Table of Contents

Component Description

The Taste and Smell examination component (variable name prefix CSX) was a new health examination component first conducted in 2012 in the second year of the NHANES 2011-2012 cycle. Since only 1-year (2012) of data collection was performed, it is a restricted access dataset with the NCHS Research Data Center (RDC). NHANES previously collected health examination data on most other special senses, including vision, hearing, balance, and peripheral nerve sensation; however, this was the initial NHANES health examination data collection for the senses of taste and smell.

Study Aims:
• To provide reference data for taste and smell testing for U.S. adults ages 40 years and over;
• To examine variations in the ability to smell and to taste salt and bitter tastants and analyze these variations with NHANES hypertension, nutritional, and obesity data; and
• To help estimate the prevalence of U.S. adults who may not recognize the odor of smoke and natural gas, which are important early warning signals for home safety hazards.

The NHANES Taste and Smell examination component was proposed and sponsored by the National Institute on Deafness and Other Communication Disorders (NIDCD) and co-sponsored by the Centers for Disease Control and Prevention.

Eligible Sample

A full sample of adult participants of both genders aged 40 years and over. Women who were currently pregnant (had either self-reported pregnancy or positive urine pregnancy test) or currently breastfeeding were excluded from the taste and smell examination. Participants who were unable to provide a correct ordinal ranking of the three light intensity standards on the gLMS scale were excluded from taste testing, but not from smell testing.

While quinine is an approved U.S. Food & Drug Administration beverage flavoring, quinine allergy, especially skin hypersensitivity reactions, are well documented in the medical literature (AHFS, 2011; Barr et al., 1990; Bel et al., 2009; González et al. 2002, Kanny et al. 2003). While such reactions are thought to be uncommon, any person with a prior history of allergy to quinine in medicines or beverages was excluded from quinine taste testing. Specifically, participants who answered yes to the quinine allergy question, stated they did not know, or refused to answer the question were excluded from quinine taste testing, but not from any other part of the Taste and Smell examination.

Protocol and Procedure

The examination protocol content and sequence is illustrated in the flow diagram in Appendix A. The detailed examination procedures are described in the online NHANES Taste and Smell Examination Component Manual. The exam was performed in the following sequence:

Pre-Exam Procedures:

The participant first answered a short pre-exam questionnaire. This included the two exclusion questions and a short series of questions to screen for certain conditions, such as current nasal symptoms present at the time of the exam. This could potentially influence the interpretation of the results of the smell test. This data may help to distinguish temporary from chronic impariment of smell abilities. The nasal symptom questions were not exclusion questions. The pre-examination symptom questions were administered in a “code all that apply” format. Please see the Taste and Smell Examination Procedures Manual, page 4-3 Exhibit 4-3 for an image of the data collection format screen.

Training and Rating on the Perceived Taste Intensity Scale:

Following the pre-exam questionnaire, the participant received a brief introduction to the generalized labeled magnitude scale (gLMS), used for rating perceived taste intensities (Bartoshuk et al., 2004).This is a verbally anchored quasi-logarithmic response scale with a total of 100 units presented as a vertical line graph, which has the labels "barely,” “weak,” “moderate,” “strong,” “very strong,” and "strongest of any kind" spaced at 1, 5, 16, 34, 53, and 100 units, respectively (Bartoshuk et al., 2004; Green et al, 1996). The participant was instructed to let the top value (100) represent the strongest sensation of any kind that they had experienced, including his/her experiences with light, sound, pain, temperature, or taste.

Two standardized light intensities were then presented to the participant (LED luminescence panel; Illumination Technologies, Elbridge, NY) to provide an initial opportunity to practice using the scale (a lower intensity light [CSQ450] and a higher intensity light [CSQ460]). In previous studies, pure tone audiometric stimuli have been used for this purpose; however, for NHANES, light stimuli were chosen for ease of presentation and because deficits in gross light intensity preception are less likely to be affected by aging as opposed to hearing deficits.

Following the brief practice session, the participant then rated the brightness of a standard series of three lights well separated in intensity. A moderate intensity light was presented first [CSQ470], then a dim light [CSQ480], and then a high intensity light [CSQ490] in that fixed order. If the participant rated these three lights in the correct relative order on the gLMS scale, he/she proceeded to the taste exam. If he/she was unable to, then he/she was excluded from taste testing but not smell testing.

