QUESTIONNAIRE

This questionnaire is designed to study the effects of the air-conditioning system at the workplace.
We are collecting this purely for academic purpose & hence confidentially of your data is assured.

1. Which brand of AC is used in your office?

a)LG
b) Amtrex Hitachi
c) Carrier
d) Bluestar
e)Samsung
2. Have you at any time over the past 12 months experienced discomfort or illness you believe is a result of
poor ventilation or temperature control in your workplace?

YES NO
3. If you experienced air-conditioning discomfort in the past 12 months then please indicate the type of
discomfort. (Circle a number to indicate the severity.1 being the lowest & 5 being the highest severity)
Discomfort Severity

Too Hot 1 2 3 4 5
Too Cold 1 2 3 4 5
Stuffy 1 2 3 4 5
Draughty 1 2 3 4 5
Humid 1 2 3 4 5
Dry 1 2 3 4 5
4. If you experienced illness related to air-conditioning at work, then please indicate the type of illness.
(Tick in the relevant brackets.)
Sore Throat ( ) Nasal congestion ( )
Runny Nose ( ) Fits of coughing ( )
Pains on breathing, shortness of breath ( )
Fever, Chills ( ) Headaches ( )
Muscular ache ( ) Nausea and Vomiting ( )
Malaise ( ) Fits of sneezing ( )
5. Do you think, the above mentioned problems affect your performance level ?
Yes No
6. Amongst following , rate the the effects as per severity of impact in relation to your work performance?
1 being the lowest & 5 being the highest severity
Effect Severity
Psychological Disturbance Effect 1 2 3 4 5
Productivity hampering effect 1 2 3 4 5
Health Effects 1 2 3 4 5

7. How many days off work do you estimate you have taken over the past 12 months as a result of air-
conditioning-related illness? __________________

8. For any of these days, have you applied for:

Sick Leave( )

Workers' Compensation ( )
9. Is organisation planning to Switchover any other brand AC due to these unwanted sideeffects ?
YES NO

10. Which brand will be prefer to switchover by the organisation?

a)LG b) Amtrex Hitachi c) Carrier

d) Bluestar e)Samsung

Name of Participant=
Email ID=
Contact No.=