Building Occupants

Research on Evacuating Persons with Mobility Impairments:

Questionnaire for Occupants with Mobility Impairments

Purpose

This questionnaire is being conducted by the National Institute of Standards and Technology (NIST), an agency of the U.S. Department of Commerce.

The efficient evacuation of people from fire in a high-rise building is a critical concern both for existing buildings and for the design of new buildings. It is particularly important to address the needs of people who have difficulties evacuating quickly during a fire emergency. Elevators may assist in solving this problem if their safety is trusted. The focus of this research is to gain an understanding of the knowledge, views, and experiences of people with mobility difficulties regarding fire evacuation using elevators. The outcome will be guidance to designers and building managers on aspects of fire evacuation that concern occupants with mobility impairments and on how to improve elevator design and usage during fire emergencies.

This questionnaire will ask you for basic information on your mobility with regard to evacuation, your previous evacuation experiences, and your preferences on how to evacuate during a fire emergency. At the end of the questionnaire, you will be asked whether you would be willing to discuss these issues in more detail in a one-on-one interview with a member of the research team.

Completing this questionnaire is voluntary, and you may choose not to answer any specific question. Your assistance will be greatly appreciated to help improve the safety of high-rise building occupants.

Background

1. How many floors are in the building you work in? ____

2. What floor do you work on? ____

3. How long have you worked in the building? ____ (years)

4. During a normal workday, how do you move vertically from the main floor to your workplace?

• Stairs

• Elevator

• I work on the main/ground floor

5. Please tell us about your everyday mobility on stairs, inside or outside of the workplace. Without assistance from another person but with the use of any mobility aid you normally use (crutches, cane, etc.), how many stairs can you go up or down?

(Please choose the appropriate response for each item)

	Yes, easily	Yes, but with some difficulty	Yes, but with great difficulty	Not at all
A few steps?
One flight of stairs?
2 to 3 flights of stairs?
4 or more flights of stairs?

(For this research, a flight of stairs is defined as the stairs that lead from one floor to the next, even if they are in two sets.)

6. Please indicate which of the following mobility aids you use daily in your workplace:

• Crutches

• Cane/walking stick

• Wheelchair

• Other Please specify ________________________

• None of the above

7. How long have you been using one or more mobility aids? (Please select one.)

• Days

• Weeks

• Months

• Years

8. Do you require assistance during fire evacuations? (Please select one.)

• Always

• Often

• Sometimes

• Never

Demographic Information

9. What is your age? (Please select one.)

• 0-25

• 26-35

• 36-45

• 46-55

• 56+

10. Are you? Male ___ Female ___

Fire Evacuation Experience – Within the Past Year

11. Has the fire alarm sounded in your building within the past year? Y/N/Can’t recall

12. Was there any instance within the past year in which you:

(Please select all that apply)

• Relocated to a staging area to wait for help

• Relocated to a refuge area for the duration of the incident (i.e., formal area of refuge, horizontal exit, remaining inside the stairwell)

• Left your floor

13. Within the past year, have you had to leave your floor during a fire drill or a real fire emergency? Y/N/Don’t recall

1. Think about the time or times you left your floor. How did you travel?

(Please mark all that apply)

• Stairs without assistance from another person

• Stairs with assistance

• Stairs using evacuation device (e.g., stair descent device, mechanical lift, evacuation chair)

• Elevator without assistance from another person

• Elevator with assistance

• Other Please describe _____

2. Were you able to select the method of evacuation? Y/N/Can’t recall

3. Between how many floors did you have to travel?

(For multiple evacuations, please mark all that apply)

___ 1 floor

___ 2 to 4 floors

___ 5 or more floors

Fire Evacuation Training

14. Have you received some form of training on the building fire evacuation procedures within the last year? This can include fire drills. Y/N/Don’t recall

Fire Evacuation Preferences

15. What are your preferred methods for responding to a fire emergency in rank order (from 1=most satisfactory to 9=least satisfactory):

___ Using stairs without assistance from another person

___ Using stairs with assistance

___ Using stairs using evacuation chair

___ Using elevator without assistance from another person

___ Using elevator with assistance

___ Remaining on the same floor

___ Other Please describe _________________________________

Request for Participation

16. Would you be willing to participate in a face-to-face or phone interview about your emergency experiences in buildings? Y/N

    1. If yes, please provide your contact information:

Name _____________________________

Phone ____________________________

Email _____________________________

NOTE: This collection of information contains Paperwork Reduction Act (PRA) requirements approved by the Office of Management and Budget (OMB). Notwithstanding any other provisions of the law, no person is required to respond to, nor shall any person be subject to a penalty for failure to comply with, a collection of information subject to the requirements of the PRA unless that collection of information displays a currently valid OMB control number. Public reporting burden for this collection is estimated to be 15 minutes per response, including the time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed and completing and reviewing the collection of information. Send comments regarding this burden estimate or any aspect of this collection of information, including suggestions for reducing this burden, to the National Institute of Standards and Technology, Attn: Kathryn Butler, kathryn.butler@nist.gov, 301-975-6673.

OMB Control No. 0693-XXXX

Expiration Date: XX-XX-XXXX