SELF-ADMINISTERED QUESTIONNAIRE

1. Name:__________________________
2. Age:_____
3. Gender:
Male Female
4. Nature of work:

Solid Waste Worker Office worker

5. Years of service:
0-2 3-5 6-8 Specify: ____
6. If Solid Waste Worker, what are the Protective Equipments
being used?
Gloves Boots Safety Goggles Hard Hat Mask None
7. Frequency of used of protective equipments:
Always Often Sometimes Seldom Never