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Adult Brain Tumor - Occupational History & Exposure Questionnaire

The following questionnaire segment contains questions that have been used as part of DCEG or other epidemiologic studies. This segment has not necessarily been reviewed or analyzed by the Technical Evaluation Committee. Please view it as a starting point that can be adapted or improved upon as appropriate. Learn more about DCEG Questionnaire Development Resources.

Questionnaire Topic: 

Occupational History/ Exposures 

Study Title: 

Study of Brain Tumors in Adults 



Principal Investigator(s): 

P. Inskip 

Type of Questionnaire: 


Last Year of Data Collection: 


Short/Long Form: 

Long Form 


Stewart PA, Stewart WF, Heineman EF, Dosemeci M, Linet M, Inskip P. A novel approach to data collection in a case-control study of cancer and occupational exposures. Int J Epidemiol 1996;25:744-52.

Stewart PA, Stewart WF, Siemiatycki J, Heineman EF, Dosemeci M. Questionnaires for collecting detailed occupational information for community-based case-control studies. Am Ind Hyg Assoc J 1998;59:39-44

Main questionnaire: 

Download Occupational_Hist_Exp_Adult_Brain_Tumor_questionnaire (Word, 25 KB)

Sample Job Modules: 

Butcher – Download Butcher_Occupational_Hist_Exp_Adult_Brain_Tumor_questionnaire (Word, 18 KB)

Electrician – Download Electrician_Occupational_Hist_Exp_Adult_Brain_Tumor_questionnaire (Word, 37 KB)

Back to Occupational History and Exposures

Learn more about DCEG Questionnaire Development Resources