on all examinees and included
standing height, body weight, triceps and subscapular
skinfolds, and several other anthropometric measurements.
4. Puretone audiometry Tests were carried out on examined
persons between the ages of 4 and 19 years, permitting
determination of threshold levels of hearing for
frequencies of 500, 1000, 2000, and 4000 Hertz for right
and left ears.
5. Speech recording, involving use of tape recording of the
subject's repetition of specially developed sentences,was
carried out on examined persons between the ages of 4 and
6 years, permitting interpretations as an indication of
problems with articulation and language development.
6. Allergy tests, involving skin tests (prick test) with
eight common allergens (housedust, alternaria, cat fur,
dog fur, ragweed, oak, rye grass, and Bermuda grass).The
tests were made on examined persons between the ages of 6
and 74 years, to obtain degrees of skin reaction.
D. X-Rays
For examined persons ages 25-74 years, two x-rays were made.
No x-rays were taken of pregnant women and no lumbar x-rays
were taken on women under 50 years of age.
1. X-ray of cervical and lumbar spine, were taken to provide
evidence of osteoarthritis and degenerative disc disease,
and
2. X-ray of chest, to be used in the diagnosis of respiratory
diseases and to serve as a measure of left ventricular
enlargement.
E. Urine tests
Tests as follows were performed on casual samples of urine:
1. N-Multistix tests for qualitative protein, glucose,
ketones, bilirubin, blood, urobilinogen, pH, and
bacteriuria (nitrite test) were done for examined persons
ages 6-74 years.
2. Urinary sediments, including red cells, white cells, and
casts, were measured for a subsample of examined adults
ages 20-74 years.
3. Gonorrhea cultures, of urinary sediments were performed
for male and female examined persons ages 12-40 years.
However, of those females who received the Glucose
Tolerance Test (GTT) only those ages 20-24 years had the
gonorrhea test performed.
4. Analyses for pesticide residue and metabolite levels,were
carried out on a subsample of examined persons ages 12-74
years, including measures of the body burdens from
exposure to alkyl phosphate residues and metabolites,
carbamate residues, phenolic compound residues and
malathion metabolites.
F. Tests on blood samples
Samples of blood provide a broad range of information related
to health and nutrition. The particular tests performed
varied with the specific target condition and age group as
described in the Series 1, No.15 program description (page
39).
1. Glucose tolerance test (GTT)
This test involved collection of blood specimens while in
a fasting state, as well as at one and two hours after
glucose challenge. The test was performed on a specified
subsample of examined adults to provide estimates of the
prevalence of diabetes.
2. Tests related to liver function
(a) Post-prandial liver bile acid test. This test
measures the ability of the liver to remove bile
acids from the blood following consumption of a food
preparation which induces eventual addition of bile
acids to the blood via contraction of the
gallbladder.
(b) Liver biochemistries performed include bilirubin,
SGOT, and alkaline phosphatase tests.
3. Anemia-related laboratory tests
The tests made to characterize anemia consisted of
protoporphyrin,iron,total iron binding capacity (TIBC),
zinc, copper, red cell folates, serum folates, serum
ferritin, B12, and the determination of abnormal
hemoglobin.
4. Other nutritional biochemistries
These tests include albumin,Vitamin A and Vitamin C.
5. Serum lipids
Because of their important relevance to cardiovascular
disease, determinations were made of cholesterol,
triglycerides, and high density lipoprotein (HDL).
6. Biochemistries for body burden from environmental
exposures
Determinations were made of body burden levels of lead
and pesticide residues and metabolites.Tests were also
performed for carboxyhemoglobin which reflects
environmental exposure to carbon monoxide and the
individual's smoking habits.
7. Hematology
The hematology included determinations of hemoglobin,
hematocrit,red blood cell count,white blood cell count
and differential leukocyte analysis, and red blood cell
morphology and hemoglobin phenotyping.
8. Kidney function
The only quantitative test for kidney function performed
on blood samples was the serum creatinine test.
9. Syphilis
The serology determinations for syphilis included
qualitative and quantitative ART, a FTA-ABS and MHA-TP.
USE OF NHANES DATA
NCHS requests the cooperation of recipients of data tapes in certain actions
related to their use:
1. Any publication based on the data should acknowledge the National
Center for Health Statistics (NCHS) as the original source.It should
include a disclaimer which credits the authors for any analyses,
interpretations, or conclusions, and not NCHS, which is responsible
only for the data.
2. Consumers who wish to publish a technical description of the data
should make a reasonable effort to ensure that the description is not
inconsistent with that published by NCHS.This does not mean, however,
that NCHS will review such descriptions.
3. The National Center for Health Statistics would appreciate receiving
reprints of journal articles or other publications based upon find-
ings from the NHANES II survey. Please forward copies to:
Division of Health Examination Statistics
National Center for Health Statistics
Center Building, Room 2-58,
3700 East-West Highway
Hyattsville, Maryland 20782
EDITING OF THE DATA SETS
The data users' tapes have been subjected to a great deal of careful editing.
Some of the continuous data items have extremely high or low values and it
has been verified that they do in fact appear that way on the original inter-
view documents; that is, it has been verified that the values have not been
incorrectly keyed.Within each data tape numerous consistency checks have been
performed. However, due to the large volume of data collected in the survey,
it is likely that a small number of errors or discrepancies remain undetected.
The Division of Health Examination Statistics, NCHS would appreciate if any
such errors are detected that they be brought to our attention so that errata
sheets can be issued to previous purchasers and corrections made if new data
tapes are created.
USE OF SAMPLE WEIGHTS
NHANES II uses a multistage sample designed to represent the civilian
noninstitutionalized population of the United States,6 months-74 years of age.
Since the sample is not a simple random one, it is necessary to incorporate
the person's sample weight for proper analysis of the data.The sample weight
is a composite of the individual selection probability, adjustments for
nonresponese, and poststratification adjustments.
NHANES II provides information on 20,322 interviewed and examined individuals.
In addition to the general examination components, several more detailed
examinations were performed on subsamples of the population. Therefore,
instead of there being one sample weight per person,there are several sample
weights for each person. If a person was not selected for a particular
subsample, their associated subsample weight is zero. When analyzing the
special subsamples, the analyst must be careful to select the appropriate
sampling weight from the weights found in tape locations 282-317. For a more
complete description of how the sample weights are calculated, see the
detailed note section of this documentation.
SAMPLE DESIGN, VARIANCE ESTIMATION, AND HYPOTHESIS TESTING
The data collected in the Second National Health and Nutrition Examination
Survey (NHANES II) were obtained through a complex sample design involving
both clustering and stratification.Because of the complex design and the
ratio adjustments applied to the sample weights (see previous section on use
of sample weights), the direct application of standard statistical analysis
methods for variance estimation and hypothesis testing may be very misleading.
The modification of statistical analysis procedures to incorporate the
effects of complex survey designs is an important area of research;however,
the current methodologies appropriate for the analysis of data from such
surveys have not been made readily available in the standard packaged
statistical software.
There are computer programs available which do provide the capability of
variance estimation for complex sample designs. The balanced repeated
replication approach 1/ is utilized in &REPERR-&PSALMS-OSIRIS.IV 2/ to
calculate the variance-covariance matrix.SESUDAAN, SURREGR 3/ and SUPERCARP
4/ are programs that calculate the variance-covariance matrix using the
linearization approach 5/ (Taylor series expansion).
In order to provide the user with the capability of estimating the complex
sample variances in the NHANES II data using the above procedures, we have
provided Strata and Pseudo Primary Sampling Unit (PSU) codes on all data
tapes in positions 324-326. These variables and the sample weights are
necessary for the calculation of variances.
Even though the overall number of examined persons in this survey is quite
large for statistical inference purposes, subclass analyses can lead to
estimaters that are unstable, particularly estimates of variances.
Consequently, analyses of subclasses require that the user pay particular
attention to the coefficient of variation for the estimates of means,
proportions and totals.In addition, small sample sizes, or a small number
of PSU's used in the variance calculations may produce unstable estimates
of the variances using the above computer programs.
An NCHS Series 2 publication discussing these issues is in publication.6/
REFERENCES
1. National Center for Health Statistics: Replication an Approach to the
Analysis of Data from Complex Surveys by P.J. McCarthy. Vital and Health
Statistics Series 2-No. 14. DHEW Pub. No.(PHS) 79-1269. Public Health
Service. Washington, D.C. U.S. Government Printing Office, 1966.
2. Survey Research Center Computer Support Group, OSIRIS IV User's Manual,
Institute for Social Research, 1979.
3. Holt, M.M.: SURREGR: Standard errors of regression coefficients from
sample survey data. (unpublished) Research Triangle Institute, NC, 1977.
4. Hidiruglou, M.A.,Fuller,W.A.,Hickman, R.D.:(SUPERCARP) Survey Section,
Statistical Laboratory,Iowa State University. Ames, Iowa. Sixth Edition.
October 1980.
5. Woodruff, R.S.: A simple method for approximating the variance of a
complicated estimate. JASA 66:411-414, 1971.
6. National Center for Health Statistics: A General Statistical Methodology
for the Analysis of Data from a Complex Survey: NHANES I by J.R. Landis,
J.H. Lepkowski, S.A. Stehouwer, and S.A. Eklund. Vital and Health
Statistics, Series 2. (In publication)
GENERAL NOTES, DEMOGRAPHIC INFORMATION, NHANES II
An advance letter, announcing the forthcoming arrival of an interviewer from
the U.S.Bureau of the Census,was mailed to each household that fell into the
NHANES II probability sample. The interviewer subsequently visited the
household to ascertain its composition and to administer a questionnaire,the
primary purpose of which was to obtain demographic information. The
questionnaire was administered to each potential sample person in each
household that was available and competent enough to respond to questions.In
the event that a potential sample person was not at home at the time of
interview, any responsible adult in the household was asked to respond to
the questions for the absent person.
DEMOGRAPHIC DATA SUMMARY - NHANES II
Tape Positions 1-33
Tape Positions
Sample Sequence Number 1- 5
Catalog Number (5371-for Demographic Data only) 6- 9
Data user work area 10
Size of place 11
SMSA-not SMSA 12
Data user work area 13-23
Type of living quarters 24
Land usage 25
If rural, asked does this place have 10 acres or more? 26
If 10 acres or more, asked if in the last 12 months did sales
of farm produce and livestock amount to $50 or more? 27
If 10 acres or more, asked to $250 or more? 28
Data user work area 29
Total number of persons in household 30-31
Total number of sample persons in household 32-33
Tape Positions 34-90
Sample Person Data
Tape Positions
Data user work area 34
Family relationship 35
Data user work area 36
Family unit number 37-41
Data user work area 42-44
Age-months (at interview) 45-46
Age-years (at interview) 47-48
Data user work area 49-50
Date of birth-month 51-52
Date of birth-year 53-54
Sex 55
Race 56
In what state was he/she born? 57-58
Is he/she married, widowed, divorced, separated or
never married? 59
Natural origin or ancestry 60-61
Education level 62-63
Grade completed 64
What was he/she doing during most of the past 12 months? 65
What was he/she doing? 66
Did he/she work at a job or business at any time during the
past three months? 67
Did he/she work full or part-time when working? 68
Was he/she working within last two weeks not counting work
around the house? 69
Even though he/she did not work, does he/she have a job or
business? 70
Was he/she looking for work or on layoff from a job? 71
Which, looking for work or on layoff from a job? 72
What kind of industry or business is this? 73- 75
What kind of work was he/she doing? 76- 78
Was he/she in private company or business or individual for
wages, salary or commission? 79
Did he/she ever serve in the armed forces of the U.S.? 80
When did he/she serve? 81
Data user work area 82- 90
Tape Positions 91-246
Household Data
Tape Positions
How many rooms are in this...? Count the kitchen, but not the bathroom 91
How many bedrooms are in this...? 92
Ask only of unrelated household members. Do you have complete
kitchen facilities in your living quarters, that is a kitchen
sink with piped water, a refrigerator and a range or cookstove? 93
Do you have access to complete kitchen facilities in this
house? 94
Do you have access to a range or cookstove? 95
Do you have access to a refrigerator? 96
Do you have access to a sink with piped water? 97
Is there piped water in this house (these living quarters)? 98
Is there both hot and cold water? 99
Are these kitchen facilities used by anyone not living in
this household? 100
What is the main type of heating system you have? 101-102
Do you have air conditioning? 103
How many motor vehicles are owned or regularly used for
transportation by members of your family? 104
Is any language other than English spoken by family members
living here? 105
What language? 106
Which of these income groups represents your total combined
family income for the past 12 months? 107-108
During the past 12 months, how much money did you and
all members of your family receive in wages or salaries
before deductions (under $7,000 only)? 109-112
Social security or railroad retirement? 113
Data user work area 114
If yes, how much? 115-118
Welfare payments or other public assistance? 119
Data user work area 120
If yes, how much? 121-124
Unemployment compensation or workmen's compensation? 125
Data user work area 126
If yes, how much? 127-130
Government employee pension or private pensions? 131
Data user work area 132
If yes, how much? 133-136
Dividends, interest or rent? 137
Data user work area 138
If yes, how much? 139-142
Net income from their own business (nonfarm)
professional practice, or partnership? 143
Data user work area 144
If yes, how much? 145-148
Net income from a farm? 149
Data user work area 150
If yes, how much? 151-154
Veteran's payments? 155
Data user work area 156
If yes, how much? 157-160
Alimony, child support or other support from persons not
in household? 161
Data user work area 162
If yes, how much? 163-166
Any other income? 167
Data user work area 168
If yes, how much? 169-172
Total amount 173-176
Check Item B 177
Are you certified to participate in the food stamp program? 178
Are you buying food stamps now? 179
What is the main reason you are not participating in the
program? 180
Are you certified for commodity distribution program? 181
Are you receiving commodity foods now for your family? 182
Why aren't you participating in the program? 183
Date of exam 184-189
Age in years (at examination) 190-191
Data user work area 192-205
Race-sex recode for sample persons 206
Farm, nonfarm recode for sample person 207
Interview status 208
Region 209
Poverty index 210-212
Data user work area 213-246
Tape Positions 247-281
Head of Household Data
Tape Positions
Age in years 247-248
Data user work area 249-250
Date of birth-month 251-252
Date of birth-year 253-254
Sex 255
Race 256
In what state was he/she born? 257-258
Is he/she married, widowed, divorced, separated or
never married? 259
Natural origin or ancestry? 260-261
Education level 262-263
Grade completed 264
What was he/she doing during most of the past 12 months? 265
What was he/she doing? 266
Did he/she work at a job or business at any time during the
past three months? 267
Did he/she work full or part-time when working? 268
Was he/she working within last two weeks not counting work
around the house? 269
Even though he/she did not work, does he/she have a job or
business? 270
Was he/she looking for work or on layoff from a job? 271
Which?, looking for work or on layoff from a job? 272
Type of industry or business 273-275
What kind of work was he/she doing? 276-278
Was he/she in private company or business or individual for
wages, salary or commission? 279
Did he/she ever serve in the armed forces of the U.S.? 280
When did he/she serve? 281
Tape Positions 282-350
Sample Weights
Tape Positions
Examined final weight 282-287
Medical history interview final weight 288-293
Glucose Tolerance Test final examined weight 294-299
Lead final examined weight 300-305
Carboxyhemoglobin final examined weight 306-311
Bile acids final examined weight 312-317
Data user work area 318-323
Strata code 324-325
Pseudo PSU code 326
Poverty, Nonpoverty segments 327
(Not coded on Intake, Recall, Anthro and Glucose tapes)
Data user work area 328-350
1USE OF SPECIAL TERMS, DEMOGRAPHIC DATA, NHANES II
The term "data user work area" refers to blank areas in the data tape which
are reserved for the user as needed.
The term "blank, but applicable",is used to indicate a data item that was to
have a response for a sample person but none was given. The terms "blank" and
"Not applicable"refer to data items where the sample person was not supposed
to respond to the question or receive the examination component.
To more fully understand the questionnaire skip patterns and the
categorizations used,see the Plan and Operation of the Second National Health
and Nutrition Examination Survey document included with this documentation.
All the questionnaires are included in this document.
RECORD LAYOUT, DEMOGRAPHIC DATA
Tape Locations 1-50
NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY - NHANES II
DEMOGRAPHIC DATA
TAPE NHANES II DATA SOURCE
LOC. ITEM DESCRIPTION & CODES OR NOTES
001- Sample Sequence Number
005 00001-27796
006- Catalog Number
009 5371
010 Data User Work Area
011 Size of Place See Detailed Notes
1 - Urbanized area with 3,000,000 or
more
2 - Urbanized area 1,000,000 to
2,999,999
3 - Urbanized area with 250,000 to
999,999
4 - Urbanized area under 250,000
5 - Urban place 25,000 or more outside
urbanized area
6 - Urban place 10,000-24,999 outside
urbanized area
7 - Urban place 2,500 to 9,999 outside
urbanized area
8 - Rural
012 SMSA-Not SMSA See Detailed Notes
1 - In SMSA, in central city
2 - In SMSA, not in central city
4 - Not in SMSA
013- Data User Work Area
023
024 Type of living quarters
1 - Housing unit
2 - Other unit
025 Land Usage
1 - Urban
2 - Rural
026 If rural, asked does this place have
10 acres or more?
1 - Yes
2 - No
9 - Not Applicable
027 If 10 acres or more, asked if in the
last 12 months did sales of farm produce
and livestock amount to $50 or more?
1 - Yes
2 - No
9 - Not Applicable
028 If less than 10 acres, asked if in the
last 12 months did sales or farm produce
and livestock amount to $250 or more?
