Items:

1. In the past 12 months, did you mine or extract materials such as [oil, gold, copper, stones, coal...]?

Response Options:
Yes- 1
No- 2

2. Was mining or extracting materials such as [oil, gold, copper, stones, coal...] MAINLY performed…?

Response Options:
For own useconsumption of the household- 1
For sale profit- 2
Wage work- 3

3. In the past 12 months, did you individually make any incomemonetary gains from these activities?

Response Options:
Yes- 1
No- 2

4. What is the approximate share of your individual income that came from …? (include income from selling, trading and handling these materials)

Insert percentage [ ]

5. Have you followed any of the following practices in tandem with your miningoil pumping activities?

• Sold or donated waste rocks to construction sites or other sites for re-use
• Sold or moved tailings to construction sites for re-use
• Used biosolids to replenish depleted topsoil
  Recycled water used during extraction (for further extraction)
• Treated refuse water to neutralize bacterial contaminants
• Discarded refuse to water streams, aquifers or oceans
• Buried refuse on nearby land
• Stripped topsoil to expand mining site

Response Options:
Yes- 1
No- 2

6. Have you experienced any of the following issues in the last 12 months?

• Respiratory disease
• Skin disease
• Liver problems, such as cancer
• Esophagus problems, such as cancer
• Increased incidence of disease among my livestock
• Insect and crustacean plagues affected my livelihood (harvest, catch, etc.)

Response Options:
Yes- 1
No- 2