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Scientific Data Documentation
Tuberculin Test Results (1971-75)DSN: CC37.HANES1.TB ABSTRACT GENERAL INFORMATION HEALTH AND NUTRITION EXAMINATION SURVEY, 1971-1975 Contents HANES 1971-1975 Description of Survey Target Population Data Collection Use of HANES Data Errors in the Data Sets and Survey Differences Variance Estimation General Notes Demographic Data Demographic Data Summary Record Layout Demographic Data Detailed Notes Demographic Data DESCRIPTION OF SURVEY Description of Survey: A detailed description of the design, content and operation of HANES I is provided in the following reports: Plan and Operation of the Health and Nutrition Examination Survey, DHEW Pub. No. (HSM) 73-1310, Series 1, Nos. 10a and 10b, Public Health Service, Washington, D. C., U. S. Government Printing Office, February 1973. Also provided is a draft report on the augmentation survey of adults describing the relevant field work conducted between July 1974 and October 1975. TARGET POPULATION Target Population: HANES I was conducted on a nationwide probability sample of approximately 32,000 persons, ages 1-74 years, from the civilian, noninstitutionalized population of the coterminous United States, excepting those persons residing on Indian reservations. The survey started in April 1971 and for many survey components was completed in June 1974. The HANES I sample was selected so that certain population groups thought to be at high risk of malnutrition (persons with low incomes, preschool children, women of childbearing age and the elderly) were oversampled at known rates. Adjusted sampling weights were then computed within 60 age, sex and race categories in order to inflate the sample in such a manner as to closely reflect the noninstitutionalized population, ages 1-74 years, of the United States at the midpoint of the survey. Although the main emphasis of HANES I was on nutrition, a subset of those sample persons aged 25-74 received a more detailed health examination which was continued through October 1975. No particular oversampling of subgroups of the population was done in this subsample (e.g., women of childbearing age were not oversampled as they were for the major nutrition component of HANES I). This subsample is also representative of the United States population aged 25-74 during the time of HANES I. After the nutrition survey was completed, the detailed examination given to the 25-74 age group was continued until the total number of examined persons was approximately double the number of examinees who received the detailed examination during the nutrition survey. DATA COLLECTION Data Collection: Information for all examined sample persons in HANES I was obtained by means of a household interview, a general medical history, a 24-hour dietary intake recall interview, a food frequency interview, a food program questionnaire, a general medical examination, dental, dermatological and ophthalmological examinations, anthropometric measurement, hand-wrist x-rays (of those ages 1-17 only) and 24 hematological, blood chemistry, and urological laboratory determinations. In addition to the information received on all examined persons by means of the above questionnaires, procedures and measurements, the following data were gathered on the subsample of adults aged 25-74: a medical history supplement; supplementary questionnaires concerning arthritis, respiratory and cardiovascular conditions (when applicable); a health care needs question- naire; a general well-being questionnaire; an extended medical examination; x-rays of the chest and hip and knee joints; audiometry, electrocardiography; goniometry; spirometry; pulmonary diffusion and tuberculin tests; along with additional laboratory determinations. USE OF HANES DATA With the goal of mutual benefit, NCHS requests the cooperation of recipients of data tapes in certain actions related to their use: A. Any published material derived from the data should acknowledge the National Center for Health Statistics as the original source. It should also include a disclaimer which credits any analyses, interpretations, or conclusions reached to the author (recipient of the tape) and not to NCHS, which is responsible only for the initial data. B. Consumers who wish to publish a technical description of the data will make a reasonable effort to insure that the description is not inconsistent with that published by NCHS. This does not mean, however that NCHS will review such descriptions. ERRORS IN THE DATA SETS AND SURVEY DIFFERENCES The data users' tapes have been subjected to a great deal of careful editing. However, due to the large volume of data in the series, it is likely that a small number of errors or discrepancies remain undetected. We would appre- ciate if any such errors are detected that they be brought to our attention so that new corrected copies of the tape can be created and errata sheets issued to previous purchasers. Some of the continuous data items have extremely high or low values and we have verified that they do in fact appear that way on the hard documents; that is, we have verified that the values have not been incorrectly keyed. In general, we have not attempted to resolve any differences that may exist between estimates derived from the various subsamples of HANES I. Nor have we made any comparisons between estimates from HANES I and previous surveys conducted by the Division of Health Examination Statistics. VARIANCE ESTIMATION Because the Health and Nutrition Examination Survey is based upon a complex sample design, the assumptions of many statistical tests and routinely avail- able statistical programs are not met. For this reason, when estimates of the variances of statistics from HANES are computed, the technique of estimation must be based upon complex sampling theory. In order to provide the user with the capability of estimating the complex sample variances, we have provided Strata and Primary Sampling Unit (PSU) codes on the HANES user tapes in tape positions 194-198. However, these codes are suitable for making variance estimates only for examination locations 1-65 and 1-100. To compute variance estimates for examination locations 1-35 or 66-100, it is necessary to recode the current Strata-PSU codes according to the specifications that follow. The resultant recoded Strata-PSU codes should be used only for locations 1-35 and 66-100. One computer program that should be widely available sometime around the summer of 1978 as part of the Statistical Analysis System (available from the SAS Institute, Inc., Post Office Box 10066, Raleigh, North Carolina 27605) is capable of using the Strata-PSU codes provided for HANES to compute complex sample variances. Other programs may also be available. In those Strata, referred to as certainty or self-representing Strata, the PSU codes are actually the segment numbers. Neither the Strata codes nor the PSU codes are the original codes used in the formation of the HANES sample design, but are nonetheless a unique Recoding of the original codes. For further discussion of the sample design of HANES, the user should consult the publications of the National Center for Health Statistics--Series-Nos. 10a and 14 and the detailed note for tape positions 158-193. Recode Specifications for Strata-PSU Codes First.--Create a files with only those records in the file for examination locations 1-35.* Second.--Retain 1he original Strata-PSU codes in Strata 7-10 and 13 in the original form as the recoded Strata-PSU codes. Third.--Recode the remaining strata according tot he chart below. Fourth.--Repeat the process for examination locations 66-100.* Old Strata # (tape positions 194-195) New Strata # New PSU 01 01 001 02 01 002 03 03 001 06 03 002 04 04 001 05 04 002 11 11 001 12 11 002 14 14 001 21 14 002 15 15 001 16 15 002 17 17 001 20 17 002 18 18 001 19 18 002 22 22 001 25 22 002 23 23 001 24 23 002 26 26 001 27 26 002 28 28 001 29 28 002 30 30 001 35 30 002 31 31 001 32 31 002 33 33 001 34 33 002 *See detailed note for tape positions 158-193. GENERAL NOTES, DEMOGRAPHIC DATA, HANES I Demographic Information: 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 sample area. 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 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. Asterisks on the Tape Description: Some of the data items were obtained only for a particular subsample of HANES. Consequently some of these items appear to have a great deal of missing data (coded as blank) due to nonresponse, but in fact the data are missing because the design of HANES dictated that the item was to be obtained only for a particular subsample. (For further discussion of the various subsamples in HANES the user should see the detailed note for tape positions 158-193.) To alert the user to this fact asterisks were put on the tape des- cription. One asterisk denotes that the data item was obtained only on examinees at locations 1-65, two asterisks denote that it was ob- tained only at location 66-100 and three asterisks denote that it was obtained only on examinees receiving the detailed examination. DEMOGRAPHIC DATA SUMMARY - HANES I Tape Positions Sample sequence number ............................................. 1 Size of place ...................................................... 10 SMSA-not SMSA ...................................................... 11 Type of living quarters............................................. 12 Land usage ......................................................... 13 If rural, asked - How many acres of land are included .............. 14 If 10 acres/more asked - Sale of crops/etc. amount to $50 or more .. 15 If 10 acres/less asked - Sale of crops/etc. amount to $250 or more . 16 Age - head of household ............................................ 17 Sex - head of household ............................................ 19 Highest grade attended - head of household ......................... 20 Race - head of household ........................................... 22 Total number of persons in household ............................... 23 Total sample persons in household .................................. 25 Number of rooms in house ........................................... 27 Is there piped water ............................................... 28 If yes, is there hot and cold piped water .......................... 29 If yes to piped water - Does house have a sink with piped water .... 30 Does house have a range or cook stove .............................. 31 Does house have a refrigerator ..................................... 32 Are kitchen facilities used by anyone not living in household ...... 33 Total family income group .......................................... 34 NOTE: The following income questions were asked only if "Total Family Income" was less than $7,000 Tape Positions During Past Year Did you or Any Members of Your Family Receive Money From: Wages or salaries .................................................. 36 If yes - How much altogether before deductions ..................... 37 Social Security or Railroad Retirement ............................. 41 If yes - How much altogether ....................................... 42 Welfare payments or other public assistance ........................ 46 If yes - How much altogether ....................................... 47 Unemployment or Workman's Compensation ............................. 51 If yes - How much altogether ....................................... 52 Government employee pensions or private pensions ................... 56 If yes - How much altogether ....................................... 57 Dividends, interest or rent ........................................ 61 If yes - How much altogether ....................................... 62 Net income from own non-farm business, professional practice or partnership ...................................................... 66 If yes - How much altogether ....................................... 67 Net income from a farm ............................................. 71 If yes - How much altogether ....................................... 72 Veteran's payments ................................................. 76 If yes - How much altogether ....................................... 77 Alimony, child support or contributions from persons not living in household ........................................................ 81 If yes - How much altogether ....................................... 82 Any other income ................................................... 86 If yes - How much altogether ...................................... 87 Total amount....................................................... 91 Family unit code ................................................... 95 Relationship to head of household .................................. 100 Age at interview ................................................... 101 Race of examined person ............................................ 103 Sex of examined person ............................................. 104 Marital status ..................................................... 105 Date of birth (month and year) ..................................... 106 Place of birth ..................................................... 110 Highest grade of regular school ever attended ...................... 112 Did he finish the grade ............................................ 114 Is he attending school now ......................................... 115 Has he ever attended a school of any kind .......................... 116 If yes - What kind of school ....................................... 117 Any language other than English frequently spoken in the household.. 118 If yes - What language ............................................. 119 What is your main ancestry or national origin ...................... 120 What was he doing most of past three months ........................ 122 If "something else" - What was he doing ............................ 