1 - Yes
2 - No
9 - Not Applicable
029 Data User Work Area
030- Total Number Of Persons In Household
031
01 - 15 - As given
032- Total Number Of Sample Persons In
033 Household
01 - 06 - As Given
Sample Person Data
034 Data User Work Area
035 Family Relationship
1 - Head one person living alone or
with non-relatives
2 - Head 2 or more related persons in
family
3 - Wife
4 - Child
5 - Other relative
6 - Foster child
7 - Husband
036 Examination Status
1 - Examined
037- Family Unit Code See Detailed Notes
041
00001-21050 - As Given
042- Data User Work Area
044
045- Age-Months At Interview
046
06-11 Months
Blank, if greater than 11 months
047- Age-Years At Interview
048
01 - 74 Years
00, If less than 12 months
049- Data User Work Area
050
Tape Locations 51-100
051- Date-Of-Birth-Month
052
01 - 12 Month
053- Date-Of-Birth-Year
054
01 - 79 Year
055 Sex
1 - Male
2 - Female
056 Race See Detailed Notes
1 - White
2 - Black
3 - Other
057- In what state was he/she born? See Detailed Notes
058
01 - 97
88 - Blank, but applicable
059 Is he/she married, widowed, divorced,
separated, or never married?
1 - Under 17
2 - Married
3 - Widowed
4 - Divorced
5 - Separated
6 - Never married
8 - Blank, but applicable
060- Natural Origin or Ancestry
061
01 - Countries of Central or South
America
02 - Chicano
03 - Cuban
04 - Mexican
05 - Mexicano
06 - Mexican-American
07 - Puerto Rican
08 - Other Spanish
09 - Other European, such as German,
French, English, Irish
10 - Black, Negro or Afro-American
11 - American Indian or Alaskan Native
12 - Asian or Pacific Islander Such as
Chinese, Japanese, Korean,
Philippino, Samoan
13 - Another Group Not Listed
88 - Blank, but applicable
062- Highest Grade Of School Attended
063
00 - None (regardless of age)
21 - 28 - Elementary Grades (1-8)
31 - 34 - High School (1-4)
41 - 45 - College (1-5+)
88 - Blank, but applicable
064 Grade Completed
1 - Yes
2 - No
8 - Blank, but applicable
Blank
065 What was he/she doing during most of
the past 12 months?
1 - Working
2 - Keeping house
3 - Something else
8 - Blank, but applicable
Blank
066 What was he/she doing?
1 - Layoff
2 - Retired
3 - Student
4 - Ill
5 - Staying home
6 - Looking for work
7 - Unable to work
8 - Blank, but applicable
0 - Other
Blank
067 Did he/she work at a job or business at
any time during the past three months?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
068 Did he/she work full or part-time when
working?
1 - Full time
2 - Part time
8 - Blank, but applicable
Blank
069 Was he/she working within last two
weeks not counting work around the
house?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
070 Even though he/she did not work does
he/she have a job or business?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
071 Was he/she looking for work or on
layoff from a job?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
072 Which looking for work or on layoff
from a job?
1 - Looking
2 - Layoff
3 - Both
8 - Blank, but applicable
Blank
073- What kind of industry or business is See Detailed Notes
075 this?
017 - 998 (last digit 7, 8, 9)
000 - Blank, but applicable
Blank
076- What kind of work was he/she doing? See Detailed Notes
078
001 - 992 - Occupation (last digit
0-6)
000 - Blank, but applicable
Blank
079 Was he/she in private company or
business or working for individual for
wages, salary or commission?
1 - Private
2 - A Federal government employee
3 - A State government employee
4 - A local government employee
5 - Incorporated-Own
6 - Self-employed (or farm)
7 - Working without pay in family
business or farm
8 - Never worked
0 - Blank, but applicable
Blank
080 Did he/she ever serve in the armed
forces of the U.S.?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
081 When did he/she serve?
1 - Vietnam
2 - Korean War
3 - World War II
4 - World War I
5 - Post Vietnam
6 - Other Service
8 - Blank, but applicable
9 - Do not know
Blank
082- Data User Work Area
090
Household Data
091 How many rooms are in this..? Count
the kitchen, but not the bath.
1 - 8 Rooms
9 - 9 Or More Rooms
092 How many bedrooms are in this - ?
0 - 7 Bedrooms - More than 7 bedrooms
coded as 7
093 Ask only of unrelated household members.
Do you have complete kitchen facilities
in your living quarters, that is a
kitchen sink with piped water, a
refrigerator and a range or cookstove?
1 - Yes
2 - No
Blank
094 Do you have access to complete kitchen
facilities in this house?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
095 Do you have access to a range or
cookstove?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
096 Do you have access to a refrigerator?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
097 Do you have access to a sink with
piped water?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
098 Is there piped water in this house
(these living quarters)?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
099 Is there both hot and cold water?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
100 Are these kitchen facilities used by
anyone not living in this household?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
Tape Locations 101-150
101- What is the main type of heating system
102 you have?
11 - Steam or hot water system
12 - Central warm air furnace with
ducts to individual rooms or
central heat pump (forced air)
13 - Built in electric units
(permanently installed in wall,
ceiling or baseboard
14 - Floor, wall or pipeless furnace
15 - Circulating, radiant or room
heaters, with flue or vent,
burning gas, oil, or kerosene
16 - Circulating, radiant, or room
heaters (not portable) without
flue or vent burning gas, oil or
kerosene
17 - Fireplace or stoves burning coal,
wood or coke
18 - Portable room heaters of any kind
19 - Some other type
20 - None, unit is not heated
88 - Blank, but applicable
103 Do you have air conditioning?
1 - Yes, individual room unit
2 - Yes, central air conditioning
3 - No
8 - Blank, but applicable
104 How many motor vehicles are owned or
regularly used for transportation by
members of your family?
0 - None
1 - 8 Vehicles (more than 8 coded as 8)
9 - Blank, but applicable
105 Is any language other than English
spoken by family members living here?
1 - Yes
2 - No
8 - Blank, but applicable
106 What language?
0 - German
1 - Italian
2 - French
3 - Polish
4 - Russian
5 - Spanish
6 - Chinese
7 - Other language
8 - Blank, but applicable
9 - Not applicable
107- Which of these income groups represents See Detailed Notes
108 your total combined family income for
the past 12 months?
11 - Under $1,000
12 - $1,000-1,999
13 - $2,000-2,999
14 - $3,000-3,999
15 - $4,000-4,999
16 - $5,000-5,999
17 - $6,000-6,999
18 - $7,000-9,999
19 - $10,000-14,999
20 - $15,000-19,999
21 - $20,000-24,999
22 - $25,000 and over
88 - Blank, but applicable
109- During the past 12 months, how much
112 money did you and all members of your
family receive in wages or salaries
before deductions?
0000 - 6999 Amount
8888 - Blank, but applicable
Blank
113 Social security or railroad
retirement?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
114 Data User Work Area
115- If yes, how much?
118
0038 - 6828 Amount
8888 - Blank, but applicable
Blank
119 Welfare payments or other public
assistance?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
120 Data User Work Area
121- If yes, how much?
124
0012 - 6800 Amount
8888 - Blank, but applicable
Blank
125 Unemployment Compensation or Workman's
Compensation
1 - Yes
2 - No
8 - Blank, but applicable
Blank
126 Data User Work Area
127- If yes, how much?
130
0015 - 5640 Amount
8888 - Blank, but applicable
Blank
131 Government Employee Pension or Private
Pensions?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
132 Data User Work Area
133- If yes, how much?
136
0036 - 6000 Amount
8888 - Blank, but applicable
Blank
137 Dividends, Interest or Rent?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
138 Data User Work Area
139- If yes, how much?
142
0001 - 5200 Amount
8888 - Blank, but applicable
Blank
143 Net income from their own business
(nonfarm) professional practice, or
partnership?
1 - Yes
2 - No
3 - Loss
8 - Blank, but applicable
Blank
144 Data User Work Area
145- If yes, how much?
148
0001 - 6800 Amount
8888 - Blank, but applicable
Blank
149 Net income from a farm?
1 - Yes
2 - No
3 - Loss
8 - Blank, but applicable
Blank
150 Data User Work Area
Tape Locations 151-205
151- If yes, how much?
154
0000 - 6500 Amount
8888 - Blank, but applicable
Blank
155 Veterans payments?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
156 Data User Work Area
157- If yes, how much?
160
0060 - 6000 Amount
8888 - Blank, but applicable
Blank
161 Alimony, child support or other support
from persons not in household?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
162 Data User Work Area
163- If yes, how much?
166
0020 - 6900 Amount
8888 - Blank, but applicable
Blank
167 Any other income?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
168 Data User Work Area
169- If yes, how much?
172
0003 - 6403 Amount
8888 - Blank, but applicable
Blank
173- Total Amount Q 21 & 22
176
0000 - 6999 Amount
8888 - Blank, but applicable
Blank
177 Check Item B
2 - Food stamps available
4 - Both - Food Stamps and
commodities
178 Are you certified to participate in
the food stamp program?
1 - Yes
2 - No
8 - Blank, but applicable
Don't know
179 Are you buying food stamps now?
1 - Yes, Regularly
2 - Yes, Occasionally
3 - No
8 - Blank, but applicable
Blank
180 What is the main reason you are not
participating in the program?
1 - No need
2 - Not enough money at the time
3 - No transportation
4 - Pride
5 - Other
8 - Blank, but applicable
Blank
181 Are you certified for commodity
distribution program?
1 - Yes
2 - No
9 - Do not know
Blank
182 Are you receiving commodity foods now
for your family?
1 - Yes, regularly
2 - Yes, occasionally
3 - No
Blank
183 Why aren't you participating in the
program?
1 - No need
2 - No transportation
3 - Pride
4 - Other
8 - Blank, but applicable
Blank
184- Date of Exam Month Control Record
185
01 - 12
186- Date of Exam Day Control Record
187
00 - 31
188- Date of Exam Year Control Record
189
76 - 80
190- Age Years At Examination
191
01 - 75 Years
00 - If less than 12 months or non-
examined
192- Data User Work Area
205
Tape Locations 206-250
206 Race Sex Recode For Sample Person See Detailed Notes
1 - Male, White
2 - Male, Black
3 - Male, Other
4 - Female, White
5 - Female, Black
6 - Female, Other
207 Farm, Non-Farm Recode For Sample Person See Detailed Notes
1 - Farm
2 - Non-Farm
208 Interview Status
1 - Interviewed
209 Region See Detailed Noted
1 - Northeast
2 - Midwest
3 - South
4 - West
210- Poverty Index (x.xx) See Detailed Notes
212
001 - 880 - As Given
999 - Unknown
213- Data User Work Area
246
Head of Household Data
247- Age Years
248
15 - 99 Years (more than 100 coded
as 99)
249- Data User Work Area
250
Tape Locations 251-305
251- Date-Of-Birth-Month
252
01 - 12 Month
88 - Blank, but applicable
253- Date-Of-Birth-Year
254
00 - 99 Year
255 Sex
1 - Male
2 - Female
256 Race See Detailed Notes
1 - White
2 - Black
3 - Other
257- In what state was he/she born? See Detailed Notes
258
01 - 97
88 - Blank, but applicable
259 Is he/she married, widowed, divorced,
separated, or never married?
1 - Under 17
2 - Married
3 - Widowed
4 - Divorced
5 - Separated
6 - Never married
8 - Blank, but applicable
260- Natural Origin or Ancestry?
261
01 - Countries of Central or South
America
02 - Chicano
03 - Cuban
04 - Mexican
05 - Mexicano
06 - Mexican-American
07 - Puerto Rican
08 - Other Spanish
09 - Other European, such as German,
French, English, Irish
10 - Black, Negro or Afro-American
11 - American Indian or Alaskan Native
12 - Asian or Pacific Islander Such as
Chinese, Japanese, Korean,
Philippino, Samoan
13 - Another Group Not Listed
88 - Blank, but applicable
262- Highest Grade Attended
263
00 - None (regardless of age)
21 - 28 - Elementary Grades (1-8)
31 - 34 - High School (1-4)
41 - 45 - College (1-5+)
88 - Blank, but applicable
264 Grade Completed
1 - Yes
2 - No
8 - Blank, but applicable
Blank
265 What was he/she doing during most of
the past 12 months?
1 - Working
2 - Keeping house
3 - Something else
8 - Blank, but applicable
Blank
266 What was he/she doing?
1 - Layoff
2 - Retired
3 - Student
4 - Ill
5 - Staying home
6 - Looking for work
7 - Unable to work
8 - Blank, but applicable
0 - Other
Blank
267 Did he/she work at job or business
during past three months?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
268 Did he/she work full or part-time when
working?
1 - Full time
2 - Part time
8 - Blank, but applicable
Blank
269 Did he/she work at any time the last
two weeks not counting work around
the house?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
270 Even though he/she did not work, does
he/she have a job or business?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
271 Was he/she looking for work or on
layoff from a job?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
272 Which, looking for work or on layoff
from a job?
1 - Looking
2 - Layoff
3 - Both
8 - Blank, but applicable
Blank
273- Type of industry or business? See Detailed Notes
275
017 - 998 (last digit 7, 8, 9)
000 - Blank, but applicable
Blank
276- What kind of work was he/she doing? See Detailed Notes
278
001 - 992 - Occupation (last digit
0-6)
000 - Blank, but applicable
Blank
279 Was he/she in private company or
business or working for individual for
wages, salary or commission?
1 - Private
2 - A Federal government employee
3 - A State government employee
4 - A local government employee
5 - Incorporated-Own
6 - Self-employed (or farm)
7 - Working without pay in family
business or farm
8 - Never worked
0 - Blank, but applicable
Blank
280 Did he/she ever serve in the armed
forces of the U.S.?
1 - Yes
2 - No
8 - Blank, but applicable
Blank
281 When did he/she serve?
1 - Vietnam
2 - Korean War
3 - World War II
4 - World War I
5 - Post Vietnam
6 - Other Service
8 - Blank, but applicable
9 - Do not know
Blank
SEE DETAILED NOTES FOR POSITIONS
282-326
282- Examined Final Weight
287
001218 - 079634
288- Medical History Interview Final Weight
293
001171 - 071969
294- Glucose Tolerance Test Final Examined
299 Weight
003502 - 084477
000000
300- Lead Final Examined Weight
305
001218 - 084115
000000
Tape Locations 306-350
306- Carboxyhemoglobin Final Examined Weight
311
002546 - 110759
000000
312- Bile Acids Final Examined Weight
317
003519 - 087638
000000
318- Data User Work Area
323
324- STRATA
325
01 - 32
326 PSEUDO Primary Sampling Unit
1 OR 2
328 Poverty/Non-Poverty Segments
1-Non-Poverty
2-Poverty
328- Data User Work Area
350
DETAILED NOTES, DEMOGRAPHIC DATA
Size of Place
Size of place classification was derived from the 1970 census. According to
the definition used in the 1970 census, the urban population was comprised of
all persons living in (a) places of 2,500 inhabitants or more incorporated as
cities, boroughs (except Alaska),villages and towns (except towns in New York,
New England States,and Wisconsin),but excluding those persons living in the
rural portions of extended cities; (b) unincorporated places of 2,500
inhabitants or more; and (c) other territories included in urbanized areas.
the remaining population was classified as rural.
Urban areas are further classified by population size for places within
urbanized areas and other places outside urbanized areas.
SMSA
Except in New England,a standard metropolitan statistical area is basically a
county or a group of contiguous counties which contains at least one city of
50,000 inhabitants or more, or "twin cities" with a combined population of at
least 50,000. In addition to the county or counties containing such a city or
cities, contiguous counties are included in an SMSA if, according to the 1970
census, they are socially and economically integrated with the central city.
Each SMSA must include at least one central city,and the complete title of an
SMSA identifies the central city or cities. In New England, SMSA's consist of
towns and cities, rather than counties.
Family Unit Code
All related sample persons in the same family unit have the same computer
generated family unit code. This will enable analysis of individual family
units.
Race
The race of the respondent was marked by observation and the interviewers
were instructed to assume the race of all related persons was the same as the
respondent unless otherwise learned.The race categories were "White","Black"
or "Other". If the appropriate category could not be marked by observation,
then race was asked. Interviewers were instructed to record persons who
responded with something other than White or Black,such as Japanese,Chinese,
American Indian, Korean, Hindu, Eskimo, etc., as "Other"; and to include
Mexicans,Puert Ricans and other persons of Latin American descent in "White",
unless definitely Black, American Indian, or of other non-white race.
Tape Positions 57-58 and 257-258
United States
Name of Place Code
Alabama 01
Alaska 02
Arizona 04
Arkansas 05
California 06
Colorado 08
Connecticut 09
Delaware 10
District of Columbia 11
Florida 12
Georgia 13
Hawaii 15
Idaho 16
Illinois 17
Indiana 18
Iowa 19
Kansas 20
Kentucky 21
Louisiana 22
Maine 23
Maryland 24
Massachusetts 25
Michigan 26
Minnesota 27
Mississippi 28
Missouri 29
Montana 30
Nebraska 31
Nevada 32
New Hampshire 33
New Jersey 34
New Mexico 35
New York 36
North Carolina 37
North Dakota 38
Ohio 39
Oklahoma 40
Oregon 41
Pennsylvania 42
Rhode Island 44
South Carolina 45
South Dakota 46
Tennessee 47
Texas 48
Utah 49
Vermont 50
Virginia 51
Washington 53
West Virginia 54
Wisconsin 55
Wyoming 56
Outlying Areas of the United States
Name of Place Code Description
American Samoa 60 U.S. territory in the Pacific
Canal Zone 61 Territory in Panama leased by U.S.
Canton and Enderbury Islands 62 Under common US-UK administration
Guam 66 U.S. territory in the Pacific
Johnston Atoll U.S. territory in the Pacific,
includes Sand Island
Midway Islands 71 U.S. territory in the Pacific
Puerto Rico 72 Commonwealth associated with the
U.S.
