[ Environmental Risk Analysis ]

Environmental Risk Analysis

Student Survey

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Survey # ______	Date of Survey: ____________________
Name of Participant:______________________________		Age:_____	Sex:_____
Survey conductor:________________________________
Carefully read the list of potential hazards.
Determine the level of risk that you believe is associated with each hazard in your community.
Use this scale:
	0 means you believe that this hazard poises no perceivable risk to your community.
	1 means you believe that this hazard poises a low-risk to your community.
	2 means that you believe that this hazard poises a medium-risk to your community.
	3 means that you believe that this hazard poises a high-risk to your community.

Type of Hazard	Hazard	Perception of Risk	Comments
Biological	disease-causing bacteria
Biological	disease-causing viruses
Biological	sexually transmitted diseases
Biological	pollen
Biological	parasites
Biological	animals (including insects)
Chemical	harmful chemicals in the air
Chemical	harmful chemicals in the water
Chemical	harmful chemicals in food
Chemical	harmful chemicals in living environment
Chemical	harmful chemicals in working environment
Physical	ionizing radiation (human sources)
Physical	ionizing radiation (natural sources)
Physical	noise
Physical	odors
Physical	fires
Physical	floods
Physical	drought
Physical	tornados
Physical	hurricanes
Physical	landslides
Physical	extreme temperatures
Physical	earthquakes
Physical	volcanoes
Cultural	unsafe working conditions
Cultural	living conditions
Cultural	smoking
Cultural	diet
Cultural	drugs
Cultural	drinking
Cultural	criminal assault
Cultural	unsafe sex
Cultural	poverty
Cultural	over-population/crowding
Cultural	economic instability

The Integrating Technology into Science Instruction webpages project is partially funded by grants from The Boeing Company and The Ralph M. Parsons Foundation. Integrating Technology into Instruction is a project of Target Science (target@laep.org) and is displayed on the Los Angeles Educational Partnership Learning Exchange. Target Science is an initiative of the Los Angeles Educational Partnership.
Updated August 2000