School Air Quality Survey for Students

Health and learning problems triggered by poor indoor air quality in schools can vary. It is vital that the student, backed up by a health care professional, work with the facility director in analyzing patterns that may provide clues to the link with indoor air pollution.

A diary or log of symptoms correlated with time and place may prove helpful. Following are some excerpts from the Healthy Schools Network’s survey. For the full questionnaire, with all 11 carefully researched and presented questions, see Shop for Green Guides, below.

School Air Quality Survey for Students

1. Which school do you or your child attend?_______________
   
   ___Room numbers (s) or floors of classes
   
   ___How long attending this school?
   

   
   

2. Air Quality Complaints: Yes_____ No_____
   
   ___Temperature too cold
   
   ___Temperature too hot
   
   ___Lack of air circulation
   
   ___Noticeable odors
   
   ___Disturbing noises
   
   Other (specify)__________
   

   
   

3. Health Problems or symptoms:
   

   ___Aching Joints
   
   ___Discolored Skin
   
   ___Dizziness
   
   ___Hearing Disturbances
   
   ___Sneezing
   
   ___Skin irritation, itching
   
   ___Headaches
   
   ___Nausea
   
   ___Irritability
   
   ___Respiratory problems
   
   ___Numbness
   
   ___Chest tightness
   
   ___Hoarseness
   
   ___Fatigue/drowsiness/weakness
   
   ___Back pain
   
   ___Problems with contact lenses
   
   ___Heartburn
   
   ___Throat sore or dry
   
   ___Sinus congestion
   
   ___Dry, flaking skin
   
   ___Concentration Difficulties
   
   ___Eye irritation or burning
   
   ___Muscle twitching
   
   Other health problems or symptoms (Specify)____________