Swan Islands 74 U.S. territory in the Caribbean
Trust Territories of the Pacific 75 U.S. administered, includes
Islands Caroline, Mariana, and Marshall
Island Groups
U.S. Miscellaneous Caribbean 76 Includes Navassa Islands, Quito
Islands Sueno Bank, Roncador Cay,
Serrana Bank, Serranilla Bank
U.S. Miscellaneous Pacific 77 Includes Kingman Reef, Howland,
Islands Baker and Jarvis Islands,
Palmyra Atoll
Virgin Islands 78 U.S. territory in the Caribbean
Wake Island 79 U.S. territory in the Pacific
Foreign Countries
North America 91
South America 92
Europe 93
Africa 94
Asia 95
Australasia 96
Pacific Islands 97
Industry and Occupation Codes
A person's occupation may be defined as his principal job or business. For
this survey purpose, the principal job or business of a respondent is defined
in one of the following ways: If the person worked during the two-week
interview period or had a job or business, the question concerning his
occupation (or work) applies to his job during that period.If the respondent
held more than one job, the question is directed to the one at which he spent
the most time. It refers to the one he considers most important when equal
time is spent at each job. A person who has not begun work at a new job, is
looking for work, or is on layoff from work is questioned about his last
full-time civilian job.A full-time job is defined as one at which the person
spent 35 or more hours per week and which lasted two consecutive weeks or
more. A person who has a job to which he has not yet reported and has never
had a previous job or business is classified as a "new worker".
The 1970 census of population Alphabetical Index of Industries and Occupa-
tion was used in the coding of both the industry and occupation. Library of
Congress Number 74-612012. For sale by the Superintendent of Documents,U.S.
Government Printing Office, Washington, D.C. 20402. $3.00. Stock Number
0301-2283.
Family Income Group
The respondent was handed a card with 12 income ranges listed as Group A to
Group L and asked "Which of these income groups represents your total com-
bined family income for the past 12 months,that is,yours, your ...'s, etc?
include income from all sources such as wages,salaries,social security or
retirement benefits, help from relatives, rent from property and so forth."
If the respondent answered Group A through G,that is with an income less than
$7,000,then questions 21 and 22 detailing exact sources and amounts of income
were asked; otherwise, these questions were skipped.
No effort was made to reconcile amounts reported in detailed questions 21 and
22 with the categorical response to the family income group question. During
the survey time period, no adjustments to the income groups or $7,000 value
were made to account for inflation.
Land
Land used for farming purposes (Code 1 in Tape Position 207) was identified
as being rural land (Code 2 in Tape Position 25) consisting of 10 or more
acres (Code 1 in Tape Position 26) with crop sales amounting to $50 or more
(Code 1 in Tape Position 27), or rural land (Code 2 in Tape Position 25)
consisting of less than 10 acres(Code 2 in Tape Position 26)with crop sales
amounting to $250 or more (Code 1 in Tape Position 28).All other land is
classified as nonfarm (Code 2 in Tape Position 207).
Region
The United States was divided into four broad geographic regions of
approximately equal population. Those regions, which deviate somewhat from
the groups used by the Bureau of Census, are as follows:
Region States Included
Northeast Maine, Vermont, New Hampshire,
Massachusetts, Connecticut, Rhode
Island, New York, New Jersey, and
Pennsylvania
South Delaware, Maryland, District of
Columbia, West Virginia, Virginia,
Kentucky, Tennessee, North Carolina,
South Carolina, Georgia, Florida,
Alabama, Mississippi, Louisiana, and
Arkansas
Midwest Ohio, Illinois, Indiana, Michigan,
Wisconsin, Minnesota, Iowa, Missouri
West Washington, Oregon, California, Nevada,
New Mexico, Arizona, Texas, Oklahoma,
Kansas, Nebraska, North Dakota, South
Dakota, Idaho, Utah, Colorado, Montana,
Wyoming, Alaska, Hawaii
Poverty Index
Income status was determined by the Poverty Income Ratio (PIR). Poverty
statistics published in the Census Bureau reports 1-5 were based on the
poverty index developed by the Social Security Administration (SSA) in 1964.
(For a detailed discussion of the SSA poverty standards, see reference 6.)
Modifications in the definition of poverty were adopted in 1969.7 The stand-
ard data series in poverty for statistical use by all executive departments
and establishments has been established.8
The two components of the PIR are the total income of the household (numera-
tors the median of the income group for incomes $7,000 and above; the sum of
the porponent parts of the income questions for incomes under $7,000) and a
multiple of the total income necessary to maintain a family with given
characteristics on a nutritionally adequate food plan3 (denominator). The
dollar value of the denominator of the PIR is constructed from a food plan
(economy plan) necessary to maintain minimum recommended daily nutritional
requirements.The economy plan is designated by the Department of Agriculture
for "emergency or temporary use when funds are low."
For families of three or more persons,the poverty level was set at three
times the cost of the economy food plan.For smaller families and persons
living alone,the cost of the economy food plan was adjusted by the relatively
higher fixed expenses of these smaller households.
The denominator or poverty income cutoff adjusts the family poverty income
maintenance requirements by the family size, the sex of the family head, the
age of the family head in families with one or two members, and the place of
residence (farm, nonfarm).Annual revisions of the poverty income cutoffs are
based on the changes in the average cost of living as reflected in the
Consumer Price Index.
As shown in the tables, the annual income considered to be the poverty level
increases as the family size increases. A family with any combination of
characteristics and with the same income as shown in the table has been
designated as having a PIR or poverty level of 1.0. The same family with
twice the income found in the table would have a PIR of 2.0. Ratios of less
than 1.0 can be described as "below poverty",ratios greater than or equal to
1.0, as "at or above poverty".
Poverty thresholds are computed on a national basis only. No attempt has been
made to adjust these thresholds for regional,state,or other variations in the
cost of living (except for the farm, nonfarm difference).None of the noncash
public welfare benefits such as food stamp bonuses are included in the income
of the low income families receiving these benefits.PIR has been adjusted by
year (see tables) and accounts in some part for inflation.
1 U.S. Bureau of the Census, Current Population Reports, Series P-60, No.
107, "Money Income and Poverty Status of Families and Persons in the
United States: 1976" (Advance Report) U.S. Government Printing Office,
Washington, D.C., 1977.
2 U.S. Bureau of the Census, Current Population Reports, Series P-60, No.
116, "Money Income and Poverty Status of Families and Persons in the
United States: 1977" (Advance Report) U.S. Government Printing Office,
Washington, D.C., 1978.
3 U.S. Bureau of the Census, Current Population Reports, Series P-60, No.
120, "Money Income and Poverty Status of Families and Persons in the
United States: 1978" (Advance Report), U.S. Government Printing Office,
Washington, D.C., 1979.
4 U.S. Bureau of the Census, Current Population Reports, Series P-60, No.
125, "Money Income and Poverty Status of Families and Persons in the
United States: 1979" (Advance Report), U.S. Government Printing Office,
Washington, D.C., 1980.
5 U.S. Bureau of the Census, Current Population Reports, Series P-60, No.
127, "MoneyIncome and Poverty Status of Families and Persons in the
United States: 1980"(Advance Data from the March 1981 Current Population
Survey), U.S. Government Printing Office, Washington, D.C., 1981.
6 Orshansky, M.: "Counting the Poor: Another Look at the Poverty Profile",
Social Security Bulletin, January 1965; "Who's Who Among the Poor: A
demographic View of Poverty", Social Security Bulletin, July 1965.
7 U.S. Bureau of the Census, Current Population Reports, Series P-23,
No. 28 "Special Studies", U.S. Government Printing Office, Washington,
D.C., August 12, 1969.
8 Circular No. A-46,Transmitted Memorandum No. 9,Executive Office of the
President, Bureau of the Budget, August 29, 1969, and Exhibit L (rev.).
Table 15
Weighted Average Thresholds-Poverty Cutoffs in 1976, by Size of
Family and Sex of Head, By Farm-Nonfarm Residence
NONFARM
SIZE OF FAMILY UNIT Total Total Male Head Female Head
(Dollars) (Dollars) (Dollars) (Dollars)
1 Person (Unrelated
Individual). . . . . . . . . 2 877 2 884 3 016 2 788
14 to 64 Years . . . . . . . 2 954 2 959 3 069 2 840
65 Years And Over. . . . . . 2 720 2 730 2 758 2 722
2 Persons. . . . . . . . . . . 3 688 3 711 3 721 3 660
Head 14 to 64 Years. . . . . 3 806 3 826 3 846 3 733
Head 65 Years and Over . . . 3 417 3 445 3 447 3 428
3 Persons. . . . . . . . . . . 4 515 4 540 4 565 4 414
4 Persons. . . . . . . . . . . 5 786 5 815 5 818 5 790
5 Persons. . . . . . . . . . . 6 838 6 876 6 884 6 799
6 Persons. . . . . . . . . . . 7 706 7 760 7 766 7 709
7 Persons Or More. . . . . . . 9 505 9 588 9 622 9 375
FARM
SIZE OF FAMILY UNIT Total Male Head Female Head
(Dollars) (Dollars) (Dollars)
1 Person (Unrelated Individual). . . . . 2 438 2 532 2 348
14 to 64 Years . . . . . . . . . . . . 2 542 2 608 2 413
65 Years And Over. . . . . . . . . . . 2 322 2 344 2 313
2 Persons. . . . . . . . . . . . . . . . 3 128 3 133 3 033
Head 14 to 64 Years. . . . . . . . . . 3 267 3 271 3 159
Head 65 Years and Over . . . . . . . . 2 928 2 928 2 922
3 Persons. . . . . . . . . . . . . . . . 3 858 3 864 3 734
4 Persons. . . . . . . . . . . . . . . . 4 950 4 953 4 840
5 Persons. . . . . . . . . . . . . . . . 5 870 5 871 5 847
6 Persons. . . . . . . . . . . . . . . . 6 585 6 584 6 607
7 Persons Or More. . . . . . . . . . . . 8 072 8 068 8 428
Table 15
Weighted Average Thresholds-Poverty Cutoffs in 1977, by Size of
Family and Sex of Head, By Farm-Nonfarm Residence
NONFARM
SIZE OF FAMILY UNIT Total Total Male Head Female Head
(Dollars) (Dollars) (Dollars) (Dollars)
1 Person (Unrelated
Individual). . . . . . . . . 3 067 3 075 3 214 2 969
14 to 64 Years . . . . . . . 3 147 3 152 3 267 3 023
65 Years And Over. . . . . . 2 895 2 906 2 936 2 898
2 Persons. . . . . . . . . . . 3 928 3 951 3 961 3 907
Head 14 to 64 Years. . . . . 4 054 4 072 4 095 3 981
Head 65 Years and Over . . . 3 637 3 666 3 670 3 646
3 Persons. . . . . . . . . . . 4 806 4 833 4 860 4 708
4 Persons. . . . . . . . . . . 6 157 6 191 6 195 6 162
5 Persons. . . . . . . . . . . 7 279 7 320 7 329 7 238
6 Persons. . . . . . . . . . . 8 208 8 261 8 268 8 197
7 Persons Or More. . . . . . . 10 137 10 216 10 249 9 995
FARM
SIZE OF FAMILY UNIT Total Male Head Female Head
(Dollars) (Dollars) (Dollars)
1 Person (Unrelated Individual). . . . . 2 588 2 672 2 498
14 to 64 Years . . . . . . . . . . . . 2 709 2 776 2 569
65 Years And Over. . . . . . . . . . . 2 475 2 495 2 563
2 Persons. . . . . . . . . . . . . . . . 3 318 3 325 3 176
Head 14 to 64 Years. . . . . . . . . . 3 466 3 474 3 278
Head 65 Years and Over . . . . . . . . 3 128 3 131 3 079
3 Persons. . . . . . . . . . . . . . . . 4 093 4 110 3 893
4 Persons. . . . . . . . . . . . . . . . 5 273 5 274 5 213
5 Persons. . . . . . . . . . . . . . . . 6 247 6 247 6 237
6 Persons. . . . . . . . . . . . . . . . 7 026 7 026 7 040
7 Persons Or More. . . . . . . . . . . . 8 708 8 706 8 738
Table A-3
Weighted Average Thresholds at the Poverty Level in 1978, by Size
of Family and Sex of Head, By Farm-Nonfarm Residence
NONFARM
SIZE OF FAMILY UNIT Male Female
Total Total Head1 Head1
1 Person (Unrelated
Individual). . . . . . . . . $3,302 $3,311 $3,460 $3,196
14 to 64 Years . . . . . . . 3,386 3,392 3,516 3,253
65 Years And Over. . . . . . 3,116 3,127 3,159 3,118
2 Persons. . . . . . . . . . . 4,225 4,249 4,258 4,206
Head 14 to 64 Years. . . . . 4,363 4,383 4,407 4,286
Head 65 Years and Over . . . 3,917 3,944 3,948 3,923
3 Persons. . . . . . . . . . . 5,178 5,201 5,231 5,065
4 Persons. . . . . . . . . . . 6,628 6,662 6,665 6,632
5 Persons. . . . . . . . . . . 7,833 7,880 7,888 7,806
6 Persons. . . . . . . . . . . 8,825 8,891 8,895 8,852
7 Persons Or More. . . . . . . 10,926 11,002 11,038 10,765
FARM
SIZE OF FAMILY UNIT Male Female
Total Head1 Head1
1 Person (Unrelated Individual). . . . . $2,795 $2,898 $2,690
14 to 64 Years . . . . . . . . . . . . 2,913 2,987 2,764
65 Years And Over. . . . . . . . . . . 2,661 2,685 2,650
2 Persons. . . . . . . . . . . . . . . . 3,578 3,582 3,497
Head 14 to 64 Years. . . . . . . . . . 3,731 3,737 3,614
Head 65 Years and Over . . . . . . . . 3,352 3,354 3,313
3 Persons. . . . . . . . . . . . . . . . 4,413 4,430 4,216
4 Persons. . . . . . . . . . . . . . . . 5,681 5,683 5,622
5 Persons. . . . . . . . . . . . . . . . 6,714 6,714 6,700
6 Persons. . . . . . . . . . . . . . . . 7,541 7,543 7,462
7 Persons Or More. . . . . . . . . . . . 9,373 9,386 8,813
1 For one person (i.e., unrelated individual), sex of the individual.
Table 17
Weighted Average Thresholds-Poverty Cutoffs in 1979, by Size and
Type of Family, By Farm-Nonfarm Residence
NONFARM
Families With
SIZE OF FAMILY UNIT Total Total Female HHLDR,
No Husband1 All Other
Present Families2
(Dollars) (Dollars) (Dollars) (Dollars)
1 Person (Unrelated
Individual). . . . . . . . . 3 683 3 689 3 556 3 855
14 to 64 Years . . . . . . . 3 773 3 778 3 619 3 912
65 Years And Over. . . . . . 3 472 3 479 3 469 3 515
2 Persons. . . . . . . . . . . 4 702 4 725 4 669 4 737
Head 14 to 64 Years. . . . . 4 858 4 878 4 762 4 905
Head 65 Years and Over . . . 4 364 4 390 4 362 4 394
3 Persons. . . . . . . . . . . 5 763 5 784 5 624 5 820
4 Persons. . . . . . . . . . . 7 386 7 412 7 381 7 416
5 Persons. . . . . . . . . . . 8 736 8 775 8 690 8 785
6 Persons. . . . . . . . . . . 9 849 9 914 9 843 9 922
7 Persons Or More. . . . . . . 12 212 12 280 12 037 12 322
FARM
Families With
Female HHLDR,
No Husband All Other
SIZE OF FAMILY UNIT Total Present1 Families2
(Dollars) (Dollars) (Dollars)
1 Person (Unrelated Individual). . . . . 3 138 3 001 3 236
14 to 64 Years . . . . . . . . . . . . 3 254 3 076 3 324
65 Years And Over. . . . . . . . . . . 2 963 2 948 2 988
2 Persons. . . . . . . . . . . . . . . . 3 987 3 917 3 991
Head 14 to 64 Years. . . . . . . . . . 4 156 4 027 4 163
Head 65 Years and Over . . . . . . . . 3 730 3 686 3 732
3 Persons. . . . . . . . . . . . . . . . 4 917 4 680 4 928
4 Persons. . . . . . . . . . . . . . . . 6 329 6 261 6 332
5 Persons. . . . . . . . . . . . . . . . 7 492 7 509 7 492
6 Persons. . . . . . . . . . . . . . . . 8 424 8 309 8 428
7 Persons Or More. . . . . . . . . . . . 10 533 10 178 10 547
1 Includes female unrelated individuals.
2 Includes male unrelated individuals.
Table 17
Weighted Average Thresholds-Poverty Cutoffs in 1980, by Size and
Type of Family, By Farm-Nonfarm Residence
NONFARM
Families With
SIZE OF FAMILY UNIT Total Total Female HHLDR,
No Husband1 All Other
Present Families2
(Dollars) (Dollars) (Dollars) (Dollars)
1 Person (Unrelated
Individual). . . . . . . . . 4 184 4 190 4 037 4 379
14 to 64 Years . . . . . . . 4 286 4 290 4 109 4 441
65 Years And Over. . . . . . 3 941 3 949 3 938 3 990
2 Persons. . . . . . . . . . . 5 338 5 363 5 316 5 373
Head 14 to 64 Years. . . . . 5 518 5 537 5 415 5 568
Head 65 Years and Over . . . 4 954 4 983 4 946 4 988
3 Persons. . . . . . . . . . . 6 539 6 565 6 388 6 605
4 Persons. . . . . . . . . . . 8 385 8 414 8 382 8 418
5 Persons. . . . . . . . . . . 9 923 9 966 9 878 9 976
6 Persons. . . . . . . . . . . 11 215 11 269 11 227 11 274
7 Persons Or More. . . . . . . 13 883 13 955 13 767 13 986
FARM
Families With
Female HHLDR,
No Husband All Other
SIZE OF FAMILY UNIT Total Present1 Families2
(Dollars) (Dollars) (Dollars)
1 Person (Unrelated Individual). . . . . 3 539 3 392 3 680
14 to 64 Years . . . . . . . . . . . . 3 693 3 492 3 773
65 Years And Over. . . . . . . . . . . 3 359 3 347 3 392
2 Persons. . . . . . . . . . . . . . . . 4 502 4 302 4 513
Head 14 to 64 Years. . . . . . . . . . 4 714 4 497 4 721
Head 65 Years and Over . . . . . . . . 4 233 4 185 4 237
3 Persons. . . . . . . . . . . . . . . . 5 573 5 271 5 587
4 Persons. . . . . . . . . . . . . . . . 7 170 7 152 7 170
5 Persons. . . . . . . . . . . . . . . . 8 472 8 373 8 474
6 Persons. . . . . . . . . . . . . . . . 9 613 9 168 9 625
7 Persons Or More. . . . . . . . . . . . 11 915 12 133 11 389
1 Includes female unrelated individuals.
2 Includes male unrelated individuals.
Tape Positions 282-323
A multistage estimation procedure was used to calculate the various NHANES
II subsample sample weights that are necessary to use in any analysis of the
data.The procedure has three basic components:(1) inflation by reciprocals
of the probabilities of selection, (2) adjustment for nonresponse, and (3)
poststratification ratio adjustment by age-sex-race. A brief description
of each component is as follows:
Inflation by reciprocals of the sampling probabilities.Since the survey
utilized a three-stage sample design, there were three probabilities of
selection: (1) the probability of selecting the PSU,(2) the probability
of selecting a segment (housing unit),and (3) the probability of select-
ing a sample person.
