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