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This short 8 multiple-choice question survey is to help gauge the awareness of Respirable Crystalline Silica in residential bricklaying.

Any personal information collected is for prize notification purposes.

3.What is your awareness level of the danger of respirable crystalline silica ? *

4. Do you think respirable crystalline silica exposure is a health risk to Bricklayers? *

Yes

No

5. What is your awareness level of respirable crystalline silica in Bricklaying materials? (e.g. Bricks, Blocks, Mortar?) *

6. What is your awareness level of the danger of respirable crystalline silica ? *

7. What is your awareness of how to reduce exposure to respirable crystalline silica? *

1 - No awareness / Haven’t heard of this

2 - Low awareness / Heard of this but don't know how

3 - Some awareness / Heard of this and know how a little bit

4 - Full awareness / Know how

5 - Expert

8. Are you aware of the WHS requirements for respirable crystalline silica (RCS) on a worksite?

Yes / I'm Aware

No / I'm Not Aware

Name *

Email *

Phone

State *

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