Adjustment for nonresponse. Estimates from the NHANES II data were
adjusted to account for sample persons who were not examined. The
estimates were inflated by a multiplication factor calculated within five
selected income groups, three age groups, four regions, and standard
metropolitan statistical area (SMSA) or non-SMSA. The numerator of these
factors was the sum of the weights for sample persons resulting from the
reciprocal of the probability of selection, and the denominator was the
sum of the weights for examined persons also resulting from the
reciprocals of the sampling probabilities.
Poststratification by age-sex-race. The estimates were ratio adjusted within
each of 76 age-sex-race cells to an independent estimate,provided by the U.S.
Bureau of the Census, of the population of each cell as of March 1, 1978,
(approximate mid-point of the survey). The ratio adjustment was a
multiplication factor of which the numerator was the U.S.population and the
denominator was the sum of the weights adjusted for nonresponse for examined
persons. This ratio estimation process makes the sample more closely
representative of the civilian, noninstitutionalized population of the U.S.
Potential bias of nonresponse.Usually a sizeable number of sample persons who
initially are willing to complete the household information and some of the
medical history questionnaire subsequently will not participate in the
examination.This creates the potential for bias if these persons differ from
other sample persons with respect to the variables being studied. Intense
efforts were undertaken during NHANES II to develop and implement standard
procedures and inducements that would reduce the number of nonrespondents
and thereby reduce the potential for bias.
The user needs to be aware of and should explore the potential bias for
nonresponse in any analysis of the NHANES II data.
GENERAL MEDICAL EXAMINATION DATA SUMMARY - NHANES II
Tape Positions 401-499
Tape
Positions
Catalog number.................................................... 401-404
Physician's examination form blank.................................... 407
Pulse............................................................. 408-410
BLOOD PRESSURE
Systolic blood pressure........................................... 411-413
Diastolic blood pressure.......................................... 414-416
Cuff ........................................................ 417
Examiner number................................................... 418-419
HEAD, EYES, EARS, NOSE, AND THROAT
Dry, staring hair..................................................... 421
Dyspigmented hair..................................................... 422
Easily pluckable hair................................................. 423
Abnormal texture or loss of curl...................................... 424
Circumcorneal injection............................................... 425
Conjunctival injection................................................ 426
Angular aritis................................................... 427
Pupils and is....................................................... 428
Xerosis............................................................. . 429
Lesions of cornea (other)............................................. 430
Bitot's ........................................................ 431
Conjugate e........................................................ 432
Keratomalacia....................................................... . 433
Strabismus.......................................................... . 434
Xerophthalmia....................................................... . 435
Conjunctiva other)................................................... 436
Lids and sclera (other)............................................... 437
Angular lesions of lips............................................... 438
Angular scars of lips................................................. 439
Cheilosis........................................................... . 440
Filiform papillary atrophy of tongue.................................. 441
Fungiform papillary hypertrophy of tongue............................. 442
Geographic ngue..................................................... 443
Fissures of ongue.................................................... 444
Serrations or swelling of tongue...................................... 445
Scarlet beefy tongue.................................................. 446
Magenta e........................................................ 447
Bleeding ........................................................ 448
Diffuse marginal inflammation......................................... 449
Swollen red apillae.................................................. 450
Recession........................................................... . 451
Naso-labial borrhea.................................................. 452
Visible enlarged parotids............................................. 453
Bossing of ull...................................................... 454
EXTERNAL EAR
Right ........................................................ 456
Left ........................................................ 457
Operative scar - Left................................................. 458
Operative scar - Right................................................ 459
Pierced ears - Left................................................... 462
Pierced ears - Right.................................................. 463
AUDITORY CANAL
Right auditory canal.................................................. 464
Left auditory canal................................................... 465
Occluded - ght...................................................... 466
Occluded - ft....................................................... 467
Occluded by - Right................................................... 468
Occluded by - Right................................................... 469
DRUM
Right ........................................................ 470
Left ........................................................ 471
Dull/Transparent - Right.............................................. 472
Dull/Transparent - Left............................................... 473
Bulging/Retracted - Right............................................. 474
Bulging/Retracted - Left.............................................. 475
Calcium plaques - Right............................................... 476
Calcium plaques - Left................................................ 477
Red - ........................................................ 478
Red - ........................................................ 479
Fluid - ........................................................ 480
Fluid - ........................................................ 481
Scars - ........................................................ 482
Scars - ........................................................ 483
Perforated - Right.................................................... 484
Perforated - Left..................................................... 485
Nares
Right ........................................................ 488
Left ........................................................ 489
Obstruction - Right................................................... 490
Obstruction - Left.................................................... 491
Deviated septum - Right............................................... 492
Deviated septum - Left................................................ 493
Swollen turbinates - Right............................................ 494
Swollen turbinates - Left............................................. 495
Chronic inflammation - Right.......................................... 496
Chronic inflammation - Left........................................... 497
Polyps - t........................................................ 498
Polyps - ........................................................ 499
Tape Positions 502-591
NECK
Neck................................................................ . 502
Adenopathy.......................................................... . 503
Tracheal ation.................................................... 504
THYROID EVALUATION
WHO ation.................................................... 506
OTHER THYROID FINDINGS
Other thyroid findings................................................ 507
Tenderness.......................................................... . 508
Nodule.............................................................. . 509
Isthmus............................................................. . 510
CHEST EVALUATION
Findings/No indings.................................................. 512
Beading of bs....................................................... 513
Follicular hyperkeratosis of upper back............................... 514
Wheezing on auscultation - diffuse.................................... 515
Wheezing on auscultation - focal...................................... 516
Decreased breath sounds (diffuse)..................................... 517
Masses t)....................................................... 518
Auscultation........................................................ . 519
Right Chest - Upper Lobe
Diminished breath sounds.............................................. 520
Bronchial breath sounds............................................... 521
Rales............................................................... . 522
Rhonchi............................................................. . 523
Wheeze.............................................................. . 524
Right Chest - Middle Lobe
Diminished breath sounds.............................................. 525
Bronchial breath sounds............................................... 526
Rales............................................................... . 527
Rhonchi............................................................. . 528
Wheeze.............................................................. . 529
Right Chest - Lower Lobe
Diminished breath sounds.............................................. 530
Bronchial breath sounds............................................... 531
Rales............................................................... . 532
Rhonchi............................................................. . 533
Wheeze.............................................................. . 534
Left Chest - Upper Lobe
Diminished breath sounds.............................................. 535
Bronchial breath sounds............................................... 536
Rales............................................................... . 537
Rhonchi............................................................. . 538
Wheeze.............................................................. . 539
Left Chest - Lower Lobe
Diminished breath sounds.............................................. 540
Bronchial breath sounds............................................... 541
Rales............................................................... . 542
Rhonchi............................................................. . 543
Wheeze.............................................................. . 544
Heart
P.M.I............................................................... . 546
Interspace.......................................................... . 547
Midclavicular line.................................................... 548
Thrills............................................................. . 549
Thrills - tolic.................................................... 550
Thrills - stolic................................................... 551
First heart ound..................................................... 552
Second heart sound.................................................... 553
Murmurs............................................................. . 554
Systolic ur(s).................................................... 555
Diastolic mur(s)................................................... 556
Apex - ic....................................................... 557
Apex - lic...................................................... 558
Midprecordium - systolic.............................................. 559
Midprecordium - diastolic............................................. 560
Left base - ystolic.................................................. 561
Left base - iastolic................................................. 562
Right base - Systolic................................................. 563
Right base - Diastolic................................................ 564
Origin - al....................................................... 565
Origin - ic....................................................... 566
Origin - uspid.................................................... 567
Origin - onic..................................................... 568
Origin - Atrial septal defect......................................... 569
Origin - Ventricular septal defect.................................... 570
Origin - r........................................................ 571
Origin.............................................................. . 572
Other cardiac or cardiovascular findings.............................. 573
Edema............................................................... . 574
Cyanosis............................................................ . 575
Irregular se....................................................... 576
Neck vein tension.................................................. 578
PULSE - ARTERIAL EVALUATION
Palpatation
Right ........................................................ 579
Right ........................................................ 580
Right dorsalis pedis.................................................. 581
Left ........................................................ 582
Left ........................................................ 583
Left dorsalis pedis................................................... 584
Pulsations
Right ........................................................ 585
Right ........................................................ 586
Right dorsalis pedis.................................................. 587
Left ........................................................ 589
Left ........................................................ 590
Left dorsalis pedis................................................... 591
Tape Positions 593-699
ABDOMINAL EVALUATION AND KIDNEY
Findings/No indings.................................................. 593
Hepatomegaly........................................................ . 594
Splenomegaly........................................................ . 595
Uterine gement................................................... 596
Inguinal ia....................................................... 597
Femoral a........................................................ 598
Umbilical nia...................................................... 599
Pot ........................................................ 600
Mass(es)............................................................ . 601
Areas............................................................. 606-610
Surgical s........................................................ 612
Area.............................................................. 613-617
Costovertebral tenderness............................................. 619
JOINTS
Findings/No indings.................................................. 620
Shoulder
Tender.............................................................. . 621
Swelling............................................................ . 622
Deformity........................................................... . 623
Pain on n........................................................ 624
Other............................................................... . 625
Elbow
Tender.............................................................. . 626
Swelling............................................................ . 627
Deformity........................................................... . 628
Pain on n........................................................ 629
Other............................................................... . 630
Wrist
Tender.............................................................. . 631
Swelling............................................................ . 632
Deformity........................................................... . 633
Pain on n........................................................ 634
Other............................................................... . 635
Metacarpophalangael
Tender - t........................................................ 636
Tender - ........................................................ 637
Swelling - ght...................................................... 638
Swelling - ft....................................................... 639
Deformity - ight..................................................... 640
Deformity - eft...................................................... 641
Pain on Motion - Right................................................ 642
Pain on Motion - Left................................................. 643
Other - ........................................................ 644
Other - ........................................................ 645
Proximal Interphalangeal
Tender - t........................................................ 646
Tender - ........................................................ 647
Swelling - ght...................................................... 648
Swelling - ft....................................................... 649
Deformity - ight..................................................... 650
Deformity - eft...................................................... 651
Pain on Motion - Right................................................ 652
Pain on Motion - Left................................................. 653
Other - ........................................................ 654
Other - ........................................................ 655
Distal Interphalangeal
Tender - t........................................................ 656
Tender - ........................................................ 657
Swelling - ght...................................................... 658
Swelling - ft....................................................... 659
Deformity - ight..................................................... 660
Deformity - eft...................................................... 661
Heberden's nodes - Right.............................................. 662
Heberden's nodes - Left............................................... 663
Pain on Motion - Right................................................ 664
Pain on Motion - Left................................................. 665
Other - ........................................................ 666
Other - ........................................................ 667
Ankle
Tender.............................................................. . 668
Swelling............................................................ . 669
Deformity........................................................... . 670
Pain on n........................................................ 671
Other............................................................... . 672
Feet
Tender.............................................................. . 673
Swelling............................................................ . 674
Deformity........................................................... . 675
Pain on n........................................................ 676