123 If "keeping house" or "something else" - Did he work at a job or business at any time during the past three months ................ 124 If "working" - Did he work full-time or part-time .................. 125 Did he work at any time last week or week before (not around house). 126 If no - Even though he did not work during that time, does he have a job or business ................................................ 127 Tape Positions Was he looking for work or on lay-off from a job ................... 128 If yes - Which ..................................................... 129 Class of worker .................................................... 130 If self-employed in "own" business and not a farm, is the business incorporated ..................................................... 131 Business or industry code .......................................... 132 Occupation code .................................................... 135 Date of examination ................................................ 138 Age at examination ................................................. 144 Farm/non-farm ...................................................... 146 Poverty index ...................................................... 147 Region ............................................................. 150 FOOD PROGRAMS APPLICABILITY ........................................ 151 Are you certified to participate in the food stamp program? ........ 152 Are you buying food stamps now? .................................... 153 What is the main reason you aren't participating in the program? ... 154 Are you certified to participate in commodity distribution program?. 155 Are you receiving commodity foods now for your family? ............. 156 Why aren't you participating in the program? ....................... 157 SAMPLE WEIGHTS ..................................................... 158 STRATA - Primary Sampling Unit (PSU) ............................... 194RECORD LAYOUT, DEMOGRAPHIC DATA HEALTH AND NUTRITION EXAMINATION SURVEY (HANES I) Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source DEMOGRAPHIC DATA 1-5 Sample Sequence Number 6-9 Catalog Number 10 Size of Place Urbanized area with: 1 - 3,000,000 or more Hshld Questionnaire 2 - 1,000,000 to 2,999,999 See Detailed Notes 3 - 250,000 to 999,999 4 - under 250,000 5 - Urban place 25,000 or more outside urbanized area 6 - Urban place 10,000 to 24,999 outside urbanized area 7 - Urban place 2,500 to 9,999 outside urbanized area 8 - Rural 11 SMSA - Not SMSA 1 - In SMSA, in central city Hsehld Questionnaire 2 - In SMSA, not in central city See Detailed Notes 3 - Not in SMSA 12 Type of Living Quarters 1 - Housing Unit Hsehld Questionnaire 2 - Other unit 13 Land Usage 1 - All other Hsehld Questionnaire 2 - Rural 7136 14 If Rural, asked How Many Acres of Land Are Included? Hsehld Questionnaire 1 - 10 or more acres 2 - Less than 10 acres 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 15 If 10 acres or more, asked if Sale of Crops, Etc. Amount to $50 or more? Hsehld Questionnaire 2 - Yes 4 - No 9 - Not applicable 16 If 10 acres or less, asked if Sale of Crops, Etc. Amount to $250 or more? Hsehld Questionnaire 3 - Yes 5 - No 9 - Not applicable 17-18 Age - Head of Hsehld 16-92 as given Hsehld Questionnaire 00 Blank, but applicable 19 Sex - Head of Hsehld Hsehld Questionnaire 1 - Male 2 - Female 20-21 Highest Grade Attended - Head of Hsehld 10 - None Hsehld Questionnaire 21 - 1st grade 22 - 2nd grade 23 - 3rd grade 24 - 4th grade 25 - 5th grade 26 - 6th grade 27 - 7th grade 28 - 8th grade 31 - 9th grade 32 - 10th grade 33 - 11th grade 34 - 12th grade 41 - First year of college 42 - Second year of college 43 - Third year of college 44 - Fourth year of college 45 - Graduate 88 - Blank, but applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 22 Race - Head of Household 1 - White Hsehld Questionnaire 2 - Negro See Detailed Notes 3 - Other 23-24 Total Number of Persons in Household 01-19 - As given Hsehld Questionnaire 25-26 Total Sample Persons in Household 01-07 - As given Hsehld Questionnaire 27 Number of Rooms in House 1-8 - As given Hsehld Questionnaire 9 - 9 or more 28 Is there piped water? 1 - Yes Hsehld Questionnaire 2 - No 29 If yes Is there Hot and Cold piped water? 1 - Yes Hsehld Questionnaire 2 - No 9 - Not applicable 30 If yes to piped water - Does House Have a Sink with Piped Water? 1 - Yes Hsehld Questionnaire 2 - No 9 - Not applicable 31 Does House Have a Range or Cook Stove? 1 - Yes Hsehld Questionnaire 2 - No Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 32 Does House have a Regrigerator? 1 - Yes Hsehld Questionnaire 2 - No 33 Are kitchen facilities used by anyone not living in household? 1 - Yes Hsehld Questionnaire 2 - No 9 - Not applicable 34-35 Total Family Income Group 11 - Under $1,000(including loss) Hsehld Questionnaire 12 - $1,000-1,999 See Detailed Notes 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 NOTE: The following income questions were asked only if "Total Family Income" was less than $7,000 DURING PAST YEAR DID YOU OR ANY MEMBERS OF YOUR FAMILY RECEIVE MONEY FROM: 36 Wages or Salaries? 1 - Yes Hsehld Questionnaire 2 - No 3 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 37-40 If yes to above, how much altogether before deductions? 0001-8000 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 41 Social Security or Railroad Retirement? 1 - Yes Hsehld Questionnaire 2 - No 3 - Blank, but applicable 9 - Not applicable 42-45 If yes to above, how much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 46 Welfare Payments or Other Public Assistance? 1 - Yes Hsehld Questionnaire 2 - No 3 - Blank, but applicable 9 - Not applicable 47-50 If yes to above, hyow much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 51 Unemployment or Workmen's Compensation? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 52-55 If yes to above, how much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 56 Government Employee Pensions or Private Pensions? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 57-60 If yes to above, how much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 61 Dividends, interest or rent? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 62-65 If yes to above, how much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 66 Net income from own non-farm business, professional practice or partnership? 1 - Yes Hsehld Questionnaire 2 - No 3 - Loss 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 67-70 If yes to above, how much altogether? 0000-7500 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 71 Net income from a farm? 1 - Yes Hsehld Questionnaire 2 - No 3 - Loss 8 - Blank, but applicable 9 - Not applicable 72-75 If yes to above, how much altogether? 0000-7500 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 76 Veteran's Payments? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 77-80 If yes to above, how much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 81 Alimony, child support or contributions from persons not living in Hsehld? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 82-85 If yes to above, how much altogether? 0001-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 86 Any other income? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 87-90 If yes to above, how much altogether? 0001-6900 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 91-94 Total Amount (Total of Positions 37-90) 0000-6999 - As given Hsehld Questionnaire 8888 - Blank, but applicable 9999 - Not applicable 95-99 FAMILY UNIT CODE Computer generated 00001-23180 See Detailed Notes 100 Relationship to Head of Household (Hsehld Questionnaire) 1 - Head (1 person living along or with non-relatives) 1920 2 - Head (2 or more related persons in family) 4912 3 - Wife 5256 4 - Child 7733 5 - Other relative 928 101-2 Age at Interview 01-74 - As given Hsehld Questionnaire Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 103 Race of Examined Person 1 - White Hsehld Questionnaire 2 - Negro See Detailed Notes 3 - Other 104 Sex of Examined Person 1 - Male Hsehld Questionnaire 2 - Female 105 Marital Status 1 - Under 17 Hsehld Questionnaire 2 - Married 3 - Widowed 4 - Never Married 5 - Divorced 6 - Separated 8 - Blank, but applicable 106-9 Date of Birth (month, year) 01-12 - Month as given Hsehld Questionnaire 00-99 - Year (1896-1973) as given 110-11 Place of Birth (As given) 01-02 Hsehld Questionnaire 04-06 See Detailed Notes 08-13 15-42 44-51 53-56 60-81 91-97 88 - Blank, but applicable 144 Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 112-13 Highest Grade of regular school ever attended? 10 - None Hsehld Questionnaire 21 - 1st grade 22 - 2nd grade 23 - 3rd grade 24 - 4th grade 25 - 5th grade 26 - 6th grade 27 - 7th grade 28 - 8th grade 31 - 9th grade 32 - 10th grade 33 - 11th grade 34 - 12th grade 41 - First year of college 42 - Second year of college 43 - Third year of college 44 - Fourth year of college 45 - Graduate 77 - Special school 88 - Blank, but applicable 99 - Not applicable 114 Did he finish the grade? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 115 Is he attending school now? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 116 Has he ever attended a school of any kind? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 117 If yes, what kind of school? 1 - Nursery Hsehld Questionnaire 2 - Kindergarten 3 - Other 4 - Headstart 5 - Daycare 8 - Blank, but applicable 9 - Not applicable 118 Is any language other than English frequently spoken in the household? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 119 If yes, what language? 0 - German Hsehld Questionnaire 1 - Italian 2 - French 3 - Polish 4 - Russian 5 - Spanish 6 - Chinese 7 - Other language 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 120-21 What is your main ancestry or national origin? 00 - German Hsehld Questionnaire 01 - Irish 02 - Italian 03 - French 04 - Polish 05 - Russian 06 - English 07 - Spanish 08 - Mexican 09 - Chinese 10 - Japanese 11 - American Indian 12 - Negro 13 - Jewish 14 - American 15 - Other 88 - Blank, but applicable 99 - Don't know 122 What was he doing most of past three months? 1 - Working Hsehld Questionnaire 2 - Keeping house 3 - Something else 8 - Blank, but applicable 9 - Not applicable 123 If "something else" from above, what was he doing? 0 - Laid off Hsehld Questionnaire 1 - Retired 2 - Student 3 - Other 4 - Ill 5 - Staying home 6 - Looking for work 7 - Unable to work 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 124 If "keeping house" or "something else" from above, did he work at a job or business at any time during the past three months? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 125 If "Working" from above, did he work full-time or part-time? 1 - Full-time Hsehld Questionnaire 2 - Part-time 8 - Blank, but applicable 9 - Not applicable 126 Did he work at any time last week or the week before (not around house)? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 127 If "no" to above, even though he did not work during that time, does he have a job or business? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 128 If "no" in Position 126, was he looking for work or on lay-off from a job? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 129 If yes to above - which? 1 - Looking Hsehld Questionnaire 2 - Lay-off 3 - Both 8 - Blank, but applicable 9 - Not applicable 130 Class of Worker 1 - Private paid Hsehld Questionnaire 2 - Government-Federal 3 - Government-Other 4 - Own 5 - Non-paid 6 - Never worked 8 - Blank, but applicable 9 - Not applicable 131 If self-employed in "own" business and not a farm, is the business incorporated? 1 - Yes Hsehld Questionnaire 2 - No 8 - Blank, but applicable 9 - Not applicable 132-34 Business or Industry Code 017-999 - As given Hsehld Questionnaire 135-37 Occupation Code 001-995 - As given Hsehld Questionnaire 138-43 Date of Examination Month - 01-12 as given Control Record Day - 01-31 as given Year - 71-75 as given Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 144-45 Age at Examination 01-75 - As given Computer Generated 146 Farm 1 - Farm Computer Generated 2 - Nonfarm See Detailed Notes 147-49 Poverty Index (X.XX) 001-997 - As given Computer Generated 998 - Index computed 998 See Detailed Notes or greater 999 - Unknown 150 Region 1 - Northeast Computer Generated 2 - Midwest See Detailed Notes 3 - South 4 - West 151 FOOD PROGRAMS APPLICABILITY 1 - Not applicable Food Programs Quest. 2 - No program available 3 - Food stamps available 4 - Commodities available 8 - Blank, but applicable 152 Are you certified to participate in the food stamp program? 1 - Yes Food Programs Quest. 2 - No 9 - Don't know Blank Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source 153 Are you buying stamps now? 1 - Yes, regularly Food Programs Quest. 2 - Yes, occasionally 3 - No 8 - Blank, but applicable Blank 154 What is the main reason you aren't participating in the program? 1 - No need Food Programs Quest. 2 - Not enough money at the time 3 - No transportation 4 - Pride 5 - Other 8 - Blank, but applicable Blank 155 Are you certified to participate in the commodity distribution program? 1 - Yes Food Programs Quest. 2 - No 9 - Don't know Blank 156 Are you receiving commodity foods now for your family? 1 - Yes, regularly Food Programs Quest. 2 - Yes, occasionally 3 - No 8 - Blank, but applicable Blank 157 Why aren't you participating in the program? 1 - No need Food Porgrams Quest. 