During the last work week how If you experienced ache, pain, discomfort, If you experienced ache,

often did you experience ache, how uncomfortable was this? pain, discomfort, did this
pain, discomfort in: interfere with your ability of
work?
Never 1-2 3-4 Once Several Slightly Moderately Very Not at Slightly Substanlly
times times ever times uncomfoortable uncomfortabl uncomfertable all interfere interfered
last last y day everyda e d
week week y
Neck V V V
Shoulder
(right) V V V
(left) V V V
Upper back V V V
Upper arm
(Right) V V V
(Left) V V V
Lower back V V V
Forearm
(Right) V V V
(Left) V V V
Wrist
(Right) V V V

(Left) V V V
Hip/buttock
V V V
s
Thigh
 During the last work week how If you experienced ache, pain, discomfort, If you experienced ache,
often did you experience ache, how uncomfortable was this? pain, discomfort, did this
pain, discomfort in: interfere with your ability of
work?
Never 1-2 3-4 Once Several Slightly Moderately Very Not at Slightly Substanlly
times times ever times uncomfoortable uncomfortabl uncomfertable all interfere interfered
last last y day everyda e d
week week y
(right) V V V
(Left) V V V
Knee
(right) V V V
(Left) V V V
Lower leg
(Right) V V V
(Left) V V V