Other............................................................... . 677
Knees
Tender.............................................................. . 678
Swelling............................................................ . 679
Deformity........................................................... . 680
Pain on n........................................................ 681
Other............................................................... . 682
Hips
Tender.............................................................. . 683
Swelling............................................................ . 684
Deformity........................................................... . 685
Pain on n........................................................ 686
Other............................................................... . 687
Back
No indings.................................................. 688
Scoliosis........................................................... . 689
Kyphosis............................................................ . 690
Lordosis............................................................ . 691
Tenderness - Sciatic notch............................................ 692
Tenderness - Sacroiliac............................................... 693
Limitation of Motion
Thoracic e........................................................ 695
Lumbar spine, Right lateral flexion................................... 696
Lumbar spine, Left lateral flexion.................................... 697
Full n........................................................ 698
Pain on n........................................................ 699
Tape Positions 700-778
Pain on flexion - Location
Cervical - Severity of pain........................................... 700
Thoracic............................................................ . 701
Low ........................................................ 702
Diffuse............................................................. . 703
Uncertain........................................................... . 704
Pain on extension - Location
Cervical - Severity of pain........................................... 705
Thoracic............................................................ . 706
Low ........................................................ 707
Diffuse............................................................. . 708
Uncertain........................................................... . 709
Pain on right lateral bending - Location
Thoracic............................................................ . 710
Low ........................................................ 711
Diffuse............................................................. . 712
Uncertain........................................................... . 713
Pain on left lateral bending - Location
Thoracic............................................................ . 714
Low ........................................................ 715
Diffuse............................................................. . 716
Uncertain........................................................... . 717
Pain on right rotation - Location
Thoracic............................................................ . 718
Low ........................................................ 719
Diffuse............................................................. . 720
Uncertain........................................................... . 721
Pain on left rotation - Location
Thoracic............................................................ . 722
Low ........................................................ 723
Diffuse............................................................. . 724
Uncertain........................................................... . 725
STRAIGHT LEG RAISING TEST
Right ........................................................ 726
Left ........................................................ 727
Increase on ankle dorsiflexion
Right ........................................................ 728
Left ........................................................ 729
MUSCULOSKELETAL EVALUATION
Findings/No indings.................................................. 731
Bowed ........................................................ 732
Knock ........................................................ 733
Epiphysial enlargement, wrists........................................ 734
Abduction of hips..................................................... 735
NEUROLOGICAL EVALUATION
Findings/No indings.................................................. 737
Absent knee erks..................................................... 738
Absent ankle jerks.................................................... 739
Positive Chvostek sign................................................ 740
Apathy.............................................................. . 741
Marked rritability.............................................. 742
SKIN EVALUATION
Findings/No indings.................................................. 744
Follicular hyperkeratosis, arms....................................... 745
Hyperpigmentation, hands and face..................................... 746
Dry or scaling skin................................................... 747
Perifolliculosis.................................................... . 748
Petechiae........................................................... . 749
Mosiac ........................................................ 750
Pellagrous rmatitis................................................. 751
Ecchymoses.......................................................... . 752
Edema............................................................... . 753
EXAMINER'S SUBJECTIVE IMPRESSION OF NUTRITIONAL STATUS
Normal/Abnormal nutrition............................................. 755
Obesity............................................................. . 756
BLOOD PRESSURE
Cuff ........................................................ 757
Time - Hour....................................................... 758-759
Time - Minutes.................................................... 760-761
Time - ........................................................ 762
Systolic - Recumbent.............................................. 763-765
Diastolic - Recumbent............................................. 768-770
Systolic - Sitting................................................ 771-773
Diastolic - Sitting............................................... 774-776
Examiner No....................................................... 777-778
Tape Positions 780-871
SUMMARY OF DIAGNOSTIC IMPRESSIONS
Severity............................................................ . 780
Certainty........................................................... . 781
ICDA Code a....................................................... 782-785
Severity............................................................ . 786
Certainty........................................................... . 787
ICDA Code b....................................................... 788-791
Severity............................................................ . 792
Certainty........................................................... . 793
ICDA Code c....................................................... 794-797
Severity............................................................ . 798
Certainty........................................................... . 799
ICDA Code d....................................................... 800-803
Severity............................................................ . 804
Certainty........................................................... . 805
ICDA Code e....................................................... 806-809
Severity............................................................ . 810
Certainty........................................................... . 811
ICDA Code f....................................................... 812-815
Severity............................................................ . 816
Certainty........................................................... . 817
ICDA Code g....................................................... 818-821
Severity............................................................ . 822
Certainty........................................................... . 823
ICDA Code h....................................................... 824-827
Severity............................................................ . 828
Certainty........................................................... . 829
ICDA Code i....................................................... 830-833
Severity............................................................ . 834
Certainty........................................................... . 835
ICDA Code j....................................................... 836-839
Severity............................................................ . 840
Certainty........................................................... . 841
ICDA Code k....................................................... 842-845
Severity............................................................ . 846
Certainty 847
ICDA Code l....................................................... 848-851
Severity............................................................ . 852
Certainty........................................................... . 853
ICDA Code m....................................................... 854-857
Severity............................................................ . 858
Certainty........................................................... . 859
ICDA Code n....................................................... 860-863
Severity............................................................ . 864
Certainty........................................................... . 865
ICDA Code o....................................................... 866-869
Examiner Number................................................... 870-871
RECORD LAYOUT, PHYSICIAN EXAMINATION DATA
Tape Positions 401-450
NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY - NHANES II
Physician Examination Data
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
401-404 Catalog number
5302 20,322
405-406 Blank 20,322
407 Physician's examination form blank See detailed
notes
1 form is blank 14
blank 20,308
408-410 Pulse All ages
See detailed
033-200 beats per minute 19,995 notes
888 blank but applicable 313
blank 14
411-413 Systolic blood pressure Age 6 years
and over
065-300 mm Hg 16,109 See detailed
888 blank but applicable 88 notes
blank 4,125
414-416 Diastolic blood pressure
035-150 mm Hg 16,055
888 blank but applicable 142
blank 4,125
417 Cuff width
1 Adult 14,462 See detailed
2 Child 1,598 notes
8 blank but applicable 137
blank 4,125
418-419 Examiner number
30-49 physician number 16,193
88 blank but applicable 4
blank 4,125
HEAD, EYES, EARS, NOSE, AND THROAT
420 1 findings 15,713 See detailed
2 no findings 4,593 notes
8 blank but applicable 2
blank 14
421 Dry, staring hair
1 yes 4
blank 20,318
422 Dyspigmented hair
1 yes 0
blank 20,322
423 Easily pluckable hair
1 yes 2
blank 20,320
424 Abnormal texture or loss of curl
1 yes 5
blank 20,317
425 Circumcorneal injection
1 yes 30
blank 20,292
426 Conjunctival injection
1 yes 1,319
blank 19,003
427 Angular blepharitis
1 yes 15
blank 20,307
428 Pupils and iris
1 yes 73
blank 20,249
429 Xerosis
1 yes 4
blank 20,318
430 Lesions of cornea (other)
1 yes 42
blank 20,280
431 Bitot's spots
1 yes 4
blank 20,318
432 Conjugate gaze
1 yes 6
blank 20,316
433 Keratomalacia
1 yes 2
blank 20,320
434 Strabismus
1 yes 79
blank 20,243
435 Xerophthalmia
1 yes 3
blank 20,319
436 Conjunctiva (other)
1 yes 152
blank 20,170
437 Lids and sclera (other)
1 yes 23
blank 20,299
438 Angular lesions of lips
1 yes 33
blank 20,289
439 Angular scars of lips
1 yes 17
blank 20,305
440 Cheilosis
1 yes 49
blank 20,273
441 Filiform papillary atrophy of tongue
1 yes 89
blank 20,233
442 Fungiform papillary hypertrophy of tongue
1 yes 971
blank 19,351
443 Geographic tongue
1 yes 138
blank 20,184
444 Fissures of tongue
1 yes 939
blank 19,383
445 Serrations or swelling of tongue
1 yes 1,002
blank 19,320
446 Scarlet beefy tongue
1 yes 26
blank 20,296
447 Magenta tongue
1 yes 4
blank 20,318
448 Bleeding gums
1 yes 5
blank 20,317
449 Diffuse marginal inflammation
1 yes 142
blank 20,180
450 Swollen red papillae
1 yes 101
blank 20,221
Tape Positions 451-501
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
451 Recession
1 yes 535
blank 19,787
452 Naso-labial seborrhea
1 yes 9
blank 20,313
453 Visible enlarged parotids
0 yes 20
blank 20,302
454 Bossing of skull
1 yes 28
blank 20,294
455 Blank 20,322
EXTERNAL EAR
456 Right ear See detailed
notes
1 no findings 16,261
2 findings 4,044
8 blank but applicable 3
blank 14
457 Left ear See detailed
notes
1 no findings 15,966
2 findings 4,339
8 blank but applicable 3
blank 14
458 Operative scar - Left mastoid
1 yes 20
blank 20,302
459 Operative scar - Right mastoid
1 yes 17
blank 20,305
460-461 Blank 20,322
462 Pierced ears - Left
1 yes 4,028
blank 16,294
463 Pierced ears - Right
1 yes 4,325
blank 15,997
AUDITORY CANAL
464 Right auditory canal See detailed
notes
1 no findings 17,914
2 findings 2,391
8 blank but applicable 3
blank 14
465 Left auditory canal See detailed
notes
1 no findings 17,977
2 findings 2,328
8 blank but applicable 3
blank 14
466 Occluded - Right
1 partially 793
2 completely 1,409
8 blank but applicable 189
blank 17,931
467 Occluded - Left
1 partially 756
2 completely 1,381
8 blank but applicable 191
blank 17,994
468 Occluded by - Right
1 cerumen 2,072
2 other 206
8 blank but applicable 113
blank 17,931
469 Occluded by - Left
1 cerumen 2,020
2 other 197
8 blank but applicable 111
blank 17,994
DRUM
470 Right drum See detailed
notes
1 no findings 17,537
2 findings 1,329
3 not visible 1,439
8 blank but applicable 3
blank 14
471 Left drum See detailed
notes
1 no findings 17,439
2 findings 1,487
3 not visible 1,379
8 blank but applicable 3
blank 14
472 Dull/Transparent - Right
1 dull (opaque) 407
2 transparent 5
blank 19,910
473 Dull/Transparent - Left
1 dull (opaque) 470
2 transparent 6
blank 19,846
474 Bulging/Retracted - Right
1 bulging 6
2 retracted 92
blank 20,224
475 Bulging/Retracted - Left
1 bulging 7
2 retracted 136
blank 20,179
476 Calcium plaques - Right
1 yes 117
blank 20,205
477 Calcium plaques - Left
1 yes 130
blank 20,192
478 Red - Right
1 red 184
2 other discolorations 41
blank 20,097
479 Red - Left
1 red 238
2 other discolorations 43
blank 20,041
480 Fluid - Right
1 fluid 18
blank 20,314
481 Fluid - Left
1 fluid 9
blank 20,313
482 Scars - Right
1 scars 508
blank 19,814
483 Scars - Left
1 scars 524
blank 19,798
484 Perforated - Right
1 with discharge 23
2 without discharge 75
blank 20,224
485 Perforated - Left
1 with discharge 21
2 without discharge 58
blank 20,243
486-487 Blank 20,322
NARES
488 Right nares See detailed
notes
1 no findings 18,061
2 findings 2,244
8 blank but applicable 3
blank 14
489 Left nares See detailed
notes
1 no findings 18,169
2 findings 2,136
8 blank but applicable 3
blank 14
490 Obstruction - Right
1 acute 143
2 chronic 85
blank 20,094
491 Obstruction - Left
1 acute 146
2 chronic 86
blank 20,090
Other Significant Findings
492 Deviated septum - Right
1 yes 453
blank 19,869
493 Deviated septum - Left
1 yes 267
blank 20,055
494 Swollen turbinates - Right
1 yes 1,457
blank 18,865
495 Swollen turbinates - Left
1 yes 1,532
blank 18,790
496 Chronic inflammation - Right
1 yes 343
blank 19,979
497 Chronic inflammation - Left
1 yes 345
blank 19,977
498 Polyps - Right
1 yes 20
blank 20,302
499 Polyps - Left
1 yes 17
blank 20,305
500-501 Blank 20,322
Tape Positions 502-550
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
NECK
502 1 no findings 19,805 See detailed
2 findings 500 note
8 blank but applicable 3
blank 14
503 Adenopathy
1 yes 492
blank 19,830
504 Tracheal deviation
1 yes 8
blank 20,314
505 Blank 20,322
THYROID EVALUATION
506 WHO Classification
1 Group 0 19,294 See detailed
2 Group 1 826 notes
3 Group 2 99
4 Group 3 15
8 blank but applicable 74
blank 14
Other Thyroid Findings
507 1 findings 117 See detailed
2 no findings 20,188 notes
8 blank but applicable 3
blank 14
508 Tenderness
1 right 8
2 left 0
3 both 7
blank 20,307
509 Nodule
1 right 55
2 left 25
3 both 15
blank 20,227
510 Isthmus
1 right 22
2 left 0
3 both 0
blank 20,300
511 Blank 20,322
CHEST EVALUATION
512 1 findings 723 See detailed
2 no findings 19,570 notes
8 blank but applicable 15
blank 14
513 Beading of ribs
1 yes 9
blank 20,313
514 Follicular hyperkeratosis of upper back
1 yes 75
blank 20,247
515 Wheezing on auscultation - Diffuse See detailed
notes
1 yes 193
blank 20,129
516 Wheezing on auscultation - Focal See detailed
notes
1 yes 83
blank 20,239
517 Decreased breath sounds (diffuse) See detailed
notes
1 yes 254
blank 20,068
518 Masses (breast)
1 right 45
2 left 50
3 both 48
blank 20,179
519 Auscultation See detailed
notes
1 no findings 19,145
2 findings 1,148
8 blank but applicable 15
blank 14
Right Chest - Upper Lobe
520 Breath sounds See detailed
notes
1 diminished breath sounds 203
2 absent breath sounds 4
blank 20,115
521 Bronchial breath sounds
1 yes 141
blank 20,181
522 Rales
1 yes 101
blank 20,221
523 Rhonchi
1 yes 105
blank 20,217
524 Wheeze
1 yes 168
blank 20,154
Right Chest - Middle Lobe
525 Breath sounds See detailed
notes
1 diminished breath sounds 133
2 absent breath sounds 2
blank 20,187
526 Bronchial breath sounds
1 yes 125
blank 20,197
527 Rales
1 yes 106
blank 20,216
528 Rhonchi
1 yes 110
blank 20,212
529 Wheeze
1 yes 160
blank 20,162
530 Breath sounds See detailed
notes
1 diminished breath sounds 152
2 absent breath sounds 5
blank 20,165
531 Bronchial breath sounds
1 yes 155
blank 20,167
532 Rales
1 yes 237
blank 20,085
533 Rhonchi
1 yes 155
blank 20,167
534 Wheeze
1 yes 192
blank 20,130
Left Chest - Upper Lobe
535 Breath sounds See detailed
notes
1 diminished breath sounds 199
2 absent breath sounds 10
blank 20,113
536 Bronchial breath sounds
1 yes 135
blank 20,187
537 Rales
1 yes 112
blank 20,210
538 Rhonchi
1 yes 107
blank 20,215
539 Wheeze
1 yes 170
blank 20,143
Left Chest - Lower Lobe
540 Breath sounds See detailed
notes
1 diminished breath sounds 139
2 absent breath sounds 11
blank 20,172
541 Bronchial breath sounds
1 yes 159
blank 20,163
542 Rales
1 yes 258
blank 20,064
543 Rhonchi
1 yes 149
blank 20,173
544 Wheeze
1 yes 190
blank 20,132
545 Blank 20,322
HEART
546 P.M.I. - Point of maximum impulse Age 18 years
and over
1 felt 5,532 See detailed
2 not felt 6,966 notes
8 blank but applicable 1
blank 7,823
547 Interspace
4 th 640
5 th 4,637
6 th 227
7 th 7
blank 14,811
548 Midclavicular line
1 at 3,615
2 inside 1,697
3 outside 158
blank 14,852
549 Thrills
1 absent 20,272
2 present 33
8 blank but applicable 3
blank 14
550 Thrills - Systolic
1 base 20
2 apex 8
blank 20,294
Tape Positions 551-600
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
551 Thrills - Diastolic
1 base 13
2 apex 6
blank 20,303
552 First heart sound
1 normal 19,365
2 accentuated 144
3 diminished 712
8 blank but applicable 87
blank 14
553 Second heart sound
1 normal 19,287
2 accentuated 245
3 diminished 680
8 blank but applicable 96
blank 14
554 Murmurs See detailed
notes
1 none 19,120
8 blank but applicable 3
blank 1,199
555 Systolic murmur(s)
1 functional 327
2 organic 708
8 blank but applicable 27
9 don't know 76
blank 19,184
556 Diastolic murmur(s)
1 functional 2
2 organic 103
8 blank but applicable 27
9 don't know 2
blank 20,188
Location
557 Apex - Systolic
1 grade 1 107
2 grade 2 180
3 grade 3 163
4 grade 4 61
5 grade 5 12
6 grade 6 3
blank 19,796
558 Apex - Diastolic
1 grade 1 1
2 grade 2 13