2 - No transportation 3 - Pride 4 - Other 8 - Blank, but applicable Blank Tape Control HANES I Data Loc. ITEM DESCRIPTION & CODES Counts Source SAMPLE WEIGHTS 158-63 Detailed Persons, Location 01-35 See Detailed Notes Blanks 164-69 All Sample Persons, Locations 01-35 See Detailed Notes Blanks 170-75 Detailed Persons, Locations 01-65 See Detailed Notes Blanks 176-81 All Sample Persons, Locations 01-65 See Detailed Notes Blanks 182- Work Area 193 194- STRATA 1/ 195 196- Primary Sampling Unit1/ 198 199- Work Area 200 1/Use only for producing variance estimates for examination locations 1-65 or 1-100. See General Note titled "Variance Estimation" for producing variance estimates for examination locations 1-35 or 66-100. DETAILED NOTES, DEMOGRAPHIC DATA Tape Position 10 - Size of Place Size of place classification was derived from the 1960 census. According to the definition used in the 1960 census, the urban population was comprised of all persons living in (a) places of 2,500 inhabitants or more incorporated as cities, boroughs, villages and towns (except towns in New York, New England, and Wisconsin); (b) the densely settled urban fringe, whether incorporated or unincorporated, or urbanized areas; (c) towns in New England and townships in New Jersey and Pennsylvania which contained no incorporated municipalities as subdivisions and had either 2,500 inhabitants or more, or a population of 2,500 to 25,000 and a density of 1,500 persons or more per square mile; (d) counties in states other than the New England states, New Jersey, and Pennsylvania, that had no incorporated municipalities within their boundaries and had a density of 1,500 persons per square mile; and (e) unincorporated places of 2,500 inhabitants or more not included in any urban fringe. 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. Tape Position 11 - SMSA 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 1960 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. Tape Positions 22 and 103 - Race The race of the respondent was marked by observation and it was assumed the race of all related persons was the same as the respondent unless otherwise learned. The race categories were "White", "Negro", or "other." If the appropriate category could not be marked by observation, then race was asked. Persons of races other than White or Negro, such as Japanese, Chinese, American Indian, Korean, Hindu, Eskimo, etc. were reported as "Other." Mexicans were included with "White" unless definitely known to be American Indian or of other nonwhite race. Tape Positions 34-35 - Total Family Income Group The income group represents the total combined family income for the past twelve (12) months. It includes income from all sources such as wages, salaries, social security or retirement benefits, help from relatives, rent from property and so forth. The income groups were not reconciled to the component parts (tape positions 36-94). The income component parts were not asked when the gross income was greater than $6,999 per annum. However, amounts greater than $6,999 appear in tape positions 37-40, 67-70, and 72-75. Some respondents reported a loss of income from their nonfarm business, professional practice, partnership or farm and this explains why some data fields are greater than $6,999, but the individual total in tape positions 91-94 does not exceed this figure. Tape Positions 95-99 - Family Unit Code All related sample persons in the same family unit have the same computer generated family unit code. This will enable detailed analysis of the individual family unit. Tape Positions 110-111 - State Codes UNITED STATES OUTLYING AREAS OF THE U.S. Standard Abbreviation Code Name of Place Cod ALABAMA Ala. 01 American Samoa 60 ALASKA Alaska 02 Canal Zone 61 ARIZONA Ariz. 04 Canton and Enderbury Islands 62 ARKANSAS Ark. 05 Caroline Islands 63 CALIFORNIA Calif. 06 Cook Islands 64 COLORADO Colo. 08 Gilbert and Ellice Islands 65 CONNECTICUT Conn. 09 Guam 66 DELAWARE Del. 10 Johnston Atoll 67 DIST. OF COLUMBIA D.C. 11 Line Islands - Southern 68 FLORIDA Fla. 12 Mariana Islands 69 GEORGIA Ga. 13 Marchall Islands 70 HAWAII Hawaii 15 Midway Islands 71 IDAHO Idaho 16 Puerto Rico 72 ILLINOIS Ill. 17 Ryukyn Islands - Southern 73 INDIANA Ind. 18 Swan Islands 74 IOWA Iowa 19 Tokelau Islands 75 KANSAS Kans. 20 U.S. Misc. Caribbean 76 KENTUCKY Ky. 21 U.S. Misc. Pacific Islands 77 LOUISIANA La. 22 Virgin Islands 78 MAINE Maine 23 Wake Islands 79 MARYLAND Md. 24 Cuba 80 MASSACHUSETTS Mass. 25 West Indies 81 MICHIGAN Mich. 26 North America 91 MINNESOTA Minn. 27 South America 92 MISSISSIPPI Miss. 28 Europe 93 MISSOURI Mo. 29 Africa 94 MONTANA Mont. 30 Asia 95 NEBRASKA Nebr. 31 Australasia 96 NEVADA Nev. 32 Pacific Islands 97 NEW HAMPSHIRE Nebr. 33 NEW JERSEY N.J. 34 NEW MEXICO N. Mex. 35 NEW YORK N.Y 36 NORTH CAROLINA N.C. 37 NORTH DAKOTA N. Dak. 38 OHIO Ohio 39 OKLAHOMA Okla. 40 OREGON Oreg. 41 PENNSYLVANIA Pa. 42 RHODE ISLANDS R.I. 44 SOUTH CAROLINA S.C. 45 SOUTH DAKOTA S. Dak. 46 UNITED STATES Standard Abbreviation Code TENNESSEE Tenn. 47 TEXAS Tex. 48 UTAH Utah 49 VERMONT Vt. 50 VIRGINIA Va. 51 WASHINGTON Wash. 53 WEST VIRGINIA W. Va. 54 WISCONSIN Wis. 55 WYOMING Wyo. 56 Tape Positions 132-134 and 135-137 - Industry & 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 spen 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 Occupations 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. Tape Position 146 - Land Land used for farming purposes (Code 1 in Tape Position 146) was identified as being rural land (Code 2 in Tape Position 13) consisting of 10 or more acres (Code 1 in Tape Position 14) with crop sales amounting to $50 or more (Code 2 in Tape Position 15), or rural land (Code 2 in Tape Position 13) consisting of less than 10 acres (Code 2 in Tape Position 14) with crop sales amounting to $250 or more (Code 3 in Tape Position 16). All Other land is classified as nonfarm (Code 2 in Tape Position 146). Tape Positions 147-149 - Poverty Index Poverty Index--Income status was determined by the Poverty Income Ratio (PIR). Poverty statistics published in the Census Bureau reports1/ were based on the poverty index developed by the Social Security Administration in 1964. (For a detailed discussion of the SSA poverty standards, see reference 2.) Modifications in the definition of poverty were adopted in 1969.3/ The standard data series in poverty for statistical use by all executive departments and establishments has been established.4/ The two components of the PIR are the total income of the household (numerator) 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 table, 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 twic 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 local variation in the cost of living (except for the farm, nonfarm difference). None of the noncash public welfare benefits such as food stamp bonuses or free food commodities are included in the income of the low income families receiving these benefits. 1/ Current Populatrion Reports, "Consumer Income," Series P-60, No. 77, May 7, 1971 2/ 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. 3/ Current Population Reports, "Special Studies," Series P-23, No. 28, August 12, 1969 4/ Circular No. A-46, Transmitted Memorandum No. 9, Executive Office of the President, Bureau of the Budget, August 29, 1969, and Exhibit L (rev.) Weighted average thresholds at the low income level in 1971 by size of family and sex of head, by farm-nonfarm residence Nonfarm Farm Size of family Total Total Male1 Female1 Total Male1 Female1 head head head head All unrelated individuals- $2,033 $2,040 $2,136 $1,978 $1,727 $1,783 $1,669 Under 65 years--------- 2,093 3,098 2,181 2,017 1,805 1,853 1,715 65 years and over------ 1,931 1,940 1,959 1,934 1,652 1,666 1,643 All families-------------- 3,700 3,724 3,764 3,428 3,235 3,242 3,079 2 persons-------------- 2,612 2,633 2,641 2,581 2,219 2,224 2,130 Head under 65 years---- 2,699 2,716 2,731 2,635 2,317 2,322 2,195 Head 65 years and over- 2,424 2,448 2,450 2,437 2,082 2,081 2,089 3 persons-------------- 3,207 3,229 3,248 3,127 2,745 2,749 2,627 4 persons-------------- 4,113 4,137 4,139 4,116 3,527 3,528 3,513 5 persons-------------- 4,845 4,880 4,884 4,837 4,159 4,159 4,148 6 persons-------------- 5,441 5,489 5,492 5,460 4,688 4,689 4,656 7 persons or more------ 6,678 6,751 6,771 6,583 5,736 5,749 5,516 1For unrelated individuals, sex of the individual. SOURCE: U.S. Department of Commerce, Social and Economic Statistics Administration, U.S. Bureau of the Census "Characteristics of the Low Income Population: 1971," Current Population Reports, Series P-60, No. 86, p. 18. Tape Position 150 - Region The United States was divided into four broad geographic regions of approximately equal population. These regions, which deviate somewhat from the groups used by the Bureau of the 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, and Wyoming. Tape Positions 158-193 - HANES HANES is a multistage, stratified, probability sample of loose clusters of persons in land-based segments. In addition, HANES is composed of two distinct examination components--a nutrition screening examination (taken by all examinees) and a more detailed examination taken by a pre-selected subsample of all examinees, ages 25-74. For the nutrition screening examination, locations 1-35 and 1-65 constituted national probability samples and for the detailed examination, locations 1-35, 1-65, 66-100 and 1-100 all constitute national probability samples. In other words, HANES is composed of six distinct subsamples of the U.S. population. For a more detailed discussion of the sample design see Series 1, No. 10a. Since each of these six subsamples is a distinct subsample of the U.S. population, such subsample requires a different set of weights. The weights are based upon the probability of selection into the sample, adjustments for nonresponse and further adjustments to approximate the U.S. noninstitu- tionalized population as of the midpoint of each subsample. In order to select all of those examinees in a particular subsample, i.e. received a particular exam component, it is necessary to exclude all examinees with a weight of zero or blank. It is also necessary to exclude all zero or blank weights because that is the only way to differentiate missing data due to nonresponse from data that is missing because the sample design dictated that a particular examinee was not supposed to receive particular examination component. It is suggested that any analyses that are desired by the researcher be per- formed using the greatest number of examinees possible; that is, if the researcher is interested in an exam component of the nutrition screening examination he should use the weight and consequently the data from the 65 location subsample rather than the 35 location subsample. For the detailed examination, the researcher should use the 100 location subsample rather than one of the others. However, some exam components were only done in a particular subsample; for example, only at the first 35 locations. In that case, the researcher has no choice in selecting a particular subsample. There may be occasions when a researcher may want to make comparisons of estimates obtained from various subsamples. For example, the prevalence of some disease condition as estimated from the first 35 locations could be compared with an estimate based upon locations 66-100. The researcher may also want to formulate hypotheses using 1 subsample and test those hypotheses using another subsample. TB DATA SUMMARY - HANES I CHEST X-RAY, PULMONARY DIFFUSION, AND TUBERCULIN TEST RESULTS SUMMARY Tape Positions Catalog number - 4251 .................................................. 201 Planimetry Left lung surface area ................................................. 205 Right lung surface area ................................................ 210 Thoracic diameter - PA ................................................. 215 Thoracic diameter - lateral 1 .......................................... 219 Thoracic diameter - lateral 2 .......................................... 223 Tracheal diameter - T2 ................................................. 227 Tracheal diameter - T3 ................................................. 230 Lateral area........................................................... 233 Heartsize A1-A2 .................................................................. 238 B1-B2 .................................................................. 242 C1-C2 .................................................................. 246 D1-D2 .................................................................. 250 E1-E2 .................................................................. 254 Pathology First Readings Cardiopulmonary findings ............................................... 258 Kyphosis ............................................................... 259 Scoliosis .............................................................. 260 Pectus ................................................................. 261 Rib fractures .......................................................... 262 Location of rib fractures .............................................. 263 Minimum rib number right ............................................... 264 Maximum rib number right ............................................... 266 Minimum rib number left ................................................ 268 Maximum rib number left ................................................ 270 Healing status ......................................................... 272 Nipple shadows ......................................................... 273 Other extrapulmonary nodules ........................................... 274 Tape Positions Intrapulmonary nodules ................................................. 275 Size of largest ........................................................ 276 Location of largest (stands 66-100) .................................... 279 Specific lobe (stands 66-100) .......................................... 280 Relative location of largest (stands 1-65) ............................. 282 Size of second largest ................................................. 283 Location of second largest (stands 66-100) ............................. 286 Specific lobe (stands 66-100) .......................................... 287 Relative location of second largest (stands 1-65) ...................... 289 Number of nodules ...................................................... 290 Number of segments containing nodules .................................. 291 Are segments containing nodules contiguous? ............................ 