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35 <br />38. WHERE IS THIS EMPLOYMENT POSITION LOCATED? <br />Record the name, city, and state of the company. <br />39. WHAT TYPE OF WORK DO YOU DO IN THIS POSITION? <br />Record the type of work performed in position. <br />40. WHEN DID YOU BEGIN AND END THIS JOB? <br />Record the year or work began and the year work ended, <br />~ecial Instructions: If the person can't remember how long they worked in the position, prompt <br />them with the following: less than one year, one to five years, six to ten years, ten or more years, <br />41. WHAT WAS YOUR PREVIOUS JOB? <br />Record the stated job or occupation. <br />42. WHERE WAS THIS EMPLOYMENT POSITION LOCATED? <br />Record the name, city, and state of the company. <br />43. WHAT TYPE OF WORK DID YOU DO IN THIS POSITION? <br />Record the type of work performed in position. <br />44. WHEN DID YOU BEGIN AND END THIS JOB? <br />Record the year or work began and the year work ended. <br />~ecial Insu uctions: If the person can't remember how long they worked in [he position, prompt <br />them with the following: less than one year, one to five years, six to ten years, ten or more years. <br />S~P~ial Instructions: Repeat Questions 41-44 to obtain worts history. The Health Department <br />needs this information for the last 3 jobs held by the person with a cancer diagnosis. <br />Recreational Hazards (related to cancer victinc) <br />45. DOES YOUR «PERSON» PARTICIPATE IN ANY RECREATIONAL ACTIVITIES <br />OR HOBBIES THAT EXPOSE THEM TO ANY CHEMICALS? <br />Select YES or NO based on the response. <br />Special Instructions: Prompt interviewee with the following examples: dark room for <br />photography, woodworking shop where you finish furniture, etc. <br />46. PLEASE LIST OR DESCRIBE ACTIVITY <br />If yes, record the name or description of the recreational activity in the area provided. <br />47. ADDITIONAL COMMENTS OR NOTES <br />Record any additional comments stated by the interviewee, <br />Page 33 of 47 <br />