3 grade 3 25
4 grade 4 7
5 grade 5 1
6 grade 6 1
blank 20,274
559 Midprecordium - Systolic
1 grade 1 63
2 grade 2 157
3 grade 3 121
4 grade 4 25
5 grade 5 10
6 grade 6 2
blank 19,944
560 Midprecordium - Diastolic
1 grade 1 0
2 grade 2 3
3 grade 3 23
4 grade 4 5
5 grade 5 0
6 grade 6 2
blank 20,289
561 Left base - Systolic
1 grade 1 58
2 grade 2 131
3 grade 3 131
4 grade 4 31
5 grade 5 7
6 grade 6 1
blank 19,963
562 Left base - Diastolic
1 grade 1 0
2 grade 2 5
3 grade 3 17
4 grade 4 5
5 grade 5 0
6 grade 6 1
blank 20,294
563 Right base - Systolic
1 grade 1 50
2 grade 2 162
3 grade 3 149
4 grade 4 50
5 grade 5 13
6 grade 6 0
blank 19,898
564 Right base - Diastolic
1 grade 1 1
2 grade 2 3
3 grade 3 10
4 grade 4 8
5 grade 5 0
6 grade 6 0
blank 20,300
565 Origin - Mitral
1 systolic 308
2 diastolic 30
3 both 20
blank 19,964
566 Origin - Aortic
1 systolic 320
2 diastolic 14
3 both 27
blank 19,961
567 Origin - Tricuspid
1 systolic 21
2 diastolic 0
3 both 0
blank 20,301
568 Origin - Pulmonic
1 systolic 86
2 diastolic 1
3 both 1
blank 20,234
569 Origin - Atrial septal defect
1 systolic 12
2 diastolic 0
3 both 1
blank 20,309
570 Origin - Ventricular septal defect
1 systolic 79
2 diastolic 0
3 both 0
blank 20,243
571 Origin - Other
1 systolic 24
2 diastolic 1
3 both 5
blank 20,292
572 Origin
9 don't know 209
blank 20,113
Other Cardiac or Cardiovascular Findings
573 1 no 19,636 See detailed
2 yes 672 notes
blank 14
574 Edema
1 yes 222
blank 20,100
575 Cyanosis
1 yes 51
blank 20,271
576 Irregular pulse
1 yes 415
blank 19,907
577 Blank 20,322
578 Neck vein distension
1 yes 53
blank 20,269
PULSE - ARTERIAL EVALUATION Age 18 years
and over
See detailed
notes
Palpation
579 Right radial
1 normal 12,074
2 sclerotic 324
3 tortuous 19
4 sclerotic and tortuous 27
5 absent 23
8 blank but applicable 32
blank 7,823
580 Right femoral
1 normal 12,005
2 sclerotic 323
3 tortuous 15
4 sclerotic and tortuous 23
5 absent 58
8 blank but applicable 75
blank 7,823
581 Right dorsalis pedis
1 normal 11,279
2 sclerotic 405
3 tortuous 10
4 sclerotic and tortuous 23
5 absent 659
8 blank but applicable 123
blank 7,823
582 Left radial
1 normal 12,037
2 sclerotic 330
3 tortuous 17
4 sclerotic and tortuous 25
5 absent 22
8 blank but applicable 68
blank 7,823
583 Left femoral
1 normal 11,987
2 sclerotic 327
3 tortuous 15
4 sclerotic and tortuous 21
5 absent 66
8 blank but applicable 83
blank 7,823
584 Left dorsalis pedis
1 normal 10,815
2 sclerotic 365
3 tortuous 10
4 sclerotic and tortuous 22
5 absent 686
8 blank but applicable 601
blank 7,823
Pulsations
585 Right radial
1 normal 12,150
2 diminished 201
3 bounding 86
4 absent 28
8 blank but applicable 34
blank 7,823
586 Right femoral
1 normal 12,042
2 diminished 251
3 bounding 87
4 absent 59
8 blank but applicable 60
blank 7,823
587 Right dorsalis pedis
1 normal 11,214
2 diminished 404
3 bounding 59
4 absent 718
8 blank but applicable 104
blank 7,823
586 Blank 20,322
589 Left radial
1 normal 12,139
2 diminished 205
3 bounding 86
4 absent 24
8 blank but applicable 45
blank 7,823
590 Left femoral
1 normal 12,029
2 diminished 249
3 bounding 83
4 absent 68
8 blank but applicable 70
blank 7,823
591 Left dorsalis pedis
1 normal 11,187
2 diminished 397
3 bounding 60
4 absent 740
8 blank but applicable 115
blank 7,823
592 Blank 20,322
ABDOMINAL EVALUATION AND KIDNEY
593 1 findings 5,294 See detailed
2 no findings 15,011 notes
8 blank but applicable 3
blank 14
594 Hepatomegaly
1 yes 131
blank 20,191
595 Splenomegaly
1 yes 21
blank 20,301
596 Uterine enlargement
1 yes 64
blank 20,258
597 Inguinal hernia
1 yes 90
blank 20,232
598 Femoral hernia
1 yes 1
blank 20,321
599 Umbilical hernia
1 yes 427
blank 19,895
600 Pot belly
1 yes 59
blank 20,263
Tape Positions 601-650
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
601 Mass(es)
1 yes 82
blank 20,240
602-605 Blank 20,322
606-610 Areas See detailed
notes
Areas 1-9 indicated 82
00000 blank but applicable 0
blank 20,240
611 Blank 20,322
Surgical Scars
612 1 yes 4,688
blank 15,634
613-617 Areas See detailed
notes
Areas 1-9 indicated 4,688
00000 blank but applicable 0
blank 15,634
618 Blank 20,322
619 Costovertebral tenderness
1 yes 35
blank 20,287
JOINTS Age 10 and
over
620 1 findings 12,225 See detailed
2 no findings 2,831 notes
8 blank but applicable 4
blank 5,262
Shoulder
621 Tender
1 right 55
2 left 38
3 both 59
blank 20,170
622 Swelling
1 right 5
2 left 1
3 both 9
blank 20,307
623 Deformity
1 right 6
2 left 4
3 both 5
blank 20,307
624 Pain on motion
1 right 90
2 left 61
3 both 91
blank 20,080
625 Other
1 right 13
2 left 9
3 both 4
blank 20,296
Elbow
626 Tender
1 right 25
2 left 13
3 both 44
blank 20,240
627 Swelling
1 right 5
2 left 5
3 both 7
blank 20,305
628 Deformity
1 right 34
2 left 17
3 both 8
blank 20,263
629 Pain on motion
1 right 34
2 left 19
3 both 46
blank 20,223
630 Other
1 right 3
2 left 3
3 both 1
blank 20,315
Wrist
631 Tender
1 right 29
2 left 12
3 both 40
blank 20,241
632 Swelling
1 right 8
2 left 6
3 both 14
blank 20,294
633 Deformity
1 right 28
2 left 12
3 both 18
blank 20,264
634 Pain on motion
1 right 27
2 left 17
3 both 49
blank 20,229
635 Other
1 right 2
2 left 3
3 both 0
blank 20,317
Metacarpophalangael Number involved
636 Tender - Right
1-5 joints involved 73
blank 20,249
637 Tender - Left
1-5 joints involved 66
blank 20,256
638 Swelling - Right
1-5 joints involved 62
blank 20,260
639 Swelling - Left
1-5 joints involved 55
blank 20,267
640 Deformity - Right
1-5 joints involved 125
blank 20,197
641 Deformity - Left
1-5 joints involved 113
blank 20,209
642 Pain on motion - Right
1-5 joints involved 65
blank 20,257
643 Pain on motion - Left
1-5 joints involved 64
blank 20,258
644 Other - Right
1-5 joints involved 5
blank 20,317
645 Other - Left
1-5 joints involved 5
blank 20,317
Proximal Interphalangeal Number involved
646 Tender - Right
1-5 joints involved 106
blank 20,216
647 Tender - Left
1-5 joints involved 95
blank 20,227
648 Swelling - Right
1-5 joints involved 108
blank 20,214
649 Swelling - Left
1-5 joints involved 98
blank 20,224
650 Deformity - Right
1-5 joints involved 230
blank 20,092
Tape Positions 651-700
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
651 Deformity - Left
1-5 joints involved 198
blank 20,124
652 Pain on motion - Right
1-5 joints involved 102
blank 20,220
653 Pain on motion - Left
1-5 joints involved 92
blank 20,220
654 Other - Right
1-5 joints involved 4
blank 20,318
655 Other - Left
1-5 joints involved 4
blank 20,318
Distal Interphalangeal Number involved
656 Tender - Right
1-5 joints involved 79
blank 20,243
657 Tender - Left
1-5 joints involved 70
blank 20,252
658 Swelling - Right
1-5 joints involved 59
blank 20,263
659 Swelling - Left
1-5 joints involved 52
blank 20,270
660 Deformity - Right
1-5 joints involved 175
blank 20,147
661 Deformity - Left
1-5 joints involved 151
blank 20,171
662 Heberden's nodes - Right
1-5 joints involved 1,395
blank 18,927
663 Heberden's nodes - Left
1-5 joints involved 1,277
blank 19,045
664 Pain on motion - Right
1-5 joints involved 65
blank 20,257
665 Pain on motion - Left
1-5 joints involved 62
blank 20,260
666 Other - Right
1-5 joints involved 6
blank 20,316
667 Other - Left
1-5 joints involved 7
blank 20,315
Ankle
668 Tender
1 right 30
2 left 24
3 both 55
blank 20,213
669 Swelling
1 right 25
2 left 23
3 both 48
blank 20,226
670 Deformity
1 right 37
2 left 37
3 both 37
blank 20,211
671 Pain on motion
1 right 34
2 left 19
3 both 59
blank 20,210
672 Other
1 right 6
2 left 4
3 both 4
blank 20,308
Feet
673 Tender
1 right 17
2 left 9
3 both 52
blank 20,244
674 Swelling
1 right 7
2 left 5
3 both 28
blank 20,282
675 Deformity
1 right 17
2 left 14
3 both 107
blank 20,184
676 Pain on motion
1 right 13
2 left 11
3 both 51
blank 20,247
677 Other
1 right 3
2 left 2
3 both 6
blank 20,311
Knees
678 Tender
1 right 83
2 left 69
3 both 149
blank 20,021
679 Swelling
1 right 50
2 left 43
3 both 86
blank 20,143
680 Deformity
1 right 35
2 left 41
3 both 174
blank 20,072
681 Pain on motion
1 right 127
2 left 93
3 both 206
blank 19,896
682 Other
1 right 24
2 left 29
3 both 76
blank 20,193
Hips
683 Tender
1 right 52
2 left 33
3 both 86
blank 20,151
684 Swelling
1 right 2
2 left 2
3 both 9
blank 20,309
685 Deformity
1 right 18
2 left 13
3 both 21
blank 20,270
686 Pain on motion
1 right 79
2 left 70
3 both 151
blank 20,022
687 Other
1 right 19
2 left 13
3 both 21
blank 20,269
BACK
688 1 no findings 17,389 See detailed
2 findings 2,916 notes
8 blank but applicable 3
blank 14
689 Scoliosis
1 yes 685
blank 19,637
690 Kyphosis
1 yes 873
blank 19,449
691 Lordosis
1 yes 264
blank 20,058
692 Tenderness - Sciatic notch
1 right 42
2 left 29
3 both 49
blank 20,203
693 Tenderness - Sacroiliac
1 right 58
2 left 37
3 both 76
blank 20,151
694 Blank 20,322
Limitation of Motion
695 Thoracic spine
1 yes 858
blank 19,464
696 Lumbar spine, right lateral flexion
1 yes 986
blank 19,336
697 Lumbar spine, left lateral flexion
1 yes 977
blank 19,345
698 Full extension
1 yes 1,011
blank 19,311
PAIN ON MOTION
699 1 negative 2,024 See detailed
2 positive 891 notes
8 blank but applicable 1
blank 17,406
Pain on flexion - Location
700 Cervical - Severity of pain
0 None 30
1 doubtful 16
2 minimal 112
3 moderate 152
4 maximal 14
8 blank but applicable 567
blank 19,431
Tape Positions 701-750
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
701 Thoracic
1 yes 92
blank 20,230
702 Low Back
1 yes 235
blank 20,087
703 Diffuse
1 yes 96
blank 20,226
704 Uncertain
1 yes 8
blank 20,314
Pain on extension - Location
705 Cervical - Severity of pain
0 none 24
1 doubtful 15
2 minimal 129
3 moderate 168
4 maximal 14
8 blank but applicable 541
blank 19,431
706 Thoracic
1 yes 99
blank 20,223
707 Low Back
1 yes 283
blank 20,039
708 Diffuse
1 yes 93
blank 20,229
709 Uncertain
1 yes 7
blank 20,315
Pain on right lateral bending - Location
710 Thoracic
1 yes 98
blank 20,224
711 Low Back
1 yes 270
blank 20,052
712 Diffuse
1 yes 85
blank 20,237
713 Uncertain
1 yes 5
blank 20,317
Pain on left lateral bending - Location
714 Thoracic
1 yes 98
blank 20,224
715 Low Back
1 yes 301
blank 20,021
716 Diffuse
1 yes 82
blank 20,240
717 Uncertain
1 yes 5
blank 20,317
Pain on right rotation - Location
718 Thoracic
1 yes 100
blank 20,222
719 Low Back
1 yes 202
blank 20,120
720 Diffuse
1 yes 80
blank 20,242
721 Uncertain
1 yes 2
blank 20,320
Pain on left rotation - Location
722 Thoracic
1 yes 98
blank 20,224
723 Low Back
1 yes 195
blank 20,127
724 Diffuse
1 yes 80
blank 20,242
725 Uncertain
1 yes 2
blank 20,320
STRAIGHT LEG RAISING TEST
726 Right leg
1 negative 19,888
2 positive 312
8 blank but applicable 108
blank 14
727 Left leg
1 negative 19,871
2 positive 332
8 blank but applicable 105
blank 14
Increase on ankle dorsiflexion
728 Right
1 yes 208
2 no 16,230
8 blank but applicable 3,870
blank 14
729 Left
1 yes 224
2 no 16,218
8 blank but applicable 3,866
blank 14
730 Blank 20,322
MUSCULOSKELETAL EVALUATION See detailed
notes
731 1 findings 1,567
2 no findings 18,738
8 blank but applicable 3
blank 14
732 Bowed legs
1 yes 812
blank 9,510
733 Knock knees
1 yes 755
blank 19,567
734 Epiphysial enlargement, wrists
1 yes 1
blank 20,321
735 Abduction of hips (Ortoloni's maneuver) Under age 3
1 yes 0
blank 20,322
736 Blank 20,322
NEUROLOGICAL EVALUATION See detailed
notes
737 1 findings 2,027
2 no findings 18,278
8 blank but applicable 3
blank 14
738 Absent knee jerks
1 yes 589
blank 19,733
739 Absent ankle jerks
1 yes 707
blank 19,615
740 Positive Chvostek sign
1 yes 998
blank 19,324
741 Apathy
1 yes 33
blank 20,289
742 Marked hyperirritability
1 yes 89
blank 20,233
743 Blank 20,322
SKIN EVALUATION
744 1 findings 671 See detailed
2 no findings 19,634 notes
8 blank but applicable 3
blank 14
745 Follicular hyperkeratosis, arms
1 yes 137
blank 20,185
746 Hyperpigmentation, hands and face
1 yes 60
blank 20,262
747 Dry or scaling skin
1 yes 362
blank 19,960
748 Perifolliculosis
1 yes 17
blank 20,305
749 Petechiae
1 yes 60
blank 20,262
750 Mosaic skin
1 yes 7
blank 20,315
Tape Positions 751-799
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
751 Pellagrous dermatitis
1 yes 3
blank 20,319
752 Ecchymoses
1 yes 67
blank 20,255
753 Edema
1 yes 53
blank 20,269
754 Blank 20,322
EXAMINER'S SUBJECTIVE IMPRESSION OF
NUTRITIONAL STATUS
755 1 normal nutrition 17,754
2 abnormal nutrition 2,527
8 blank but applicable 27
blank 14
756 1 obesity 2,949
2 no obesity 17,337
8 blank but applicable 22
blank 14
BLOOD PRESSURE See detailed
notes
Cuff Width
757 1 adult 14,478
2 child 1,580
8 blank but applicable 139
blank 4,125
Time
758-761 0001-1259 16,113
8888 blank but applicable 84
blank 4,125
762 1 AM 8,538 See detailed
2 PM 7,524 notes
8 blank but applicable 135
blank 4,125
Blood Pressure
763-765 Systolic - Recumbent Age 6 & over
68-300 mm Hg 16,084
888 blank but applicable 113
blank 4,125
766-767 Blank 20,322
768-770 Diastolic - Recumbent
35-150 mm Hg 16,020
888 blank but applicable 177
blank 4,125
771-773 Systolic - Sitting
65-300 mm Hg 16,074
888 blank but applicable 123
blank 4,125
774-776 Diastolic - Sitting
35-150 mm Hg 16,035
888 blank but applicable 162
blank 4,125
777-778 Examiner no.
02-88 Examiner Number 16,196
00 blank but applicable 1
blank 4,125
SUMMARY OF DIAGNOSTIC IMPRESSIONS
779 1 normal: no abnormal findings 8,671 See detailed
2 abnormal: significant findings noted 11,632 notes
8 blank but applicable 5
blank 14
Code a
780 Severity
1 minimal 4,806
2 moderate 5,304
3 severe 1,360
8 blank but applicable 162
blank 8,690
781 Certainty
0 Not at all certain - 9 Extremely
certain 11,047
"-" blank but applicable 135
blank 8,690
782-785 ICDA code
Code a 11,632
8888 blank but applicable 0
blank 8,690
Code b
786 Severity
1 minimal 2,382
2 moderate 3,186
3 severe 813
8 blank but applicable 110
blank 13,831
787 Certainty
0 Not at all certain - 9 Extremely
certain 6,439
"-" blank but applicable 52
blank 13,831
788-791 ICDA code
Code b 6,491
8888 blank but applicable 0
blank 13,831
Code c
792 Severity
1 minimal 1,265
2 moderate 1,905
3 severe 462
8 blank but applicable 71
blank 16,619
793 Certainty
0 Not at all certain - 9 Extremely
certain 3,662
"-" blank but applicable 41
blank 16,619
794-797 ICDA code
Code c 3,703
8888 blank but applicable 0
blank 16,619
Code d
798 Severity
1 minimal 659
2 moderate 1,145
3 severe 294
8 blank but applicable 34
blank 18,190
799 Certainty
0 Not at all certain - 9 Extremely
certain 2,106
"-" blank but applicable 26
blank 18,190
Tape Positions 800-851
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
800-803 ICDA code
Code d 2,132
blank 18,190
Code e
804 Severity
1 minimal 374
2 moderate 635
3 severe 176
8 blank but applicable 24
blank 19,113
805 Certainty
0 Not at all certain - 9 Extremely
certain 1,196
'-' blank but applicable 13
blank 19,113
806-809 ICDA code
Code e 1,209
8888 blank but applicable 0
blank 19,113
Code f
810 Severity
1 minimal 180
2 moderate 359
3 severe 97
8 blank but applicable 16
blank 19,670
811 Certainty
0 Not at all certain - 9 Extremely
certain 643
'-' blank but applicable 9
blank 19,670
812-815 ICDA code
Code f 652
8 blank but applicable 0
blank 19,670
Code g
816 Severity
1 minimal 102
2 moderate 193
3 severe 52
8 blank but applicable 8
blank 19,967
817 Certainty
0 Not at all certain - 9 Extremely
certain 349
'-' blank but applicable 6
blank 19,967
818-821 ICDA code
Cde g 355
8888 blank but applicable 19,967
Code h
822 Severity
1 minimal 48
2 moderate 86
3 severe 28
8 blank but applicable 4
blank 20,156
823 Certainty
0 Not at all certain - 9 Extremely
certain 164
'-' blank but applicable 2
blank 20,156
824-827 ICDA code
Code h 166
blank 20,156
Code i
828 Severity
1 minimal 24
2 moderate 45
3 severe 17
8 blank but applicable 4
blank 20,232
829 Certainty
0 Not at all certain - 9 Extremely
certain 87
'-' blank but applicable 3
blank 20,232
830-833 ICDA code
Code i 90
8888 blank but applicable 0
blank 20,232
Code j
834 Severity
1 minimal 5
2 moderate 19
3 severe 10
8 blank but applicable 1
blank 20,287
835 Certainty
0 Not at all certain - 9 Extremely
certain 34
'-' blank but applicable 1
blank 20,287
836-839 ICDA code
Code j 35
blank 20,287
Code k
840 Severity
1 minimal 4
2 moderate 6
3 severe 3
blank 20,309
841 Certainty
0 Not at all certain - 9 Extremely
certain 13
blank 20,309
842-845 ICDA code
Code k 13
blank 20,309
Code l
846 Severity
1 minimal 3
2 moderate 1
blank 20,318
847 Certainty
0 Not at all certain - 9 Extremely
certain 4
blank 20,318
848-851 ICDA code
Code l 4
blank 20,318
Code m
Tape Positions 852-900
POSITION ITEM DESCRIPTION AND CODES COUNTS SOURCE AND NOTES
852 Severity
2 moderate 2
8 blank but applicable 0
blank 20,320
853 Certainty
0 Not at all certain - 9 Extremely
certain 2
'-' blank but applicable 0
blank 20,320
854-857 ICDA code
Code m 2
blank 20,320
Code n
858 Severity
blank 20,322
859 Certainty
blank 20,322
860-863 ICDA code
blank 20,322
Code o
864 Severity
blank 20,322
865 Certainty
blank 20,322
866-869 ICDA code
blank 20,322
870-871 Examiner number
30-49 Physician number 20,288
88 blank but applicable 20
blank 14
872-900 Blank 20,322
DETAILED NOTES, PHYSICIAN EXAMINATION DATA
Physician's examination form blank
Survey participants who completed other components of the examination but
for whom the physician's examination form is blank are indicated with a
"1" in this position. Their records are blank in positions 408-900.
Pulse
Any pulse value less than 30 was changed to "888", blank but applicable.
Pulse values greater than 150 were left as stated by the examiner;
typically, values in the higher ranges were accompanied by comments
such as "crying baby".
Blood Pressure
At the beginning of the physical examination the physician took the
sample person's blood pressure while the sample person was in a sitting
position. The sample person's blood pressure was taken twice more at the
end of the exam, once while the sample person was recumbent and again
while sitting. The following guidelines, based on the American Heart
Association's "Recommendations for Human Blood Pressure Determinations
by Sphygmomanometers" (Committee to Revise Standardization of High Blood
Pressure Readings, New York, American Heart Association, October 1951)
were generally observed:
1. The cuff was at least 20 percent wider than the diameter of
the arm or covered approximately two-thirds of the arm. (An
adult 13 cm. cuff and a pediatric 9.5 cm. cuff were provided.)
2. The manometer was at eye level with the physician.
3. The meniscus of the mercury instruments was checked weekly for
zero-level calibration.
4. While measuring, the rate of falling pressure was maintained 2-3
mm. Hg per heartbeat, which was slow enough to detect the first
and last sounds but sufficiently rapid to avoid intermittent
trapping of blood between systolic and diastolic levels.
5. For diastolic pressure, the level was recorded at the point
of complete cessation of Korotkoff's sounds or, if there was
no cessation, the point of muffling.
6. Measurements were recorded to the nearest 2 mm. on the scale.
Cuff Width
Cuff width was not edited for consistency with measured arm girth for
anthropometric data.
Tape Positions 420-779
Tape Positions 420, 456, 457, 464, 465, 470, 471, 488, 489, 502, 507,
512, 519, 546, 554, 573, 593, 620, 688, 699, 731, 737,
744, 779
"Blank" in these findings/ no findings fields represents participants for
whom demographic data exist but for whom there is no examination data;
these participants have a "1" in position 407.
"Blank but applicable" ("8") indicates a survey partially completed. This
field and the range of tape positions subordinate to this field were not
completed on the form; "8" is imputed in this field and the subordinate
positions are left blank.
Ear Drum
If the auditory canal was indicated as "completely occluded", a "not
visible" finding was imputed for the ear drum.