292 Etiology of nodules .................................................... 293 Localized segmental infiltrates (stands 66-100)......................... 294 Local of infiltrates: Specific lobe (stands 66-100).................... 295 Localized segmental infiltrates (stands 1-65) .......................... 297 Diffuse nonsegmental nonhomogeneous infiltrates (stands 66-100) ........ 298 Diffuse nonsegmental nonhomogeneous infiltrates (stands 1-65) .......... 299 Underlying condition ................................................... 300 Diffuse homogeneous symmetrical infiltrates ............................ 301 Presumed etiology ...................................................... 302 Proportion or fraction of PA X-ray which appears normal ................ 303 Other infiltrates ...................................................... 304 Emphysema .............................................................. 305 Blebs or bullae ........................................................ 306 Calcified nodes ........................................................ 307 Enlarged nodes ......................................................... 309 Pleural disease ........................................................ 310 Location of pleural disease ............................................ 311 Presumed cause of effusion ............................................. 312 Azygos vein ............................................................ 313 Locus of pulmonary artery enlargement .................................. 314 Enlargement of right heart ............................................. 316 Cephalization of pulmonary vessels ..................................... 317 Interstitial fluid ..................................................... 318 Kerley lines........................................................... 319 Rosettes ............................................................... 320 Alveolar fluid ......................................................... 321 Enlargement of left heart .............................................. 322 Tape Positions Pathology Second Readings Cardiopulmonary findings ............................................... 323 Kyphosis ............................................................... 324 Scoliosis .............................................................. 325 Pectus ................................................................. 326 Rib fractures .......................................................... 327 Location of rib fractures .............................................. 328 Minimum rib number right ............................................... 329 Maximum rib number right ............................................... 331 Minimum rib number left ................................................ 333 Maximum rib number left ................................................ 335 Healing status ......................................................... 337 Nipple shadows ......................................................... 338 Other extrapulmonary nodules ........................................... 339 Intrapulmonary nodules ................................................. 340 Size of largest ........................................................ 341 Location of largest .................................................... 344 Specific lobe .......................................................... 345 Size of second largest ................................................. 348 Location of second largest ............................................. 351 Specific lobe .......................................................... 352 Number of nodules ...................................................... 355 Number of segments containing nodules .................................. 356 Are segments containing nodules contiguous? ............................ 357 Etiology of nodules .................................................... 358 Localized segmental infiltrates ........................................ 359 Local of infiltrates: Specific lobe ................................... 360 Diffuse nonsegmental nonhomogeneous infiltrates ........................ 363 Underlying condition ................................................... 365 Diffuse homogenous symmetrical infiltrates ............................. 366 Presumed etiology ...................................................... 367 Proportion or fraction of PA X-ray which appears abnormal .............. 368 Other infiltrates ...................................................... 369 Emphysema .............................................................. 370 Blebs or bullae ........................................................ 371 Calcified nodes ........................................................ 372 Enlarged nodes ......................................................... 374 Pleural disease ........................................................ 375 Location of pleural disease ............................................ 376 Presumed cause of effusion ............................................. 377 Azygos vein enlarged ................................................... 378 Locus of pulmonary artery enlargement .................................. 379 Enlargement of right heart ............................................. 381 Tape Positions Cephalization of pulmonary vessels ..................................... 382 Interstitial fluid ..................................................... 383 Kerley lines........................................................... 384 Rosettes ............................................................... 385 Alveolar fluid ......................................................... 386 Enlargement of left heart .............................................. 387 Pathology Final Readings Cardiopulmonary findings ............................................... 388 Kyphosis ............................................................... 389 Scoliosis .............................................................. 390 Pectus ................................................................. 391 Rib fractures .......................................................... 392 Location of rib fractures .............................................. 393 Minimum rib number right ............................................... 394 Maximum rib number right ............................................... 396 Minimum rib number left ................................................ 398 Maximum rib number left ................................................ 400 Healing status ......................................................... 402 Nipple shadows ......................................................... 403 Other extrapulmonary nodules ........................................... 404 Intrapulmonary nodules ................................................. 405 Size of largest ........................................................ 406 Location of largest (stands 66-100) .................................... 409 Specific lobe (stands 66-100) .......................................... 410 Relative location of largest (stands 1-65) ............................. 412 Size of second largest ................................................. 413 Location of second largest (stands 66-100) ............................. 416 Specific lobe (stands 66-100) .......................................... 417 Relative location of second largest (stands 1-65) ...................... 419 Number of nodules ...................................................... 420 Number of segments containing nodules .................................. 421 Are segments containing nodules contiguous? ............................ 422 Etiology of nodules .................................................... 423 Localized segmental infiltrates (stands 66-100)......................... 424 Local of infiltrates: Specific lobe (stands 66-100).................... 425 Localized segmental infiltrates (stands 1-65) .......................... 427 Diffuse nonsegmental nonhomogeneous infiltrates (stands 66-100) ........ 428 Diffuse nonsegmental nonhomogeneous infiltrates (stands 1-65) .......... 429 Underlying condition ................................................... 430 Diffuse homogenous symmetrical infiltrates ............................. 431 Presumed etiology ...................................................... 432 Proportion or fraction of PA X-ray which appears abnormal............... 433 Other infiltrates ...................................................... 434 Tape Positions Emphysema .............................................................. 435 Blebs or bullae ........................................................ 436 Calcified nodes ........................................................ 437 Enlarged nodes ......................................................... 439 Pleural disease ........................................................ 440 Location of pleural disease ............................................ 441 Presumed cause of effusion ............................................. 442 Azygos vein enlarged ................................................... 443 Locus of pulmonary artery enlargement .................................. 444 Enlargement of right heart ............................................. 446 Cephalization of pulmonary vessels ..................................... 447 Interstitial fluid ..................................................... 448 Kerley lines........................................................... 449 Rosettes ............................................................... 450 Alveolar fluid ......................................................... 451 Enlargement of left heart .............................................. 452 Pulmonary Diffusion DLCO - First Trial ..................................................... 501 DLCO - Second Trial .................................................... 504 DLCO - Third Trial ..................................................... 507 Summary DLCO........................................................... 510 Tuberculin Test Site injected .......................................................... 551 PPD-S Induration (left arm) ............................................ 552 PPD-B Induration (right arm ) .......................................... 554 Where were results read? ............................................... 556 Days between test and reading .......................................... 557 Type of reader ......................................................... 558 Was test read? ......................................................... 559 PPD-S and PPD-B both present: difference in readings .................. 560 Induration reading classification: PPD-S and PPD-B .................... 563 RECORD LAYOUT, TB DATA Tape Locations 201-363 NATIONAL HEALTH AND NUTRITION EXAMINATION SURVEY (NHANES I - 1971-1975) CHEST X-RAY, PULMONARY DIFFUSION, AND TUBERCULIN TEST RESULTS DATA TAPE Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source CHEST X-RAY DATA 201- Catalog Number 204 4251 6913 PLANIMETRY (STANDS 1-100) 205- Left lung surface area (sq. cm) See Detailed Notes 209 (XXX.XX - decimal not shown on tape) 06191 - 34523 - AS given 6524 8888 - Blank, but applicable 389 210- Right lung surface area (sq. cm) See Detailed Notes 214 (XXX.XX - decimal not shown on tape) 09352 - 44832 - As given 6523 88888 - Blank, but applicable 390 215- Thoracic diameter - PA (cm) *See Detailed Notes 218 (XX.XX - decimal not shown on tape) 2001 - 3832 - AS given 3545 8888 - Blank, but applicable 309 Blank 3059 219- Thoracic diameter - lateral 1 (cm) *See Detailed Notes 222 (XX.XX - decimal not shown on tape) 1041 - 2805 - AS given 3596 8888 - Blank, but applicable 258 Blank 3059 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 223- Thoracic diameter - lateral 2 (cm) *See Detailed Notes 226 (XX.XX - decimal not shown on tape) 1014 - 2850 - AS given 3596 8888 - Blank, but applicable 258 Blank 3059 227- Tracheal diameter - T2 (cm) *See Detailed Notes 229 (X.XX - decimal not shown on tape) 087 - 314 - As given 3607 888 - Blank, but applicable 247 Blank 3059 230- Tracheal diameter - T3 (cm) *See Detailed Notes 232 (X.XX - decimal not shown on tape) 091 - 291 - As given 3605 888 - Blank, but applicable 249 Blank 3059 233- Lateral area (sq. cm) See Detailed Notes 237 (XXX.XX - decimal not shown on tape) 16324 - 70112 - As given 6493 88888 - Blank, but applicable 420 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source HEARTSIZE (STANDS 1-100) 238- A1-A2 (cm) See Detailed Notes 241 (XX.XX - decimal not shown on tape) 0800 - 2199 - As given 6503 8888 - Blank, but applicable 410 242- B1-B2 (cm) See Detailed Notes 245 (XX.XX - decimal not shown on tape) 1213 - 4026 - As given 6503 8888 - Blank, but applicable 410 246- C1-C2 (cm) See Detailed Notes 249 (XX.XX - decimal not shown on tape) 0926 - 2380 - As given 6493 8888 - Blank, but applicable 420 250- D1-D2 (cm) See Detailed Notes 253 (XX.XX - decimal not shown on tape) 0769 - 2040 - As given 6521 8888 - Blank, but applicable 392 254- E1-E2 (cm) See Detailed Notes 257 (XX.XX - decimal not shown on tape) 0615 - 1923 - As given 6504 8888 - Blank, but applicable 409 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source PATHOLOGY FIRST READINGS (STANDS 1-100) 258 Cardiopulmonary findings See Detailed Notes 1 - Findings 1851 8 - Blank, but applicable 383 9 - No findings 4679 Thorax 259 Kyphosis **See Detailed Notes 1 - Present 111 8 - Blank, but applicable 153 9 - No findings 2795 Blank 3854 260 Scoliosis 1 - Present 560 8 - Blank, but applicable 383 9 - No findings 5970 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 261 Pectus 1 - Carinatum 3 2 - Excavatum 145 8 - Blank, but applicable 383 9 - No findings 6382 262 Rib fractures 1 - Present 69 8 - Blank, but applicable 383 9 - No findings 6461 263 Location 1 - Right rib cage 34 2 - Left rib cage 30 3 - Both rib cages 5 8 - Blank, but applicable 383 9 - No findings 6461 264- Minimum rib