Appendix 2: Sample Survey Questionnaire
Telephone questionnaire for environmental survey
Please note that for most of the questions you only enter the codes.
Introduction
READ "Good evening, my name is <name> from <company>, an independent environmental research company. We are currently carrying out research looking at environmental issues in your local community. Could I please speak to a person in your household who is over 18 years old, and whose birthday it is next?"
Once contact is established reintroduce self if necessary and READ:
"The survey only takes five minutes to complete and all your responses will remain totally confidential. Would now be a convenient time, or may I call back later?"
If yes, continue.
If no, make time to call back, and note on summary sheet.
If refused, thank and close, and note on summary sheet.
If asked who the survey is for, READ:
"We need to keep the research as objective as possible, so I can't tell you that straight away. However, I promise that I will tell you at the end of the questionnaire."
If refused, thank and close, and note on summary sheet.
If agree, continue (note on summary sheet). READ:
1a "What do you consider to be the main environmental issues facing your local community at present, if any? By environmental issues I mean things that affect the physical environment like water quality and pollution." Do not read list. Code all mentions.
- Air pollution
- Noise
- Water pollution
- Drinking-water quality
- Sprays/pesticides/herbicides, etc.
- Motor vehicle emissions
- Other (specify)
- Don't know Go to Q2
- None Go to Q2
1b "Of the issues you have mentioned, which do you feel is the most important to your community?" Do not read list. Code one only. Note responses in priority order.
- Air pollution (general)
- Air pollution from industry
- Noise (general)
- Noise from industry
- Water pollution (general)
- Water pollution from industry
- Drinking-water quality
- Sprays/pesticides/herbicides, etc.
- Motor vehicle emissions
- Other (specify)
2a "During spring, do you suffer any effects from plant pollen such as hayfever or allergies?"
- Yes Continue
- No Go to Q3
- Refused Go to Q3
2b "How much of a problem is this for you?" READ OUT all three and rotate order in which they are read out.
- Not very serious
- Somewhat serious
- Very serious
2c "Does this problem require you to take any forms of medication?"
- Yes
- No
- Sometimes
3a "How often do you notice noise from any local industries?" READ and rotate order.
- All the time Continue
- Often
- Sometimes
- Seldom
- Never Go to Q4
3b "To what degree does this noise annoy you? You might want to write this scale down. Do you find this noise ..." READ scale and rotate order.
- Definitely not annoying
- Very little annoyance
- Little annoyance
- Some annoyance
- Annoying
- Quite annoying
- Very annoying
- Extremely annoying
3c "What is the most common source of this noise?" Do not read out.
- Industry
- Parties
- Traffic
- Other (specify)
4a "How often do you notice an odour or smell from industry in or around your home?" READ and rotate order.
- All the time Continue
- Often
- Sometimes
- Seldom
- Never Go to Q5
4b "To what degree does this odour annoy you? Do you find this odour is ..." READ scale and rotate order.
- Definitely not annoying
- Very little annoyance
- Little annoyance
- Some annoyance
- Annoying
- Quite annoying
- Very annoying
- Extremely annoying
4c "What do you think is the most common cause of this odour?" Do not read out. Add appropriate causes, e.g.
- Fertiliser factory
- Sewer line
- Traffic
- Asphalt
- Wool scour
- Fish processing
- Other (Please write it down )
4d "Can you describe this odour?" Do not read out. Add appropriate descriptors, e.g.
- Do not know
- Chemical/acidic
- Sulphur/rotten eggs
- Fertiliser
- Oily
- Fishy
- Coal fire
- Sewer
- Other (Please write it down )
4e "Can you specify the activity that causes this odour?" Do not read out. List relevant local industries:
- Do not know
- Other (Please write it down )
5 "Finally, just a few short questions to finish. What is your occupation?"
- Agriculture/fishery
- Clerical
- Elementary (unskilled)Sales/service
- Homemaker
- Legislation, administration, management
- Plant/machine operators
- Professional
- Technical
- Trade
- Retired
- Study
- Unemployed
6 How old are you?
- 18-19
- 20-24
- 25-29
- 30-34
- 35-39
- 40-44
- 45-49
- 50-54
- 55-59
- 60-64
- 65-69
- 70-74
- 75-79
- 80-84
- 85+
7 "Do you live on the <east> side of <relevant road or local landmark> or on the <west> side of <relevant road or local landmark>." Please write response.
If respondent refuses, assure them that their personal details will not be divulged.
8 Code gender:
- Male
- Female
"Thank you for your time. This research has been conducted on behalf of <client>. If you have any queries you can contact <contact>, collect on <phone>. My name is <name>.