Thyroid Evaluation
The World Health Organization (WHO) criteria used for grading goiter are:
Group 0: Persons without goiter. By definition, these are persons whose
thyroid glands are less than 4 to 5 times enlarged.
Group 1: Persons with palpable goiters. The thyroid is considered to be
more than 4 to 5 times enlarged although not visible with head in
normal position. Most of these will be readily visible with the
head thrown back and the neck fully extended.
Group 2: Persons with visible goiters. Persons with goiters which are
easily visible with the head in normal position, but which
are smaller than those in Group 3. Palpation may be helpful
in determining the mass of the gland, but is not needed for
diagnosis.
Group 3: Persons with very large goitrs. The goiters of persons in this
category can be recognized at a considerable distance. They are
grossly disfigured and may be of such size as to cause mechanical
difficulties with respiration and the wearing of clothes.
(Perez, C., Scrimshaw, N.S., and Munoz, J.A., Technique of endemic
goitre surveys. In endemic Goitre; p. 369, see esp. p. 376, World
Health Organization Monograph Series No. 44, Geneva, 1960.)
Wheezing on auscultation
No attempt was made to correlate on auscultation and decreased breath
sounds with entries in section H.6, ascultation.
Chest Evaluation
If breath sounds were "absent", the description of the breath sounds
were left blank.
Heart Murmurs
No attempt was made to correlate the location of murmur with a type of
murmur or origin of murmur.
Pulse - Palpation
The form did not provide a place to record "absent palpation" in this
section. Where "absent pulse" was recorded in the next question, "normal",
"tortuous", or "blank" in this field were changed to a new code, "5", to
indicate absent palpation.
The form does not provide any place to record missing limbs. Some
observations on extremities may be missing because sample persons were
amputees. Although we know that there are amputees in the sample
population, the number is unknown.
Area(s) of Mass(es) -- Positions 606-610
If masses were present, the number(s) of the location(s), using the
numbers on the body diagram, were recorded. The number used was the
one which located the center of the mass.
Area(s) of Surgical Scar(s) -- Positions 613-617
If scars were present the number(s) of the location(s), using the
numbers on the body diagram, were recorded. The number used was the
one which located the center of the scar.
Time - AM/PM
If this section was left blank, but a corresponding time was entered,
a AM/PM value is imputed if appropriate. The rule followed is: between
12:00 and 07:00 - "PM" is imputed; between 09:00 and 11:59 - "AM" is
imputed; other ranges are ambiguous, and a value of "8", blank but
applicable, is entered.
ICDA Codes
Physicians were instructed to record their findings of abnormal conditions
on the examination form and to code these using the first 3 digits of the
Eighth Revision of the International Classification of Diseases, Adapted
for Use in the United States. Identified conditions were coded at the
end of medical examination forms. Since the examination emphasized the
cardiovascular, respiratory and musculoskeletal systems, codes relating
to these systems are expected to be more frequent.
APPENDIX B - PHYSICIAN'S EXAMINATION PROCEDURES
General
HANES is designed to gather data for statistical analysis. Rather than
have a general clinical examination performed in the manner most familiar
to the examining physician, we have a physical examination structured
to gather data on physical conditions pertinent to nutrition and certain
chronic diseases. This section of the manual, which describes the method
of performing the examination and specifies the method of recording
findings, should be followed explicitly.
Other chapters of the manual (Responsibilities of Examination Staff
Members, and Emergency Medical Procedures) describe the other obligations
and duties of the examining physician.
Format for the Examination
Certain procedures are to be deleted on the basis of age and are
indicated on the examination form.
Sitting
Blood pressure and pulse
HEENT
Hair, skin, skull, glands
Ears
Nose
Eyes
Mouth
Neck
Nodes and trachea
Chest (including heart)
Inspect
Auscult
Reclining
Heart
Inspect
Palpate
Auscult
Abdomen
Inspect
Percuss
Palpate
Arteries
Musculoskeletal
Knee
Hip
Straight leg raising
Sitting
Extremities
Lower
Upper
Neurological
DTR's
Chvostek
Standing
Inguinal Hernia
Musculoskeletal
Back
Knees
Skin
General appearance and behavior
Supine and Sitting
Blood pressure
Examination Procedure
1. Blood pressure and pulse: While the examinee is sitting, check his
blood pressure and pulse in the right extremity. (Count the pulse
for at least 30 seconds.)
2. HEENT examination: Perform a routine HEENT. Make a special note
of characterizing the hair, checking the skin for seborrhea, the
skull for bossing, and looking for parotid enlargement. Inspect the
external ear and, with an otoscope, examine the auditory canal and
tympanic membrane. Check each nostril for patency with inspiration
during alternate unilateral occlusion and examine each nostril
with an otoscope. Check the eyes (lids, conjunctiva, cornea)
and mouth (lips, tongue, buccal mucosa) for findings linked with
malnutrition and other pathology.
3. Neck examination: Observe the neck at rest for thyroid visibility
during swallowing of small aliquots of water. Repeat with the neck
extended to judge thyroid size and contour. Palpate the neck for
thyroid contour & tenderness, lymph nodes, & tracheal deviation.
4. Chest examination: Inspect the chest paying particular attention
to the skin of the upper back and to the costochondral junctions
for signs attributable to malnutrition. Auscult the chest with
care to cover representative areas for all lung segments.
5. Cardiovascular examination: While the examinee is sitting, & then
when he is supine, palpate & auscult the heart. Check especially
for cyanosis and venous distention. Check the peripheral pulses--
note the character of the artery as well as the quality of the
pulsation.
6. Abdominal examination: Inspect the abdomen for evidence of past
surgery and for stigmata of malnutrition. During quiet respiration
in the supine position, percuss the liver. Use palpation and fist
percussion to elicit CVA tenderness. With the examinee's knees and
hips flexed to relax the abdominal musculature, palpate the abdomen.
While he is standing erect, palpate for hernia.
7. Musculoskeletal examination: Examine the knees and hips for
deformities and signs of inflammation, check for tenderness & for
pain with active and passive motion, and perform the straight leg
raising test. With the examinee seated check the legs for calf
tenderness and check the extremities for evidence of arthritis and
epiphyseal swelling. Also at this time check the extremities for
pretibial edema, hyperpigmentation and pellagrous dermatitis,
follicular hyperkeratosis, xerosis, mosaic skin, petechiae, and
ecchymoses. With the examinee standing check the cervical,
thoracic, and lumbar spine for deformities, limited range of
motion, and pain with motion by having the examinee flex, extend,
laterally bend, & rotate the spine. Check for sciatic notch and
sacro-iliac tenderness. With the examinee bending forward (as
in touching toes) check for exacerbation or relief of scoliosis
(including rotary component). While the examinee is standing, again
check the knees for deformities (and the legs for varicosities).
8. Neurological examination: While the examinee is seated test for knee
jerks, ankle jerks, and facial spasm (Chvostek sign).
9. Dermatological examination: Check the skin regionally during
the other parts of the examination as described previously--see
"Folder I" on the trailer for illustrations of findings linked
with malnutrition.
10. General appearance and behavior: Take special note of the general
appearance and behavior of the examinee which might reflect organic
or functional disorders (e.g., endocrine imbalance, chromosomal
disorders, psychosis) which would confound evaluation of
nutritional status or reflect malnutrition.
11. Blood pressure: At the close of the physician's examination,
the blood pressure should be taken while examinee is both in the
supine and sitting positions.
Recording of Findings
The examination forms contain spaces for structured responses, open
ended responses, & summaries of diagnostic impressions. Since the structured
responses will be used for computer analysis, certain criteria for and/or
definitions of these responses will be given below to ensure comparability
of data collected by numerous physicians. The open ended responses are
for recording both common and rare findings (which have not been put into
structured form because of rarity or secondary importance to the goals
of the survey) so that a more complete medical record will be available
if information beyond the structured responses is needed in the future.
The summary and diagnostic impressions allows a reviewer to quickly
synthesize the physician's findings on a given examinee and to ascertain
the physician's subjective as well as objective evaluations.
Unless otherwise noted in the instructions, positive responses should
be recorded with checks in the appropriate boxes. A correction should be
made by circling the response to be negated and checking the correct box.
Either the "Findings" or "No findings" box should be checked when they
occur. If there are no findings for any section of the examination, check
the "No findings" box; if there are findings check the "Findings" box
as well as the individual boxes for whatever findings there are.
The letters "R" or "Rt.," "L" or "Lt.," and "B" mean right, left,
and both, respectively.
At the end of the chart are forms for reporting findings to physicians.
Record there any significant medical findings which need to be reported to
a physician or check the box to indicate that there are no significant
new medical findings to be reported.
Criteria and Definitions
1. Pulse and blood pressure:
Record the pulse as the number of radical pulsations per minute
and the systolic and diastolic blood pressure in even digits to
the nearest 2 mm. pressure.
2. HEENT
a. Dry staring hair: Dry, wirelike, unkempt, stiff, and often
brittle hair which sometimes may exhibit some bleaching of the
normal color.
b. Dyspigmented hair: Definite change from normal pigment of the
hair, most usually evident & best seen by carefully combing
hair strands upward & viewing the orderly array of hair in good
light. Dyspigmentation includes both change of pigment (usually
lightening of color) & depigmentation--not to be confused
with dyed or tinted hair. Dyspigmentation is always bandlike
in character and is usually associated with some change in
texture of hair in the dyspigmented band. In some ethnic groups,
particularly Negroid groups, the pigment may be slightly
reddish in color. In others, especially among straight
black-haired peoples, the bandlike depigmentation ("flag sign")
is common. Dyspigmentation is only rarely observed in adults.
c. Easily pluckable hair: A condition in which the shafts of
hair are readily removed with a minimal tug when a few strands
are grasped between the finger and thumb and gently pulled.
In such cases there is no reaction from the child, indicating
a lack of pain associated with removal of the hair.
d. Abnormal texture or loss of curl: Changes in texture of the hair
to a soft, silk-like hair. Loss of curl is self-explanatory.
e. Circumcorneal injection (bilateral): Increase in vascularity by
new ingrowth of capillary loops, with particular concentration
around the cornea in the absence of obvious causes other than
nutrition.
f. Conjunctival injection (bilateral): Generalized increase in the
vascularity of the bulbar conjunctivae in the absence of obvious
infection.
g. Angular blepharitis: A fissure located in the lateral palpebral
angle of the eyelids which presents as a crack in the epidermis
similar to the cracks found at the angles of the mouth in
angular stomatitis.
h. Pupils and Iris: Irregularity of pupil contour.
i. Xerosis (conjunctivae): The conjunctivae, upon exposure when
holding the examinee's lids open and having the examinee
rotate his eyes, appear dull, lusterless, and exhibit a
striated or roughened surface.
j. Lesions of cornea (other): Use oblique moving illumination
with small flashlight to look for opacities, surface debris,
deposits in the anterior chamber and cataract.
k. Bitot's spots: Small circumscribed, grayish or yellowish-gray,
dull, dry, foamy, superficial lesions of the conjunctivae. Seen
most often at the lateral aspect of the bulbar conjunctivae of
children. Usually bilateral. Not to be confused with pterygium.
l. Keratomalacia: Corneal softening with deformity, either
localized (usually central part of lower half of cornea)
or total.
m. Xerophthalmia: Xerophthalmia is recorded when the bulbar
conjunctiva and cornea are dry and lusterless with a decrease
in lacrimination. It is rarely associated with evidence of
infection but in extreme cases is associated with
keratomalacia.
n. Lids and Sclera: Lid edema, lid infection, and ptosis.
o. Angular lesions of lips: Record only if definitely present
bilaterally when the examinee's mouth is held half open. May
appear as pink or moist, whitish, macerated, angular lesions
which blur the mucocutaneous junction. Angular lesions are
recorded only when there is definite break in continuity of
epithelium at the angles of the mouth.
p. Angular scars of lips: Scars at the angles which, if recent,
may be pink; if old, may appear blanched.
q. Cheilosis: Different from ordinary chapping. The lips are
swollen or puffy and appear as if the buccal mucosa extends out
onto the lip. There may be desquamation. This category may be
used to include vertical fissuring of the lips. If associated
with herpes labialis, note under "Other findings."
r. Filiform papillary atrophy of tongue: The filiform papillae
are exceedingly low or absent, giving the tongue a smooth
or "slick" appearance which remains after scraping slightly
with an applicator stick.
s. Fungiform papillary hypertrophy of tongue: The fungiform
papillae can be seen and felt when a tongue blade is drawn
lightly over the anterior two-thirds of the tongue.
t. Geographic tongue: Irregularly outlined and distributed areas
of atrophy with irregular white patches resembling leukoplakia.
u. Fissures of tongue: Linear lesions or cracks with a definite
break in the continuity of the epithelium.
v. Serrations or swelling of tongue: Tooth impressions at sides
of tip, often noted when tongue is swollen.
w. Scarlet, beefy tongue: Entire tongue is red, angry in
appearance, with or without denudation or fissures. Not just
a modification of the natural color due to the loss of
papillae. Associated almost always with subjective symptoms
of hypersensitivity, burning, and even taste changes.
x. Magenta tongue: A tongue the color of alkaline phenolphthalein.
y. Nasolabial seborrhea: A definite greasy, yellowish scaling or
filiform excrescences in the nasolabial area which become more
pronounced on slight scratching with the fingernail or a tongue
blade.
z. Visible enlarged parotids: Due to difficulties in assessing
parotid enlargement, record as positive the presence of
bilateral enlargement only if clearly visible.
aa. Bossing of skull: Record abnormal prominence or protrusion of
frontal or parietal areas.
3. Thyroid evaluation
The World Health Organization (WHO) criteria used for grading
goiter are:
Grade 0: Persons without goiter. By definition these are persons
whose thyroid glands are less than 4 to 5 times enlarged.
Grade 1: Persons with palpable goiters. The thyroid is
considered to be more than 4 to 5 times enlarged although not
visible with head in normal position. Most of these will be readily
visible with the head thrown back and the neck fully extended.
Grade 2: Persons with visible goiters. Persons with goiters which
are easily visible with the head in normal position, but which
are smaller than those in Grade 3. Palpation may be helpful in
determining the mass of the gland, but is not needed for diagnosis.
Grade 3: Persons with very large goiters. The goiters of persons
in this category can be recognized at a considerable distance.
They are grossly disfigured and may be of such size as to cause
mechanical difficulties with respiration and the wearing of
clothes. (Perez, C., Scrimshaw, N.S., and Munoz, J.A., Technique of
endemic goitre surveys. In endemic Goitre; p. 369, see esp. p. 376,
World Health Organization Monograph Series No. 44, Geneva, 1960.)
Other thyroid findings: Record any tenderness, nodularity,
enlargement of the isthmus, or other abnormal thyroid findings
not included in grading thyroid size.
4. Chest evaluation:
a. Beading of ribs: A definitely palpable & visible enlargement
of the costochondral junctions.
b. Follicular hyperkeratosis of upper back: This lesion has been
likened to "gooseflesh" which is seen on chilling, but is not
generalized and does not disappear with brisk rubbing of skin.
Readily felt, it presents a "nutmeg grater" feel. Follicular
Follicular hyperkeratosis is more easily detected by the sense of
touch than by the eye. The skin is rough, with papillae formed
by keratotic plugs which project from the hair follicles. The
surrounding skin is dry and lacks the usual amount of moisture
or oiliness. Differentiation from adolescent folliculosis can
usually be made by recognition of the normal skin between the
follicles in the adolescent disorder. Follicular hypereratosis
is distinguished from perifolliculosis by the ring of
capillary congestion which occurs about each follicle in
scorbutic perifolliculosis.
c. Wheezing on auscultation: Record any wheezing, inspiratory or
expiratory, as focal or diffuse.
d. Decreased breath sounds: Record if there is diffusely decreased
breath sounds. (Focal or discrete areas of decreased breath
sounds should be recorded under "Other findings.")
e. Breast Masses: Palpate in both upright and supine positions.
If a mass is found, characterize with regard to location,
size, contour, consistency, tenderness and mobility.
5. Cardiovascular evaluation:
a. Cyanosis: Record definite cyanosis which is thought to
be related to generalized hemoglobin desaturation. (Focal
phenomena, e.g., one extremity cyanotic should be recorded
under "Other findings.")
b. Irregular pulse: Record any irregularities of pulse except
physiological variations.
c. Cardiac murmur: Record all murmurs. Grade, location,
radiation, and any other pertinent description should be
given as well as an opinion as to the origin of the murmur.
6. Abdominal evaluation:
a. Hepatomegaly: Record livers palpable 2 centimeters or more
below the right costal margin.
b. Splenomegaly: Record all palpable spleens.
c. Uterine enlargement: Record all enlarged uteri including those
enlarged secondary to pregnancy.
d. Umbilical hernia: Record all umbilical hernias.
If a hyrocele is present write it in under "Summary of
Diagnostic Imressions" with its ICDA code.
e. Inguinal and femoral hernias: Record all hernias and note
next to boxes if bilateral.
f. Potbelly: Record if abdomen appears abnormally distended and
enlarged with due recognition of the usual contour of the young
child.
g. Masses: If masses are present, check box 287. Record the
number(s) of the location(s) (see diagram for number of
locations) of the mass(es) to the right of 288. Use the number
which locates the center of the mass. Check box 289 and write
in a description of the masses, identify each by its number
location, e.g., (7) 3 cm. diameter firm, fixed, nontender.
h. Scars: If scars are present, check box 290. Record the number(s)
of the location(s) of the scar(s) to the right of 291. Use the
number which locates the center of the scar. Check box 292 and
write in a description of the scars, identifying each by its
number location, e.g., (7) 3 cm well-healed appendectomy scar.