number right 265 01-10 - As given 37 88 - Blank, but applicable 385 99 - No findings 6491 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 266- Minimum rib number right 267 02-10 - As given 37 88 - Blank, but applicable 385 99 - No findings 6491 268- Minimum rib number left 269 03-09 - As given 33 88 - Blank, but applicable 385 99 - No findings 6495 270- Maximum rib number left 271 03-11 - As given 33 88 - Blank, but applicable 385 99 - No findings 6495 272 Healing status 1 - Healed 59 8 - Blank, but applicable 383 9 - No findings 6471 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 273 Nipple shadows 1 - Present 38 8 - Blank, but applicable 383 9 - No findings 6492 Nodules 274 Other extrapulmonary nodules 1 - Present 137 8 - Blank, but applicable 383 9 - No findings 6393 275 Intrapulmonary nodules See Detailed Notes 1 - Present 388 8 - Blank, but applicable 383 9 - No findings 6142 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 276- Size of largest (mm) 278 001 - 080 - As given 385 888 - Blank but applicable 386 999 - No findings 6142 279 Location of largest **See Detailed Notes 1 - Right 163 2 - Left 155 8 - Blank, but applicable 155 9 - No findings 2586 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 280- Specific lobe **See Detailed Notes 281 Upper 01 - Apical 33 02 - Posterior 35 03 - Anterior 34 Middle 04 - Superior or lateral 26 05 - Inferior or medial 30 Lower 06 - Superior 53 07 - Medial 10 08 - Anterior 18 09 - Lateral 52 10 - Posterior 26 88 - Blank, but applicable 156 99 - No findings 2586 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 282 Relative location of largest **See Detailed Notes 1 - Right upper lobe 10 2 - Right middle lobe 5 3 - Right lower lobe 18 4 - Left upper lobe 13 5 - Left lower lobe 12 8 - Blank, but applicable 240 9 - No findings 3556 Blank 3059 283- Size of second largest (mm) 285 002-032 - As given 70 888 - Blank, but applicable 393 999 - No findings 6450 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 286 Location of second largest **See Detailed Notes 1 - Right 35 2 - Left 28 8 - Blank, but applicable 155 9 - No findings 2841 Blank 3854 287- Specific lobe **See Detailed Notes 288 Upper 01 - Apical 8 02 - Posterior 4 03 - Anterior 10 Middle 04 - Superior or lateral 6 05 - Inferior or medial 9 Lower 06 - Superior 5 07 - Medial 3 08 - Anterior 1 09 - Lateral 8 10 - Posterior 8 88 - Blank, but applicable 156 99 - No findings 2841 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 289 Relative location of second largest *See Detailed Notes 1 - Right upper lobe 3 2 - Right middle lobe 0 3 - Right lower lobe 2 4 - Left upper lobe 1 5 - Left lower lobe 0 8 - Blank, but applicable 239 9 - No findings 3609 Blank 3059 290 Number of nodules 1 - One 308 2 - Two or more 80 8 - Blank, but applicable 383 9 - No findings 6142 291 Number of segments containing nodules 1-6 - As given 320 7 - Greater than 6 4 8 - Blank, but applicable 447 9 - No findings 6142 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 292 Are segments containing See Detailed Notes nodules contiguous? 1 - Yes 9 8 - Blank, but applicable 425 9 - No findings 6479 293 Etiology of nodules 1 - Secondary to an infectious disease 286 2 - Not secondary to an infectious disease 18 3 - Combination of 1 and 2 9 8 - Blank, but applicable 458 9 - No findings 6142 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source Infiltrates 294 Localized segmental infiltrates **See Detailed Notes 1 - Right 11 2 - Left 6 8 - Blank, but applicable 153 9 - No findings 2889 Blank 3854 295- Location of infiltrates: **See Detailed Notes 296 Specific lobe Upper 01 - Apical 0 02 - Posterior 0 03 - Anterior 2 Middle 04 - Superior or lateral 4 05 - Inferior or medial 7 Lower 06 - Superior 0 07 - Medial 1 08 - Anterior 0 09 - Lateral 2 10 - Posterior 1 88 - Blank, but applicable 153 99 - No findings 2889 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 297 Localized segmental infiltrates *See Detailed Notes 1 - Right upper lobe 1 2 - Right middle lobe 10 3 - Right lower lobe 3 4 - Left upper lobe 2 5 - Left lower lobe 4 8 - Blank, but applicable 230 9 - No findings 3604 Blank 3059 298 Diffuse nonsegmental nonhomogenous **See Detailed Notes infiltrates 1 - Minimal 44 2 - Moderate 4 3 - Moderate with cavitation 11 4 - Far advanced 1 5 - Far advanced with cavitation 1 8 - Blank, but applicable 153 9 - No findings 2854 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 299 Diffuse nonsegmental nonhomogenous *See Detailed Notes infiltrates 1 - Minimal 69 2 - Moderate and Moderate with cavitation 17 3 - Far advanced and far advanced with cavitation 15 8 - Blank, but applicable 230 9 - No findings 3523 Blank 3059 300 Underlying condition 1 - Granulomatous 108 2 - Other diseases 36 8 - Blank, but applicable 401 9 - No findings 6368 301 Diffuse homogeneous symmetrical infiltrates 1 - Present 92 8 - Blank, but applicable 383 9 - No findings 6438 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 302 Presumed etiology 1 - Congestive heart failure 14 2 - Pneumoconiosis 2 3 - Sarcoidosis 0 4 - Other 75 8 - Blank, but applicable 384 9 - No findings 6438 303 Proportion of fraction or PA x-ray which appears abnormal 1- Less than 1/3 26 2 - 1/3 to 2/3 14 3 - Greater than 2/3 52 8 - Blank, but applicable 383 9 - No findings 6438 304 Other infiltrates 1 - Present 108 8 - Blank, but applicable 383 9 - No findings 6422 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 305 Emphysema a) Explicit presumptive diagnosis of emphysema 1 - Diaphragm flat on PA and lateral x-rays and presump- tive evidence of emphysema 155 2 - Diaphragm flat on PA x-ray and presumptive evidence of emphysema 6 3 - Diaphragm flat on lateral x-ray and presumptive evi- dence of emphysema 170 4 - Presumptive evidence of emphysema 31 b) Possible diagnosis of emphysema 5 - Diaphragm flat on PA and lateral x-rays 9 6 - Diaphragm flat on PA x-ray 3 7 - Diaphragm flat on lateral x-ray 96 8 - Blank, but applicable 383 9 - Findings 6060 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 306 Blebs or bullae 1 - Secondary to generalized emphysema 13 2 - Secondary to post-inflammatory scaring 6 3 - Secondary to both 1 and 2 5 4 - Independent of both 1 and 2 7 8 - Blank, but applicable 383 9 - No findings 6499 307- Calcified nodes See Detailed Notes 308 01 - Right hilar 39 02 - Left hilar 62 03 - Carinal 3 04 - Paratracheal 23 05 - Other 14 06 - Right hilar, left hilar, or Other 10 07 - Right hilar, paratracheal or Other 13 08 - Carinal and paratracheal 6 09 - Right hilar, left hilar, carinal or paratracheal 2 88 - Blank, but applicable 383 99 - No findings 6358 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 309 Enlarged nodes 1 - Right hilar 6 2 - Left hilar 4 3 - Carinal 0 4 - Paratracheal 0 5 - Other 1 6 - Right and left hilar 1 8 - Blank, but applicable 383 9 - No findings 6518 310 Pleural disease 1 - Present 290 8 - Blank, but applicable 383 9 - No findings 6240 311 Location 1 - Right 77 2 - Left 124 3 - Both 87 8 - Blank, but applicable 385 9 - No findings 6240 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 312 Presumed cause of effusion 1 - Fluid 6 2 - Tissue 280 3 - Both 3 8 - Blank, but applicable 384 9 - No findings 6240 Cardiovascular Enlargement of vessels 313 Azygos vein 1 - Yes 30 8 - Blank, but applicable 383 9 - No findings 6500 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 314- Locus of pulmonary artery 315 enlargement 01 - Right proximal 1 02 - Right distal 2 03 - Right proximal/distal 0 04 - Left proximal 2 05 - Left distal 0 06 - Left proximal/distal 0 07 - Both proximal 27 08 - Both distal 45 09 - Both proximal/distal 98 88 - Blank, but applicable 383 99 - No findings 6355 316 Enlargement of right heart 1 - Atrium enlarged 1 2 - Ventricle enlarged 53 3 - Both enlarged 5 8 - Blank, but applicable 383 9 - No findings 6471 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 317 Cephalization of pulmonary vessels 1 - Present 32 8 - Blank, but applicable 383 9 - No findings 6498 318 Interstitial fluid 1 - Present 6 8 - Blank, but applicable 383 9 - No findings 6524 319 Kerley lines 1 - A lines 0 2 - B lines 3 3 - A and B lines 5 8 - Blank, but applicable 383 9 - No findings 6522 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 320 Rosettes 1 - Present 0 8 - Blank, but applicable 383 9 - No findings 6530 321 Alveolar fluid 1 - Present 1 8 - Blank, but applicable 383 9 - No findings 6529 322 Enlargement of left heart 1 - Atrium enlarged 5 2 - Ventricle enlarged 119 3 - Both enlarged 14 8 - Blank, but applicable 383 9 - No findings 6392 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source PATHOLOGY SECOND READINGS (STANDS 66-100) 323 Cardiopulmonary findings See Detailed Notes 1 - Findings 1160 8 - Blank, but applicable 90 9 - No findings 1809 Blank 3854 Thorax 324 Kyphosis **See Detailed Notes 1 - Present 66 8 - Blank, but applicable 90 9 - No findings 2903 Blank 3854 325 Scoliosis 1 - Present 82 8 - Blank, but applicable 90 9 - No findings 2887 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 326 Pectus 1 - Carinatum 7 2 - Excavatum 85 8 - Blank, but applicable 90 9 - No findings 2877 Blank 3854 327 Rib fractures 1 - Present 57 8 - Blank, but applicable 90 9 - No findings 2912 Blank 3854 328 Location 1 - Right rib cage 22 2 - Left rib cage 31 3 - Both rib cages 4 8 - Blank, but applicable 90 9 - No findings 2912 Blank 3854 329- Minimum rib number right 330 02-10 - As given 26 88 - Blank, but applicable 90 99 - No findings 2943 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 331- Maximum rib number right 332 02-10 - As given 26 88 - Blank, but applicable 90 99 - No findings 2943 Blank 3854 333- Minimum rib number left 334 02-11 - As given 34 88 - Blank, but applicable 91 99 - No findings 2934 Blank 3854 335- Maximum rib number left 336 03-11 - As given 34 88 - Blank, but applicable 91 99 - No findings 2934 Blank 3854 337 Healing status 1 - Healed 44 8 - Blank, but applicable 98 9 - No findings 2917 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 338 Nipple shadows 1 - Present 55 8 - Blank, but applicable 90 9 - No findings 2914 Blank 3854 Nodules 339 Other extrapulmonary nodules 1 - Present 18 8 - Blank, but applicable 90 9 - No findings 2951 Blank 3854 340 Intrapulmonary nodules See Detailed Notes 1 - Present 406 8 - Blank, but applicable 90 9 - No findings 2563 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 341- Size of largest (mm) 343 002 - 080 - As given 405 888 - Blank but applicable 91 999 - No findings 2563 Blank 3854 344 Location of largest **See Detailed Notes 1 - Right 227 2 - Left 176 8 - Blank, but applicable 93 9 - No findings 2563 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 345- Specific lobe **See Detailed Notes 346 Upper 01 - Apical 45 02 - Posterior 54 03 - Anterior 45 Middle 04 - Superior or lateral 33 05 - Inferior or medial 36 Lower 06 - Superior 76 07 - Medial 7 08 - Anterior 24 09 - Lateral 42 10 - Posterior 41 88 - Blank, but applicable 93 99 - No findings 2563 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 347 Blank 6913 348- Size of second largest (mm) 350 002-035 - As given 101 888 - Blank, but applicable 91 999 - No findings 2867 Blank 3854 351 Location of second largest **See Detailed Notes 1 - Right 64 2 - Left 37 8 - Blank, but applicable 91 9 - No findings 2867 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 352- Specific lobe **See Detailed Notes 353 Upper 01 - Apical 11 02 - Posterior 11 03 - Anterior 11 Middle 04 - Superior or lateral 16 05 - Inferior or medial 10 Lower 06 - Superior 14 07 - Medial 1 08 - Anterior 4 09 - Lateral 9 10 - Posterior 14 88 - Blank, but applicable 91 99 - No findings 2867 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 354 Blank 6913 355 Number of nodules 1 - One 303 2 - Two or more 102 8 - Blank, but applicable 91 9 - No findings 2563 Blank 3854 356 Number of segments containing nodules 1-6 - As given 390 7 - Greater than 6 3 8 - Blank, but applicable 103 9 - No findings 2563 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 357 Are segments containing See Detailed Notes nodules contiguous? 