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Listed below are some environmental and social concerns. Please mark the circle that
most closely corresponds to the way you feel about these issues. For example: if you
believe that business and government should place priority on an issue, place a mark in
the “Absolutely Critical” box. If you are not familiar with this issue, then mark the “Not
familiar” box.
Environmental & Social Not at all Slightly Moderatel Very Absolutel Not
Concerns Important Important y Important y Critical Familiar
Important with this
y Issue
1. Asbestos in buildings ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
2. Nuclear waste ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
3. Abortion ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
4. Outdoor air pollution ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
5. Burning waste ○ ○ ○ ○ ○ ○
(incineration) 1 2 3 4 5 0
6. Nuclear power reactors ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
7. Cloning ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
8. Alcoholism ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
9. Chemical pollution in ○ ○ ○ ○ ○ ○
the environment 1 2 3 4 5 0
10. Road Rage ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
11 Crime and violence ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
12. Ozone depletion ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
13. Drug addiction ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
14. Indoor air pollution ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
15. Pesticides in food ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
16. Dioxins ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
17. Tap water pollution ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
18. Food additives ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
Environmental & Social Not at all Slightly Moderatel Very Absolutel Not
Concerns Important Important y Important y Critical Familiar
Important with this
y Issue
19. Traffic congestion ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
20. Cancer ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
21. Medical X-rays ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
22. Tobacco use ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
23. Loss of rainforests ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
24. Lead in paint or water ○ ○ ○ ○ ○ ○
pipes 1 2 3 4 5 0
25. Food irradiation ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
26. Motor vehicle ○ ○ ○ ○ ○ ○
accidents 1 2 3 4 5 0
27. Radon in homes ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
28. Chemical pollutants in ○ ○ ○ ○ ○ ○
the atmosphere 1 2 3 4 5 0
29. Burning fossil fuels ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
30. AIDS ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
31. Street gangs ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
32. High-voltage power ○ ○ ○ ○ ○ ○
lines 1 2 3 4 5 0
33. Bacteria in food ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
34. Climate change ○ ○ ○ ○ ○ ○
1 2 3 4 5 0
Genetic engineering of ○ ○ ○ ○ ○ ○
bacteria 1 2 3 4 5 0
36. Drug-resistant ○ ○ ○ ○ ○ ○
venereal disease 1 2 3 4 5 0
37. Ebola and other rare ○ ○ ○ ○ ○ ○
diseases 1 2 3 4 5 0
Section B
This next section contains statements about dealing with some of the environmental and social
issues. Please indicate how you agree or disagree with each statement.
Classification Items
5. Country you call home? 6. If, American, what state do you call
_______________________ home?_________________________
Thank you very much for taking time to fill out this questionnaire.