| CDE ID | CDE Description | | * 421 | EDRN Participant ID (Go To: 2176) |
| * 2176 | Visit code (Go To: 423) |
| | | Permissible Values (value): | BLN1 (1) |
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| * 423 | EDRN Protocol ID (Go To: 422) |
| * 422 | EDRN Site ID (Go To: 929) |
| * 929 | EDRN Staff ID of the person who collected the data: (Go To: 4562) |
| * 4562 | Date participant was determined to be ineligible:(DD/MM/YYYY) (Go To: 2186) |
| * 2186 | Reason(s) for ineligibility: (Go To: 1097) |
| | | Permissible Values (value): | Participant decided not to participate (10) |
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| | | | Collected less than minimum set of specimens (42) |
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| | | | Participant not monitored by MSCChC (50) |
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| | | | Participant not covered by insurance (51) |
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| | | | Participant was employed at the company for less than 5 years (52) |
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| | | | Participant age is less than 40 or greater than 79 (53) |
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| | | | Participant is unable to undergo therapy if diagnosed through this protocol (54) |
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| | | | Participant has a prior history of mesothelioma (55) |
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| | | | Participant began work at the company after 2000 (56) |
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| | | | Participant was not exposed to asbestos (57) |
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| | | | Other, specify: (97) (Go To: 2184) |
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| * 2184 | Reason for ineligibility (Other, specify): (Go To: 1097) |
| 1097 | Comments (do not include any participant identifiers) (Go To: End of Form) |