1 - Yes 15 8 - Blank, but applicable 110 9 - No findings 2934 Blank 3854 358 Etiology of nodules 1 - Secondary to an infectious disease 361 2 - Not secondary to an infectious disease 18 3 - Combination of 1 and 2 3 8 - Blank, but applicable 113 9 - No findings 2564 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source Infiltrates 359 Localized segmental infiltrates **See Detailed Notes 1 - Right 15 2 - Left 20 8 - Blank, but applicable 91 9 - No findings 2933 Blank 3854 360- Location of infiltrates: **See Detailed Notes 361 Specific lobe Upper 01 - Apical 3 02 - Posterior 0 03 - Anterior 1 Middle 04 - Superior or lateral 8 05 - Inferior or medial 7 Lower 06 - Superior 0 07 - Medial 1 08 - Anterior 2 09 - Lateral 6 10 - Posterior 7 88 - Blank, but applicable 91 99 - No findings 2933 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 362 Blank 6913 363 Diffuse nonsegmental nonhomogenous **See Detailed Notes infiltrates 1 - Minimal 16 2 - Moderate 4 3 - Moderate with cavitation 4 4 - Far advanced 1 5 - Far advanced with cavitation 1 8 - Blank, but applicable 91 9 - No findings 2942 Blank 3854 Tape Locations 364-563 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 364 Blank 6913 365 Underlying condition 1 - Granulomatous 19 2 - Other diseases 3 8 - Blank, but applicable 95 9 - No findings 2942 Blank 3854 366 Diffuse homogeneous symmetrical infiltrates 1 - Present 74 8 - Blank, but applicable 90 9 - No findings 2895 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 367 Presumed etiology 1 - Congestive heart failure 4 2 - Pneumoconiosis 5 3 - Sarcoidosis 0 4 - Other 65 8 - Blank, but applicable 90 9 - No findings 2895 Blank 3854 368 Proportion or fraction of PA x-ray which appears abnormal 1- Less than 1/3 40 2 - 1/3 to 2/3 27 3 - Greater than 2/3 7 8 - Blank, but applicable 90 9 - No findings 2895 Blank 3854 369 Other infiltrates 1 - Present 22 8 - Blank, but applicable 90 9 - No findings 2947 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 370 Emphysema a) Explicit presumptive diagnosis of emphysema 1 - Diaphragm flat on PA and lateral x-rays and presump- tive evidence of emphysema 66 2 - Diaphragm flat on PA x-ray and presumptive evidence of emphysema 3 3 - Diaphragm flat on lateral x-ray and presumptive evi- dence of emphysema 106 4 - Presumptive evidence of emphysema 23 b) Possible diagnosis of emphysema 5 - Diaphragm flat on PA and lateral x-rays 15 6 - Diaphragm flat on PA x-ray 10 7 - Diaphragm flat on lateral x-ray 96 8 - Blank, but applicable 90 9 - Findings 2650 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 371 Blebs or bullae 1 - Secondary to generalized emphysema 17 2 - Secondary to post-inflammatory scaring 1 3 - Secondary to both 1 and 2 4 4 - Independent of both 1 and 2 0 8 - Blank, but applicable 90 9 - No findings 2947 Blank 3854 372- Calcified nodes See Detailed Notes 373 01 - Right hilar 64 02 - Left hilar 64 03 - Carinal 6 04 - Paratracheal 17 05 - Other 0 06 - Right hilar, left hilar, or Other 20 07 - Right hilar, paratracheal or Other 17 08 - Carinal and paratracheal 3 09 - Right hilar, left hilar, carinal or paratracheal 1 88 - Blank, but applicable 90 99 - No findings 2777 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 374 Enlarged nodes 1 - Right hilar 3 2 - Left hilar 1 3 - Carinal 1 4 - Paratracheal 0 5 - Other 0 6 - Right and left hilar 4 8 - Blank, but applicable 90 9 - No findings 2960 Blank 3854 375 Pleural disease 1 - Present 99 8 - Blank, but applicable 90 9 - No findings 2870 Blank 3854 376 Location 1 - Right 30 2 - Left 38 3 - Both 26 8 - Blank, but applicable 95 9 - No findings 2870 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 377 Presumed cause of effusion 1 - Fluid 5 2 - Tissue 85 3 - Both 4 8 - Blank, but applicable 95 9 - No findings 2870 Blank 3854 Cardiovascular Enlargement of vessels 378 Azygos vein 1 - Yes 5 8 - Blank, but applicable 90 9 - No findings 2964 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 379- Locus of pulmonary artery 380 enlargement 01 - Right proximal 0 02 - Right distal 0 03 - Right proximal/distal 0 04 - Left proximal 2 05 - Left distal 0 06 - Left proximal/distal 0 07 - Both proximal 25 08 - Both distal 8 09 - Both proximal/distal 7 88 - Blank, but applicable 90 99 - No findings 2927 Blank 3854 381 Enlargement of right heart 1 - Atrium enlarged 0 2 - Ventricle enlarged 17 3 - Both enlarged 0 8 - Blank, but applicable 90 9 - No findings 2952 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 382 Cephalization of pulmonary vessels 1 - Present 24 8 - Blank, but applicable 90 9 - No findings 2945 Blank 3854 383 Interstitial fluid 1 - Present 9 8 - Blank, but applicable 90 9 - No findings 2960 Blank 3854 384 Kerley lines 1 - A lines 0 2 - B lines 0 3 - A and B lines 6 8 - Blank, but applicable 90 9 - No findings 2963 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 385 Rosettes 1 - Present 3 8 - Blank, but applicable 90 9 - No findings 2966 Blank 3854 386 Alveolar fluid 1 - Present 1 8 - Blank, but applicable 90 9 - No findings 2968 Blank 3854 387 Enlargement of left heart 1 - Atrium enlarged 4 2 - Ventricle enlarged 96 3 - Both enlarged 4 8 - Blank, but applicable 90 9 - No findings 2865 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source PATHOLOGY FINAL READINGS See Detailed Notes (STANDS 1-100) 388 Cardiopulmonary findings See Detailed Notes 1 - Findings 1713 8 - Blank, but applicable 319 9 - No findings 4881 Thorax 389 Kyphosis **See Detailed Notes 1 - Present 100 8 - Blank, but applicable 89 9 - No findings 2870 Blank Blank 3854 390 Scoliosis 1 - Present 533 8 - Blank, but applicable 319 9 - No findings 6061 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 391 Pectus 1 - Carinatum 3 2 - Excavatum 111 8 - Blank, but applicable 319 9 - No findings 6480 392 Rib fractures 1 - Present 76 8 - Blank, but applicable 319 9 - No findings 6518 393 Location 1 - Right rib cage 34 2 - Left rib cage 33 3 - Both rib cages 9 8 - Blank, but applicable 319 9 - No findings 6518 394- Minimum rib number right 395 01-10 - As given 41 88 - Blank, but applicable 321 99 - No findings 6551 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 396- Maximum rib number right 397 02-10 - As given 41 88 - Blank, but applicable 321 99 - No findings 6551 398- Minimum rib number left 399 02-10 - As given 41 88 - Blank, but applicable 321 99 - No findings 6551 400- Maximum rib number left 401 04-11 - As given 41 88 - Blank, but applicable 321 99 - No findings 6551 402 Healing status 1 - Healed 68 8 - Blank, but applicable 322 9 - No findings 6523 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 403 Nipple shadows 1 - Present 53 8 - Blank, but applicable 319 9 - No findings 6541 Nodules 404 Other extrapulmonary nodules 1 - Present 139 8 - Blank, but applicable 319 9 - No findings 6455 405 Intrapulmonary nodules See Detailed Notes 1 - Present 429 8 - Blank, but applicable 319 9 - No findings 6165 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 406- Size of largest (mm) 408 002 - 080 - As given 423 888 - Blank but applicable 322 999 - No findings 6168 409 Location of largest **See Detailed Notes 1 - Right 191 2 - Left 166 8 - Blank, but applicable 90 9 - No findings 2612 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 410- Specific lobe **See Detailed Notes 411 Upper 01 - Apical 39 02 - Posterior 39 03 - Anterior 45 Middle 04 - Superior or lateral 37 05 - Inferior or medial 30 Lower 06 - Superior 53 07 - Medial 15 08 - Anterior 10 09 - Lateral 57 10 - Posterior 32 88 - Blank, but applicable 90 99 - No findings 2612 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 412 Relative location of largest **See Detailed Notes 1 - Right upper lobe 10 2 - Right middle lobe 5 3 - Right lower lobe 18 4 - Left upper lobe 13 5 - Left lower lobe 12 8 - Blank, but applicable 240 9 - No findings 3556 Blank 3059 413- Size of second largest (mm) 415 002-032 - As given 92 888 - Blank, but applicable 328 999 - No findings 6493 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 416 Location of second largest **See Detailed Notes 1 - Right 47 2 - Left 38 8 - Blank, but applicable 90 9 - No findings 2884 Blank 3854 417- Specific lobe **See Detailed Notes 418 Upper 01 - Apical 11 02 - Posterior 11 03 - Anterior 11 Middle 04 - Superior or lateral 9 05 - Inferior or medial 9 Lower 06 - Superior 8 07 - Medial 2 08 - Anterior 6 09 - Lateral 9 10 - Posterior 9 88 - Blank, but applicable 90 99 - No findings 2884 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 419 Relative location of second largest *See Detailed Notes 1 - Right upper lobe 3 2 - Right middle lobe 0 3 - Right lower lobe 2 4 - Left upper lobe 1 5 - Left lower lobe 0 8 - Blank, but applicable 239 9 - No findings 3609 Blank 3059 420 Number of nodules 1 - One 326 2 - Two or more 101 8 - Blank, but applicable 319 9 - No findings 6167 421 Number of segments containing nodules 1-6 - As given 381 7 - Greater than 6 5 8 - Blank, but applicable 360 9 - No findings 6167 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 422 Are segments containing See Detailed Notes nodules contiguous? 1 - Yes 17 8 - Blank, but applicable 364 9 - No findings 6532 423 Etiology of nodules 1 - Secondary to an infectious disease 336 2 - Not secondary to an infectious disease 7 3 - Combination of 1 and 2 10 8 - Blank, but applicable 393 9 - No findings 6167 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source Infiltrates 424 Localized segmental infiltrates **See Detailed Notes 1 - Right 15 2 - Left 9 8 - Blank, but applicable 89 9 - No findings 2946 Blank 3854 425- Location of infiltrates: **See Detailed Notes 426 Specific lobe Upper 01 - Apical 1 02 - Posterior 0 03 - Anterior 2 Middle 04 - Superior or lateral 6 05 - Inferior or medial 9 Lower 06 - Superior 1 07 - Medial 1 08 - Anterior 0 09 - Lateral 3 10 - Posterior 2 88 - Blank, but applicable 89 99 - No findings 2945 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 427 Localized segmental infiltrates *See Detailed Notes 1 - Right upper lobe 1 2 - Right middle lobe 10 3 - Right lower lobe 3 4 - Left upper lobe 2 5 - Left lower lobe 4 8 - Blank, but applicable 230 9 - No findings 3604 Blank 3059 428 Diffuse nonsegmental nonhomogeneous **See Detailed Notes infiltrates 1 - Minimal 40 2 - Moderate 6 3 - Moderate with cavitation 7 4 - Far advanced 0 5 - Far advanced with cavitation 0 8 - Blank, but applicable 89 9 - No findings 2917 Blank 3854 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 429 Diffuse nonsegmental nonhomogeneous *See Detailed Notes infiltrates 1 - Minimal 69 2 - Moderate and Moderate with cavitation 17 3 - Far advanced and far advanced with cavitation 15 8 - Blank, but applicable 230 9 - No findings 3523 Blank 3059 430 Underlying condition 1 - Granulomatous 104 2 - Other diseases 34 8 - Blank, but applicable 335 9 - No findings 6440 431 Diffuse homogeneous symmetrical infiltrates 1 - Present 99 8 - Blank, but applicable 319 9 - No findings 6495 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 432 Presumed etiology 1 - Congestive heart failure 13 2 - Pneumoconiosis 2 3 - Sarcoidosis 0 4 - Other 84 8 - Blank, but applicable 319 9 - No findings 6495 433 Proportion or fraction of PA x-ray which appears abnormal 1- Less than 1/3 28 2 - 1/3 to 2/3 17 3 - Greater than 2/3 54 8 - Blank, but applicable 319 9 - No findings 6495 434 Other infiltrates 1 - Present 108 8 - Blank, but applicable 319 9 - No findings 6486 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 435 Emphysema a) Explicit presumptive diagnosis of emphysema 1 - Diaphragm flat on PA and lateral x-rays and presump- tive evidence of emphysema 136 2 - Diaphragm flat on PA x-ray and presumptive evidence of emphysema 5 3 - Diaphragm flat on lateral x-ray and presumptive evi- dence of emphysema 93 4 - Presumptive evidence of emphysema 29 b) Possible diagnosis of emphysema 5 - Diaphragm flat on PA and lateral x-rays 14 6 - Diaphragm flat on PA x-ray 4 7 - Diaphragm flat on lateral x-ray 115 8 - Blank, but applicable 319 9 - No Findings 6198 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 436 Blebs or bullae 1 - Secondary to generalized emphysema 13 2 - Secondary to post-inflammatory scaring 8 3 - Secondary to both 1 and 2 8 4 - Independent of both 1 and 2 6 8 - Blank, but applicable 319 9 - No findings 6559 437- Calcified nodes See Detailed Notes 438 01 - Right hilar 54 02 - Left hilar 71 03 - Carinal 4 04 - Paratracheal 21 05 - Other 10 06 - Right hilar, left hilar, or Other 16 07 - Right hilar, paratracheal or Other 12 08 - Carinal and paratracheal 2 09 - Right hilar, left hilar, carinal or paratracheal 8 88 - Blank, but applicable 319 99 - No findings 6396 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 439 Enlarged nodes 1 - Right hilar 10 2 - Left hilar 2 3 - Carinal 1 4 - Paratracheal 0 5 - Other 1 6 - Right and left hilar 3 8 - Blank, but applicable 319 9 - No findings 6577 440 Pleural disease 1 - Present 278 8 - Blank, but applicable 319 9 - No findings 6316 441 Location 1 - Right 76 2 - Left 119 3 - Both 82 8 - Blank, but applicable 320 9 - No findings 6316 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 442 Presumed cause of effusion 1 - Fluid 8 2 - Tissue 261 3 - Both 8 8 - Blank, but applicable 320 9 - No findings 6316 Cardiovascular Enlargement of vessels 443 Azygos vein 1 - Yes 30 8 - Blank, but applicable 319 9 - No findings 6564 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 444- Locus of pulmonary artery 445 enlargement 01 - Right proximal 1 02 - Right distal 1 03 - Right proximal/distal 0 04 - Left proximal 1 05 - Left distal 0 06 - Left proximal/distal 0 07 - Both proximal 30 08 - Both distal 19 09 - Both proximal/distal 90 88 - Blank, but applicable 319 99 - No findings 6452 446 Enlargement of right heart 1 - Atrium enlarged 1 2 - Ventricle enlarged 40 3 - Both enlarged 3 8 - Blank, but applicable 319 9 - No findings 6550 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 447 Cephalization of pulmonary vessels 1 - Present 36 8 - Blank, but applicable 319 9 - No findings 6558 448 Interstitial fluid 1 - Present 6 8 - Blank, but applicable 319 9 - No findings 6588 449 Kerley lines 1 - A lines 0 2 - B lines 3 3 - A and B lines 7 8 - Blank, but applicable 319 9 - No findings 6584 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 450 Rosettes 1 - Present 1 8 - Blank, but applicable 319 9 - No findings 6593 451 Alveolar fluid 1 - Present 1 8 - Blank, but applicable 319 9 - No findings 6593 452 Enlargement of left heart 1 - Atrium enlarged 5 2 - Ventricle enlarged 120 3 - Both enlarged 10 8 - Blank, but applicable 319 9 - No findings 6459 453- Data User Work Area 500 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source PULMONARY DIFFUSION (STANDS 1-100) 501- DLCO (m1CO/minute) - First Trial See Detailed Notes 503 (XX.X - decimal not shown on tape) 092-711 - As given 4864 000 - Unacceptable trials 190 Blank - Blank, but applicable 1859 504- DLCO (m1CO/minute) - Second Trial See Detailed Notes 506 (XX.X - decimal not shown on tape) 092-589 - As given 4978 000 - Unacceptable trials 76 Blank - Blank, but applicable 1859 507- DLCO (m1CO/minute) - Third Trial See Detailed Note 509 (XX.X - decimal not shown on tape) 003-597 - As given 4916 000 - Unacceptable trials 138 Blank - Blank, but applicable 1859 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 510- Summary DLCO (m1CO/minute) See Detailed Note 512 (XX.X - decimal not shown on tape) 092-561 - As given 5054 Blank - Blank, but applicable 1859 513- Data User Work Area 550 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source TUBERCULIN TEST (STANDS 1-35) See Detailed Notes 551 Site injected 1 - Volar forearm 1575 2 - Other 4 8 - Blank, but applicable 312 Blank - Not applicable 5022 552- PPD-S Induration (mm) (left arm) 553 00-69 - As given 1494 88 - Blank, but applicable 397 Blank - Not applicable 5022 554- PPD-B Induration (mm) (right arm) 555 00-75 - As given 1493 88 - Blank, but applicable 398 Blank - Not applicable 5022 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 556 Where were results read? 1 - Home 141 2 - Work 35 3 - Exam