7. Musculoskeletal evaluation:
a. Bowed legs (genu varum): Bilateral concave deformities of the
thighs and tibiae should be recorded, even if mild.
b. Knock knees (genu valgum): Bilateral convex deformities of the
knees and tibiae should be noted only if marked.
c. Epiphysial enlargement of wrist: This can be more easily
felt than seen and should be recorded, particularly if
present at the ulnar epiphysis.
d. Ortolani's maneuver: With the infant lying supine, the
examiner straightens and adducts the legs. The examiner's
thumb rests along the inside & the other fingers extend along
the outside of the infant's thigh. The hips and thighs are
flexed to 90* and one leg is then abducted with the examiner's
fingers gently pressing the trochanter of the femur upward and
forward. The normal hip in a relaxed infant can be abducted to
almost 90*. If dislocation is present, resistance may be felt
between 45* and 60* and a click felt as the dislocated femoral
head slips into the acetabulum.
8. Neurological evaluation
a. Absent knee jerks: Record bilaterally absent knee
jerks--unilateral absence should be described under "Other
findings."
b. Absent ankle jerks: Record bilaterally absent ankle
jerks--unilateral absence should be described under "Other
findings."
c. Positive Chvostek sign: When in tapping the malar process of
the temporal bone on both sides of the face with a percussion
hammer, a twitching of the perioral muscles of the same side is
elicited, this is a positive Chvostek sign. A positive sign
indicates hyperirritability of the neuromuscular system
as found in spasmophilia (tetany) due to calcium deficiency.
d. Apathy: This should be noted and recorded if it is marked,
particularly in young children. It has importance in
relation to protein-calorie deficiency (PCD).
e. Marked hyperirritability: This refers to behavior (not to
reflexes) and should be recorded only if marked.
9. Skin evaluation
a. Follicular hyperkeratosis, arms: See 4b.
b. Hyperpigmentation, hands and face: Asymptomatic with no
inflammatory component. It is seen most frequently on the
dorsum of the hands and lower forearms, particularly when skin
hygiene is poor. The skin is rough, dry & often has a grayish,
cyanotic base. There is not the sharp line of demarcation
at the border of the lesion such as one sees in pellagra.
c. Dry or scaling skin (xerosis): Xerosis is a clinical term used
to describe a dry & crinkled skin which is made more obvious by
pushing the skin parallel to the surface. In more pronounced
cases it is often mottled & pigmented & may appear as scaly or
alligator-like pseudoplaques, usually not greater than 5 mm in
diameter. The nutritional significance of it is not established.
Differential diagnosis must be made between this condition and
changes due to dirt, exposure, and ichthyosis.
d. Perifolliculosis: Congestion around the follicles which does
not blanch upon pressure. (See discussion of follicular
hyperkeratosis above.) There is an early ring of capillary
engorgement around some hair follicles which does not disappear
on pressure. It is more frequently encountered on the dependent
parts such as the legs. Swelling and hypertrophy of the
follicles may occur, at which time the skin becomes rough.
Follicular hyperkeratosis and perifolliculosis may coexist.
e. Petechiae: Record petechiae which you as a physician judge to
be due to abnormalities of the examinee. Do not record normal
responses to minor trauma as positives. Qualify by describing
distribution and severity, e.g., minimal pigmented purpuric
eruption on the legs. If deemed contributory, a tourniquet
test may be performed on the upper extremity with the blood
pressure cuff adjusted between systolic & diastolic pressures
for 5 minutes, and the results described.
f. Mosaic skin: This is usually found on the lower legs and
constitutes a dry, atrophic alteration of the skin with a
mosaic-like pattern and a certain luster of the surface. It
is associated with conditions where the superficial layers
of the skin are subject to stretching (increased tension) due
to underlying edema, e.g., in protein deficiency.
g. Pellagrous dermatitis: Areas of dry dermatitis-like lesions
on the dorsal surface of hands, cheeks, forehead, and if exposed
on the neck (Casals necklace).
h. Ecchymoses: Record ecchymoses which you as a physician judge
to be due to abnormalities of the examinee. Do not record
normal minor responses to known minor trauma.
10. Examiner's subjective impression of nutritional status:
This will be the examining physician's subjective appraisal of
the state of nutrition of the examinee. Indicate whether or not
you judge the examinee to have "normal nutrition" or "abnormal
nutrition." Obesity is considered to be "abnormal nutrition."
11. External ear:
Record if the ears are pierced. Check "Operative scar" only for
mastoid operation scars. Check and write under "other"
additional findings which are significant cosmetically and/or
which might impair hearing.
12. Auditory canal:
Check "Completely occluded" if there is not sufficient tympanic
membrane visible to characterize the membrane under "Drum" (below),
and check as "Partially occluded" all other cases in which
there is obstruction of or protrusion into the auditory canal.
For all positive responses check the cause of the obstruction;
write cause under "Other" for causes other than cerumen.
13. Drum:
Check "Not visible" only if "Completely occluded" is checked above.
Check as many structured responses as apply in the description of
the membrane, e.g., dull, bulging, and fluid may be checked under
R ear. However, do not check two responses for one code number.
If the membrane is perforated, check either "With discharge" or
"Without discharge." Check "Other" and write in a description
if the structured responses need to be supplemented.
14. Nares:
Check "Acute" or "Chronic" if the naris is obstructed (use physical
appearance plus history to judge if obstruction is acute or
chronic). Check as many responses under "Other significant findings"
as are necessary to describe the nares.
Nasal Polyps--These are soft, smooth, pale, movable tumors usually
multiple.
15. Neck:
Check "Adenopathy," "Tracheal deviation," or "Other (describe)" to
describe significant clinical findings (except thyroid) in the neck.
16. Chest:
In the structured response chart check the columns corresponding
to the observed abnormalities at the levels of the lobes over which
the findings are observed. (If needed, see diagrams present
in the MEC for normal distribution of pulmonary segments and
lobes.) Other auscultatory findings, and findings on inspection,
percussion, or palpation should be checked and written in under
"Other chest findings."
17. Heart:
a. PMI: Check whether the PMI is "Felt" or "Not felt." If felt,
check the number of the closest interspace and check the
relationship to the mid-clavicular line.
b. Thrills: Check whether a thrill is "Absent" or "Present."
If present, check systolic and/or diastolic to time
the thrill, and check either base or apex to locate the
maximum intensity of a given thrill. For multiple thrills,
record only the most intense one.
c. Heart sounds: Check the structured response which best
describes the first heart sound and the one which best
describes the second heart sound.
d. Murmurs: Check "None" if no murmurs are heard. If a murmur or
murmurs are heard, place checks under the appropriate
period--systolic and/or diastolic--to indicate the timing when
categorizing by type and location of the murmur(s) or the
component(s) of murmur(s) within each period--systolic and
diastolic. When typing systolic murmurs, check "Organic" if any
systolic murmur or systolic component of a murmur is thought
secondary to a cardiovascular lesion; and check "Functional" if
no systolic murmur or systolic component of a murmur is thought
secondary to a cardiovascular lesion. Check "Don't know" only if
a reasonable clinical judgment cannot be made. Follow the same
guidelines for typing diastolic murmurs. Note that "Functional,"
"Organic," and "Don't know" are to be considered mutually
exclusive responses within each period (systole, diastole). In
locating and grading a murmur, record the grade of the murmur by
checking the grade as judged at its point of maximum intensity
in the appropriate period column to the right of the structured
location response which best approximates the location of its
point of maximum intensity. Unless there are both systolic and
diastolic components to a murmur, check only one grade-location
response for each murmur; for multiple murmurs make multiple
responses. However, there should be only one response at a given
location within a given period.) To locate the origin of each
murmur or component thought secondary to a cardiovascular lesion
("Organic" will have been checked), check in the appropriate
period column (systolic, diastolic, or both) to the right
of the location of the cardiovascular lesion thought to be the
origin of the murmur; e.g., for pulmonic stenosis check to the
right of 254 in the box numbered 1. Make multiple responses
for multiple murmurs of "Organic" origin. Check "Other"
if the location of other than 251-256 and check "Don't know"
if the murmur is thought to be organic but a reasonable
clinical judgment of the origin cannot be made.
e. Other cardiac and cardiovascular findings: If there are
significant cardiac or cardiovascular findings for which there
are no other appropriate responses in either the heart or
arterial evaluation sections, check "Yes" and then check the
structured or open ended (under "Other") response which applies.
Check "No" if this space is not needed to describe cardiac
or cardiovascular findings.
18. Arterial evaluation:
Check the structured response ("Normal," "Sclerotic," "Tortuous,"
or "Sclerotic and Tortuous") which best characterizes each artery
listed, and check the structured response ("Normal," "Bounding,"
"Diminished," or "Absent") which best characterizes each pulse
listed. If the dorsalis pedis pulse is absent and the posterior
tibial pulse is present, check "Absent" for dorsalis pedis and
write in "posterior tibial" after "Other" and check its character.
If the dorsalis pedis and posterior tubial pulses are both absent,
check "Absent" for dorsalis pedis and write in "popliteal"
after "Other" and check the character of the popliteal pulse.
19. Joints:
To record findings in joints, locate the box for the finding to be
recorded (i.e., tender, swelling, deformity, limitation, Heberden's
nodes, pain on motion, other) & the joint involved. Within
the box check right, left, or both to indicate the location of
involvement for shoulder, elbow, wrist, ankle, feet, knees, & hips
and check the total number of digits involved on each side for
the MP and DIP joints. Check the total number of digits involved on
the right and on the left for each finding (note this is the total
number of digits involved and not the digit involved).
a. Back: Check the described deformities if observed; check the
location of any tenderness or limitation of motion. If there is
pain with motion, check the location at the right of the motion
which elicits the pain--"diffuse" should be checked if all three
locations (cervical, thoracic, low back) are involved, but do not
check thoracic or low back in these instances. "Uncertain"
should be checked if pain occurs but the site cannot be
specified. The severity of pain in flexion and extension of
the neck is graded 0-none, 1-doubtful, 2-minimal, 3-moderate,
and 4-maximum. If there is limitation of motion on flexion of
the lumbar spine, check box M4c(368) and describe as
limitation of flexion, lumbar spine.
b. Straight leg raising: For the SLR test, check negative
or positive for both the right and the left. Also, for
"Increase with dorsiflexion," check either "Yes" or "No" for
both the right and left.
20. Other systems:
Record here system findings which cannot be noted in other
parts of the form, eg., Reticuloendothelial--marked inguinal and
axillary adenopathy plus cervical adenopathy, pallor, and petechiae
previously noted. But if only petechiae & cervical adenopathy were
observed, they would have previously been recorded and need
not be recorded here.
21. Blood pressure:
Record the systolic and the diastolic blood pressures to the nearest
even digit for both the recumbent and the sitting positions and note
the time to the nearest minute of the determination.
22. Summary of diagnostic impressions
On the last page of the physical examination recording form under the
heading "Summary of Diagnostic Impressions" findings should be
summarized. Diagnostic impressions may be on the basis of physical
exam, history, X-ray, laboratory findings, etc. Certainly not all
findings should be listed,but those deemed significant in relation to
disease or certain condition states should be listed. However, in
order to facilitate data processing all entries under other categories
should be listed and given ICD codes. It is preferable to summarize
findings by condition such as "osteoarthritis" rather than by
listing symptoms or signs. After completing the examination,
indicate whether the examinee is "normal" or "abnormal."
If abnormal, summarize findings according to the directions
briefly outlined above. Cardiovascular (including venous disease),
musculoskeletal, and respiratory findings should be listed in
their appropriate sections with other findings below.
Following each such listing, indicate the seeming severity of each,
checking whether it appears to be either minimal, moderate,or severe.
This will be strictly subjective and based on your own appraisal.
Should there arise some difficulty in deciding between two of the
possible classifications, the lesser of the two should be selected.
Then indicate the certainty of the diagnosis using a scale
ranging from 0 to 9 according to the following criteria:
0-not at all certain
2-little bit certain
4-somewhat certain
6-fairly certain
8-very certain
9-extremely certain
The range is continuous and any number representing a degree of
certainty between two of the listed scale numbers may be selected.
When selected, the number should be written in the appropriate space.
Each condition should finally be coded according to Eighth Revision
International Classification of Diseases, Adapted for Use in the
United States, which has been modified for use in HANES. A complete
listing of these HANES modified codes are kept in each caravan.
Since the vast majority of examinees with findings will have one
or more of a small number of common conditions, the more probable
conditions with the appropriate code numbers are listed below:
Modified ICDA Codes for Use in HANES
I. Infective and Parasitic Disease (000-136)
011.X Pulmonary Tuberculosis
044.X Polio, Late Effects of
111.0 Tinea Versicolor
II. Neoplasms (140-239)
See specific Neoplasms as classified
214.X Lipoma
227.0 Hemangioma of Skin
III. Endocrine, Nutritional and Metabolic Diseases (240-279)
240.X Simple Goiter
241.X Nontoxic Nodular Goiter
242.X Hyperthyroidosis (Hyperthyroidism) with or
without Goiter
243.X Cretinism
244.X Hypothyroidism (acquired)
250.X Diabetes Mellitus
274.X Gout
277.X Obesity not specified as of Endocrine Origin
IV. Diseases of Blood and Blood Forming Organs (280-289)
280.X Iron Deficiency Anemias
282.X Hereditary Hemolytic Anemias including Sickle
Cell Disease
287.X Purpura and other Hemorrhagic Conditions
V. Mental Disorders (290-315)
295.X Schizophrenia
296.X Affective Psychoses
300.X Neuroses
303.X Alcoholism
309.X Mental Disorders not specified as Psychotic; associated
with Physical Conditions; includes Brain Syndrome
309.2 Due to Brain Trauma
309.3 Due to Circulatory Disturbance
309.6 Due to Senile or Presenile Brain Disease
VI. Diseases of the Nervous System and Sense Organs (320-389)
324.X Meningitis or Encephaslitis, late effects of
342.X Paralysis Agitans (Parkinson's Syndrome)
343.X Cerebral Spastic Infantile Paralysis
344.X Other Cerebral Paralysis
344.1 Hemiplegia
345.X Epilepsy
346.X Migraine
350.X Facial Paralysis
353.X Neuralgia or Neuritis of Sciatic Nerve
360.X Conjunctivitis and Conjunctival Infection
367.X Retinitis
373.X Strabismus
374.X Cataract
375.X Glaucoma
377.0 Vascular Lesions of Retina
377.1 Degeneration of Retina
379.X Blindness
380.X Otitis External
381.X Otitis Media without Mastoiditis
382.X Otitis Media with Mastoiditis
VII. Diseases of Circulatory System (390-458)
394.X Disease of Mitral Valve
395.X Disease of Aortic Valve
401.X Essential Benign Hypertension
402.X Hypertensive Heart Disease
403.X Hypertensive Renal Disease
412.X Chronic Ischemic Heart Disease
413.X Angina Pectoris
427.0 Congestive Heart Failure
427.3 Heart Block
427.4 Atrial Fibrillation or Flutter
427.9 Other and Unspecified Disorders of Heart Rhythm
(Other than PAT, AT, VF, Heart Block)
429.0 Cardiac Enlargement and Hypertrophy
436.X Stroke
440.X Arteriosclerosis
443.0 Raynaud's Syndrome
443.9 Intermittent Claudication, PVD, not otherwise
specified
451.X Phlebitis and Thrombophlebitis
454.0 Varicose Veins, with Ulcer
454.1 Varicose Veins, with Stasis Dermatitis without Ulcer
454.9 Varicose Veins other, without Ulcer
VIII. Disease of Respiratory System (460-519)
460.X Cold
461.X Acute Sinusitis
462.X Acute Pharyngitis
463.X Acute Tonsillitis
464.X Acute Laryngitis and Tracheitis
465.X URI of unspecified or multiple site
466.X Acute Bronchitis
491.X Chronic Bronchitis
492.X Emphysema
493.X Asthma
500.X Hypertrophy of Tonsils and Adenoids
504.X Deviated Nasal Septum
505.X Nasal Polyp
507.X Hay Fever
507.1b Allergic Rhinitis
IX. Disease of Digestive System (520-577)
529.1 Geographic Tongue
533.X Peptic Ulcer, site unspecified
550.X Inguinal Hernia not obstructed
551.0 Femoral Hernia not obstructed
551.1 Umbilical Hernia not obstructed
551.3 Diaphragmatic Hernia, not obstructed
564.1 Irritable Colon
571.X Cirrhosis of Liver
573.0 Hepatitis, not otherwise specified
574.1 Cholelithiasis with Cholecystitis or Cholangitis
(chronic)
574.9 Cholelithiasis without Cholecystitis or Cholangitis
575.X Cholecystitis, without mention of Calculus
X. Diseases of the Genitourinary System (580-629)
590.0 Chronic Pyelonephritis
XI. Complications of Pregnancy, Childbirth and the Puerperium
(630-678)
XII. Diseases of the Skin and Subcutaneous Tissue (680-709)
680.X Boil and Carbuncle
684.X Impetigo
690.X Seborrheic Dermatitis
691.X Atopic Dermatitis, Infantile Eczema, Neurodermatitis
692.X Contact Dermatitis
695.2 Erythema Nodusum
696.X Psoriasis
706.1 Acne Vulgaris
708.9 Hives
709.9 Intertrigo, Vitiligo
XIII. Diseases of the Musculoskeletal System and Connective Tissue
(710-738)
712.X Rheumatoid Arthritis
713.0 Osteoarthritis
714.0 Traumatic Arthritis
715.X Arthritis, unspecified
717.9 Fibrositis, Myalgia, Myositis
718.X Rheumatism, unspecified
725.0 Displaced Cervical Intervertebral Disc
725.1 Displaced Lumbar & Lumbosacral Intervertebral Disc
728.0 Pain in Neck
728.7 Low Back Pain
730.X Bunion
731.X Synovitis or Bursitis
735.0 Scoliosis
735.1 Kephosis
736.X Flat Foot
XIV. Congenital Anomalies (740-759)
752.1 Undescended Testicle
756.4 Pectus Excavatum
757.4 Congenital Clubnail
Miscellaneous
780.3 Abnormal Involuntary Movements (Atheosis, Tremor)
780.4 Disturbance of Coordination (Ataxia, Muscular
Incoordination)
989.X Insect Bites
b This is an artificial code not included in the ICDA codes.