center 1256 4 - Other 43 8 - Blank, but applicable 416 Blank - Not applicable 5022 557 Days between test and reading 2-4 - As given 1461 8 - Blank, but applicable 430 Blank - Not applicable 5022 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 558 Type of reader 1 - Nurse 1367 2 - Health Examination Representative 67 3 - Doctor outside of exam center 31 4 - Exam center staff doctor 9 5 - Examinee 1 6 - Public Health Nurse 1 7 - Coordinator 1 8 - R.N. outside of exam center 412 9 - Blank, but applicable 2 Blank - Not applicable 5022 559 Was test read? 1 - Test read 1494 2 - Test administered, not read 98 3 - Test administered, read negative by examinee 1 8 - Blank, but applicable 298 Blank - Not applicable 5022 Tape Control Loc. ITEM DESCRIPTION & CODES Counts HANES I Data Source 560- PPD-S and PPD-B both present: 562 difference in readings (-71)-(+59) (mm) - As given 1494 Blank - Not applicable 5421 563 Induration reading classification: PPD-S and PPD-B 1 - Both absent 396 2 - S absent, B present 1 3 - S present, B absent 2 4 - S and B present with S induration 05-09 mm and -1 S-B +1 40 5 - S and B present with S induration 05-09 mm and S-B -1 32 6 - S and B present with S induration 05-09 mm and S-B +1 88 7 - S and B present with S induration 10-69 mm 282 8 - S and B present with S induration 00-04 mm 1050 Blank - Not applicable 5022 DETAILED NOTES, TB DATA Tape Positions 205-237 - Lung Measurement Techniques Surface areas of lungs - The technique used to measure lung surface areas was that described by Harris et al in the American Journal of Medicine 50:756-763 1971.The technician first traced with a pencil on the posterior-anterior (PA) and lateral films: 1) the left lung perimeter 2) the right lung perimeter,excluding the heart and mediastinal shadows,and 3) the lateral lung perimeter, using the posterior margins of the vertebrae, the internal sternal margin and the line midway between the diaphragms. The technician then again traced the lung perimeters using the magnifying tracer of the planimeter. This data was interpreted by a Numonics model 1224 electronic digitizer, and areas were read and recorded from the display console. Thoracic diameters -- The PA diameter, given in centimeters, was the maximum transverse diameter of the chest on the PA film, as measured by the Numonics digitizer.The first and second lateral diameters were the least distance in centimeters from the superior and inferior posterior margins of the eighth thoracic vertebrae to the posterior margin of the sternum, respectively. Measurements were made with the Numonics digitizer.Thoracic diameters were not measured for examinees in the Augmentation Survey. Tracheal diameters - Tracheal diameters were measured at the levels of the superior borders of the second (T2) and the third (T3) thoracic vertebrae. Measurements were made with a straight edge and a square. Using a straight edge, the tracheal borders at the levels of T2 and T3 were marked. These lines were extended so as to best parallel their respective tracheal walls.A perpendicular to the right tracheal border was established with a square at the superior border of T2 and T3. Measurement of the distance between tracheal walls was measured along this perpendicular with a Fowler caliper,and readings were recorded to the nearest hundredth of a centimeter. Tracheal diameters were not measured for examinees in the Augmentation Survey. Tape Positions 238-257 - Heart Size Measurement Techniques Five measures of heart size were taken for each examinee in order to assess cardiac pathology and heart enlargement, using techniques suggested by Grover et al in Circulation, Volume XLVII, June 1973. As described in the article, the technician used a straight edge and pencil to establish a transverse line horizontally across the posterior-anterior (PA) x-ray between the pair of ribs (left and right) which defined the maximum intra-thoracic diameter. The distance between the internal margins of these sites,B1 and B2,defined the maximum transverse diameter of the thorax. A second line was drawn perpendicular to the first line, bisecting the chest into left and right halves. The technician then identified the points, one on the left and one on the right, which marked the most lateral cardiac margins. Another perpendicular was drawn from each of these points to the transverse thoracic line. The distance between point A1 (where the perpendicular from the left cardiac border intersected the transverse line) and the point A2 (where the perpendicular from the right cardiac border intersected the transverse thoracic line) was measured and recorded.This distance,A1 to A2,defined the maximum cardiac diameter on the PA film.The technician then marked the point that identified the junction of the right atrium and the superior vena cava, C1 and the point that marked the cardiac apex, C2.The distance between these two points was measured and recorded.The right cardio-phrenic angle,D1, was then identified,as well as the junction of the atrial appendage with the main pulmonary artery, D2.This distance, representing the cardiac broad diameter, was measured and recorded. The technician then marked a horizon- tal line on the lateral chest x-ray which transected the heart at its widest diameter.The points where the line intersected the anterior and posterior cardiac shadow were identified,and this distance was measured and recorded as the greatest cardiac diameter on the lateral film, E1 to E2. Tape Positions 258-322, 323-387, 388-452-Cardiopulmonary Findings In order to be able to determine the presence or absence of cardiopulmonary findings, a recording form was developed by the principle contract x-ray reader and the NHANES medical advisor. Since structural abnormalities can directly or indirectly influence pulmonary mechanics, the forms were expanded to include the presence of scoliosis, kyphosis, pectus, and rib fractures. The forms were structured to permit: 1) grouping of abnormalities by location or system - e.g., chest wall, pulmonary, lymphatic, pleural, and cardiovascular, 2) assessing the extent of the abnormalities (e.g., size and number of nodules) and distribution (e.g., segmental and nonsegmental infiltrates) of the disease, 3) suggesting etiologies (e.g., infections as the cause of nodules; pneumonoconiosis as the cause of pulmonary infiltrates) when sufficient information was available from the x-ray, and 4) recording into "open" recording space those observations and abnormalities which did not otherwise fit into the coded form. The assessment as to whether the nonsegmental nonhomogenous infiltrates were minimal, moderate or advanced was made according to the Diagnostic Standards and Classification of Tuberculosis (National Tuberculosis and Respiratory Disease Association, New York, NY 1969). Objective criteria concerning the other findings to be assessed were not available at the time the form was designed. The final report of the contractor responsible for making all heart size and lung measurements and all assessments for cardiopulmonary pathology is available to interested parties. In addition, a portion of that final report has been excerpted and is included as Appendix I to this document. In the excerpted portion,the contractor has provided assessments of the validity and usefulness of each of the individual pathology findings presented in this data set, as well as descriptions of problems encountered in the reading and evaluation process.Users of this data set are advised to review the excerpt prior to conducting any analyses of these data. Tape Positions 259, 324, and 389 - Kyphosis Findings related to kyphosis were not formally recorded for subjects who received the detailed examination during that part of NHANES I conducted from 1971 to 1974.Consequently, no response is coded for those 3854 subjects. For some of those subjects an observation of kyphosis was recorded in the "Comments" section of the coding form, but the observations were not consistently recorded. In addition, a number of subjects did not receive a lateral x-ray, and for these examinees the assessment of kyphosis was not reliable. Tape Positions 274-293, 339-358, 404-423 - Nodules Review of the coding form used for the part of NHANES I conducted in 1971-74 prompted a revision of the section relating to nodules prior to the Augmentation Survey conducted in 1974-75. In particular, the lung(s) and specific lobe(s) of the lung(s) in which the largest and second largest nodules were located are only coded for subjects examined in the Augmentation Survey. The relative location(s) of the largest and second largest nodules are only coded for subjects examined in 1971-74.The coding schema are approximately equivalent, except that the schema used for the subjects of the Augmentation Survey provides substantially more detail than that used for the examinees receiving the detailed examination in 1971-74. Tape Positions 294-304, 359-369, 424-434 - Infiltrates Review of the coding form used for the part of NHANES I conducted in 1971-74 prompted a revision of the section relating to infiltrates prior to the Augmentation Survey conducted in 1974-75.In particular,more detailed coding schema were developed for the specific lobe in which localized segmental infiltrates were located, and for the severity of diffuse nonsegmental nonhomogenous infiltrates. In each case the less specific schema can be derived by combining adjacent categories of the more specific schema. Tape Positions 388-452 - Pathology Final Readings Reader opinion represents a useful assessment of radiographic abnormalities. For example, Nicklaus et al (American Review of Respiratory Disease 93: 889-899, 1966) have shown that reader opinion is the best way to diagnose moderate to severe emphysema from the chest x-ray and that it correlates well with histologic findings.Hence, the present study utilized reader opinion to assess the presence or absence of heart and lung pathology. Because such opinion has been shown to have appreciable inter-observer and intra-observer error, two independent readers were utilized to establish the presence or absence of pathology. The pathology final readings do not represent a third reading of each x-ray, but instead a synthesis of the first two readings. The x-rays of those subjects examined in 1971-74 (the General Nutrition examination) were only read once,so that for those examinees the final reading is simply a copy of the first reading. The x-rays of those subjects examined in the Augmentation Survey (conducted in 1971-74) were read twice by independent readers.When the findings of the two readers agreed, the final reading is a copy of those findings. When the readers disagreed in any particular, the film was subjected to adjudication,in which the readers jointly reviewed the film and came to agreement on the disputed item(s).In a few cases,disputed films were referred to a third expert reader for adjudication. In this study, Dr. Lanie Eagleton, Associate Professor of Medicine and Chief of the Pulmonary Division of the Southern Illinois University School of Medicine, performed all the first readings.The "second" reader was one of four radiology residents at the Southern Illinois School of Medicine.Expert judgment on disputed films was provided by Dr. William Sherrick, a staff radiologist at the Southern Illinois School of Medicine specializing in chest radiology. Tape Positions 501-532 - Pulmonary Diffusion Measurements of single breath carbon monoxide diffusion capacity were per- formed on all detailed examinees using a Collins modular lung analyzer. This machine provides basic data from which estimates can be made of the rate of diffusion of gases across the pulmonary membranes. Each examinee who the physician did not disqualify performed first a Forced Expiratory Spirogram to establish his forced vital capacity and then three trials on the lung analyzer. Each trial consisted of: 1) a maximal inspiration of a gas mixture containing air,10 percent helium (He), and 0.3 percent carbon monoxide (CO), followed by 2) breathholding for about 10 seconds, and finally 3) as complete and rapid an expiration as the examinee could perform. The expired gas was analyzed for the proportions of expired He and CO. Trials were separated by rest periods of at least five minutes. Each trial and the entire test was subjected to a variety of quality control criteria, including: 1) Inspired volumes must be at least 80 percent of forced vital capacity. 2) Inspiration times must be less than three seconds. 3) Breathholding times must be between 8.5 and 11.5 seconds. 4) Expired gas samples must be at least 500 ml. 5) The volumes of inspired gas must not decrease more than 200 ml during breathholding. 6) The trials must be free of inhalation artifacts. 7) Expired CO and He measurements must not differ by more than 10 percent. Calculations of pulmonary diffusion capacity (DLCO) were performed at the end of the survey for all trials that were free of quality control violations, using the following formula: DLCO = (IVC * HEI / HEE - Weight in pounds - 75) * STPD factor * (192 / Breathholding time) * (1 / (BP - 47))* In ((COI / COE) * (HEI / HEE)) where: IVC = Inspired vital capacity HEI, HEE = Inspired and expired helium concentration STPD = Standard Temperature and Pressure correction factor BP = Uncorrected barometric pressure COI, COE = Inspired and expired carbon monoxide concentration A summary DLCO was also derived. The summary was the average of all DLCO's that were within 10 percent of the largest, or the largest alone if reproducibility had not been demonstrated or if only one trial was available. Tape Positions 551-563 - Tuberculin Test Each adult ages 25-74 years selected in the sample for the more detailed examination was given a tuberculin skin test as part of the examination component relating to respiratory conditions.Due to the difficulty in getting the examinees to return to the examining center 48-72 hours after receiving their tuberculin tests for reading, tuberculin tests were only to sample persons in stands 1-35. Examinees who had a history of a positive reaction, tuberculosis, Isoniazid prophylaxis or who were examined a day or two before the mobile examination unit was scheduled to move were not given the tubercu- lin skin tests. Simultaneous skin testing with PPD-S tuberculin antigen and PPD-B antigen permitted differentiation between reactivity caused by infection with M. tuberculosis and the other mycobacteria. Trained staff nurses administered 5 tuberculin units contained in 0.1 cc solution into the left arm and 5 units of PPD-B in 0.1 cc solution into the right arm.Both antigens used in the survey examinations were obtained from the Tuberculosis Program of the Centers for Disease Control, Public Health Service.The tuberculin skin tests were read 48-72 hours after injection. The indurated area was measured to the nearest millimeter at its widest transverse diameter. Further description of the tuberculin tests may be found in "Tuberculin Skin Test Reaction Among Adults 25-74 Years1". 1National Center for Health Statistics, A. Engel and J. Roberts: Tuberculin Skin Test Reaction Among Adults 25-74 Years, by Vital and Health Statistics. Series 11-No. 204. DHEW Pub. No. (HRA) 77-1649. Public Health Service. Hyattsville, Md. July, 1977. Quality Control When the reading and evaluation of the x-rays in this data set was initiated, objective criteria did not exist to assess the presence or absence or degree of significance for many of the fields reported in the section relating to cardiopulmonary pathology. After review of this data set by staff members of the National Center for Health Statistics,and in light of the comments raised by the primary contract reader, several studies were initiated to validate selected items from the data set.Cobb's angles were measured for all subjects with a positive findings for scoliosis (see Carter, O.D., and Haynes, S.G.: Prevalence rates and risk factors for scoliosis in U.S. adults: Results from the First National Health and Nutrition Examination Survey (NHASES I). In Preparation). The right descending pulmonary artery was measured for all subject with a positive finding for pulmonary artery enlargement (as well as for a sample of subjects who did not have positive findings) by an acknow- ledged expert in that condition,and the results are currently being anlayzed to determine proportion of false positives and negatives.Finally, all x-rays reported to show some pleural disease have been re-read by an expert in that condition, and these data are also currently being analyzed. Users may wish to consider conducting validation studies of their own prior to pursuing specific analyses.Under certain restricted circumstances, it is possible to obtain from NCHS selected subsets of x-rays from the original data set to conduct such studies.Contact Terence Drizd or Dr.Suzanne Haynes of the Medical Statistics Branch, Division of Health Examination Statistics, NCHS for more information. APPENDIX I: EXCERPT FROM FINAL REPORT OF CONTRACT X-RAY READER Kyphosis, a subjective evaluation, was a source of disagreement between readers. The data should not be used as free standing prevalence data. However,the adjudicated data should prove useful for comparison with and for assessment of other pulmonary data, e.g., spirometry and physical examina- tion data. Scoliosis was a frequent finding. Most of the differences of opinion as to the presence or absence of scoliosis occurred when there were small angula- tions which had not been recorded by one of the readers.The data should be further refined by having the angles of the scoliosis measured so that the data become quantitative as well as qualitative.This data is of good quality as a source of prevalence estimates as well as a source of comparison with spirometric abnormalities. Pectus excavatum, a subjective evaluation, was a source of substantial disagreement between readers. Since this abnormality has been linked to diaphragmatic abnormalities,it is an important finding to compare with the other data, e.g., spirometry and physical examination findings.It should not be used as a source of prevalence estimates for pectus excavatum. Nodules were the most common abnormality. They were divided into those the reader believed were: 1) nipple shadows, 2) extra-pulmonary densities, 3) radio-dense or calcified lesion judged to be secondary to a remote granulatomous infection, such as a fungal infection, a viral infec- tion, or tuberculosis, and 4) "other" nodules which had a reasonably high probability of represen- ting a neoplasm, a tumor of non-infectious etiology,or an infectious disease which had been recently acquired. The nipple shadows and the extra-pulmonary nodules were recorded because they were potential sources of error in identification of pulmonary nodules. This recording was helpful in editing and adjudicating. It should not be used for prevalence estimates and was not meant for correlation with the other pulmonary data. The sizes of the intrapulmonary nodules were recorded in millimeters. The nodules were frequently asymmetrical. The measurement instructions were not explicit as to how to measure an asymmetric nodule. Hence, the two readings were frequently different by a few millimeters - usually no more than two. However, this small difference in reading resulted in the x-rays being re- called for adjudication.The difference was resolved by reader #1 remeasuring the nodules and adjudicating the reading to the maximal diameter of the nodule. This consumed a large amount of time. However,the final data on the prevalence and the size of the nodule is good data for publication. The enumeration of the nodules presented problems,particularly when the densities near the hilum could be interpreted as either a vessel or a nodule.When there was a difference of opinion as to whether a nodule was present or absent,the lesions were adjudicated as not present. The data on the number of nodules present should prove useful for assessing the extent of the inflammatory process in the lung. The coding of the abnormalities by utilizing the smallest lung divisions which were likely to encompass the lesion, (e.g., a segment of the lung) presented a problem with adjudication. Precise anatomical location is difficult to establish from x-rays even when both posterior-anterior and lateral films are available. Furthermore, because of the variation in the size of the nodules discussed above, the positions of the nodules were frequently translocated because of differences in ranking of the size of the nodules. This difference in segmental locations was arbitrarily resolved by reader #1 after remeasuring the nodules and re-ranking them according to their maximal diameter. However, the data on segmental location is not sufficiently precise to permit publication as free standing data. Yet, the data should prove useful in planning future surveys, as well as in analyzing distribution of the abnormalities into the regions of the lungs such as left versus right or upper versus lower. The etiology of the nodules represents a judgement on the part of the readers, and it proved to have reasonable inter-reader agreement. The prevalence of post-inflammatory nodules was impressive. This data should prove useful in assessing whether extensive inflammatory nodules of the lung such as one sees in histoplasmosis have an appreciable effect on pulmonary mechanics. For the nodules which were judged to non-infectious, this data establishes an upper limit that one could expect in utilizing x-rays and evaluating the prevalence of abnormalities such as carcinoma of the lung. There was very good agreement between the readers as to the presence of pulmonary infiltrates.However, the readers varied as to how they coded a given infiltrate. Platelike atelectasis presented a particular problem in coding. This abnormality was coded by some as a nonhomogenous, nonsegmental lesion;by others as a homogeneous symmetrical lesion;and by others as "other" with a comment of platelike atelectasis. Because this is a frequent abnormality in the lung,future coding forms should have an independent space for coding platelike atelectasis. Co-existence of a diffuse nonhomogeneous, nonsegmental pulmonary infiltrate (which would be compatible with a previous tubercular or fungal infection) and a more diffuse nonhomogeneous,nonsegmental infiltrate was a frequent source of coding problems. Some readers coded this abnormality as a nonhomogeneous and as a symmetrical infiltrate of the lung. Other readers coded the infiltrates as both a nonhomogeneous nonsegmental and a homogeneous segmental infiltrate, emphasizing that there were components of both distributions present.It is my impression that these two lesions frequently co-exist and are both related to a previous tubercular or fungal infection -the major local infections causing the homogeneous and symmetrical infiltrates and the long-standing spread of antigen diffusely in the lung by bronchogenic spread leading to a more homogeneous and symmetrical infiltrate which is probably a fibrosis in the lung. Future recording forms should have an additional code which permits the reader to record this observation without entering the homogeneous and symmetrical infiltrate as an independent observation,or the coding directions should be explicit as to how to make independent judgements as to whether there were two components to the infiltrate in the lung. The assessment as to whether the nonhomogeneous,nonsegmental infiltrates were either minimal, moderate or far advanced, according to the former NTRDA classification (Diagnostic Standards and Classification of Tuberculosis, National Tuberculosis and Respiratory Disease Association, New York,NY,1969) did not present unusual problems. This is a useful assessment and should permit comparing the extent of the radiographic lesion with the severity of the pulmonary function abnormalities and with the presence or absence of pulmonary symptomatology. In contrast,there was much inter-reader disagreement in assessing whether the homogeneous, symmetrical infiltrates were extensive by making judgement as to whether 1/3, 2/3 or the entire lung was involved.This data should not be used for publication. However,it could be used for comparison with assessments of the severity of the impairment by spirometry and other pulmonary data. If these prove to correlate well, then this assessment might be further refined for use in future surveys by refining the coding instructions. Assessing whether emphysema was present and whether the diaphragms were flat was subjective.The coding instructions were not explicit on criteria to use for judging the diaphragms as flat.The failure of all the readers, except a single one of the second readers using a blank rather than a code of 8 to signify the absence of findings,was the major source of recorded differences. However, when this variability had been edited, and the reading adjudicated, the result in assessment of the prevalence of these findings represents a reasonable assessment for publication.This prevalence of findings on x-rays underestimates the prevalence of emphasyma. It has been previously reported (Am. Rev. Resp. Dis. 42: 889-899, 1966) that this is not useful in detecting milk to early stages of emphysema. The data should be quite useful for use in conjunction with other pulmonary data, including the findings on physical examination, spirometry, carbon monoxide diffusion, and the size of the lungs as assessed by planimetry. It represents confirmatory evidence for the presence of emphysema. In future surveys, there should be criteria in the instructions for assessing whether diaphragms are flat. Calcified lymph nodes were prevalent. Instances where only one reader thought a lesion was present were adjudicated as absence of this finding.Lesions that were calcified and large were frequently recorded as only calcified and not as enlarged.Enlarged nodes which were calcified were adjudicated to be recorded only as "calcified nodes." Difficulties in coding pleural disease were presented by thickening of the pleura of the apex of the heart and of the lung. These were findings which some readers did not code because they were frequent and considered normal. In the adjudication procedure, if these pleural abnormalities were marked and thought to represent an extension of significant pulmonary disease, they were coded as abnormalities.In respect to the pleural findings, these x-rays have been reexamined as a subset to review for pneumonosis. This data should be useful in judging the extent and etiology of the pleural disease and repre- sents an independent judgement by a panel of experts on pleural disease. Those x-rays that had a cardiovascular abnormality checked - azygous vein, right atrial and right ventricular enlargement, cephalization, interstitial fluids, Kerley lines, rosettes, alveolar fluid, and left atrial and left ventricular enlargement, should be reevaluated by a panel of cardiac experts to assess the nature of the cardiac abnormality.I believe the data that has been collected is a useful screen for the presence or absence of abnormality of the cardiovascular system but should not be used to report prevalence of either left or right ventricular disease. The pulmonary artery enlargement assessment was made by subjective evaluation. When both readers on the initial evaluation concurred as to the presence of the pulmonary artery abnormality,that should be used as a lower limit of the abnormality in the population. A more explicit criteria for judgment of pulmonary artery enlargement should be developed and all x-rays positive for this finding should be answered by these criteria.The current data should be useful to compare with other pulmonary observations,but should not be used as free standing data for estimating the prevalence of pulmonary hypertension. Those x-rays that were coded as showing pulmonary artery enlargement could be utilized as subsample for further evaluation by a panel of experts in pulmonary vasculature disease.