Tongue Tip Taste Testing:

The participant was then presented with two tastants: 1 mM quinine as a bitter taste and then 1 M NaCl as a salt taste in that fixed presentation order. Each tastant was gently applied to the the edge of the circle at the tip of the tongue with a cotton swab applicator in a standardized manner so as not to evoke any tactile stimulation. They were asked to keep their tongue out while rating the tastant intensity. Then they identified it as salty, bitter, sour, some other taste, or no taste. The mouth was rinsed with water before proceeding to the next tasant. The participant was asked if they had any lingering taste effect after the water rinse, and if so it was repeated until the taste was extinguished. There was a minimum wait period of 30 seconds between administering tastants.

Whole Mouth Taste Testing:

When tongue tip taste testing was completed, the participant then proceeded to the primary whole mouth taste testing. Here each participant was presented with three tastants, administered in one of two randomized presentation orders: 0.32 M NaCl, 1 mM quinine, 1M NaCl; or 1M NaCl, 1 mM quinine, 0.32 M NaCl. For each tastant, the participant was asked to take all of the 10 ml tastant solution into his/her mouth but not to swallow it. He/she were instructed to gently swish the solution in his/her mouth for 3 seconds, then spit it out. The participant then provided a tastant-specific intensity rating and identified it as salty, bitter, sour, some other taste, or no taste. The mouth was then rinsed using the same procedure as tongue tip taste testing.

The 8-Item Odor Identification Test:

This test was a brief 8-item "scratch and sniff," forced-choice smell test manufactured by Sensonics, Inc. The smell test contained four food-related and four nonfood-related odors, the latter including the odors of smoke and natural gas. The eight specific odors in their fixed order of presentation were: chocolate, strawberry, smoke, leather, soap, grape, onion, and natural gas.

In the kits, the test odorants are embedded in micro-capsules positioned on scent strips on a paper test booklet. The composition of the sents used in the NHANES study were proprietary to the smell test kit manufacturer. The stimuli to be smelled were released by scratching the odor test strips with a plastic stylus in a standardized manner. Then the participant smelled the odor and identified it. Above each odorant strip there was a list of four possible responses. For example, one of the items reads: “This odor smells most like: a) soap; b) black pepper; c) leather; or d) peanut.” The participant was required to choose one of the four choices presented. If the participant stated he/she could not smell any odor when presented with an odorant, he/she was required to choose one of the four alternatives as an answer. The “forced choice” format was employed because it is thought that even in persons with moderate impairments in olfaction; some residual ability to smell may remain even if the individual is unaware of it.

Whole Mouth Replicate Salt Taste Test:

Following odor identification testing, a single replicate whole mouth test of a salt solution was performed. The participant was randomized to receive either a .32 M NaCl or a 1 M NaCl salt solution. The replicate taste testing protocol was identical to the initial whole mouth tasting testing.

Quality Assurance & Quality Control

The NHANES health technicians had initial component training program with expert consultants and survey staff. The training included a didactic overview of the component and demonstrations conducted by the expert examiner with volunteer subjects. Supervised practice exercises followed, again conducted with volunteer subjects. During the 2012 survey, the chief health technician at each of the mobile examination centers monitored staff performance in the field. Health technician performance was also periodically monitored by NCHS staff, data collection contractor Project Officers, and the expert consultants.

The NHANES Taste and Smell Examination Component Manual includes detailed descriptions of the quality assurance and quality control measures that were used in the 2012 data collection. Equipment maintenance and calibration was performed on a routine basis by the health technicians and verified by supervisory staff. Periodic review of examination and calibration data was performed to help verify data collection accuracy.

Data Processing and Editing

All data were captured into a computerized database system, and automatically uploaded. The 2012 NHANES taste and smell examination data was also verified against the main data collection data file. Computerized data editing was performed to check for logical inconsistencies in the data and health technician errors, and to cross-check other issues potentially affecting data quality. Back-end edits of the data were performed as needed when errors were detected. Otherwise, no data values were excluded from the data release.

Analytic Notes

The 2012 Taste and Smell dataset, like other 1-year NHANES datasets is accessible as a restricted access NCHS Research Data Center (RDC) data file. The Taste and Smell examination component was designed as a brief screening examination and was developed during two pilot tests in 2010 and 2011, then fielded in the NHANES 2012 survey cycle midway into the ongoing NHANES 2011-2012 data collection. In the MEC, the average time to complete the Taste and Smell exam was 15 minutes. The tastants and odors for the study were selected by NIDCD and the study consultants. Propylthiouracil taste testing was not included since its status as a prescription medication required special informed consent (Cooper, 2005; Bandyopadhyay et al., 2002; NTP, 2013). However, genetic samples were collected in NHANES 2012, and may become available for future study. The following technical notes are provided for data analysts:

i. Pre-Exam Questions:
After the 2011 Taste and Smell pilot test, a change was planned for one of the Pre-Exam questions relating to nasal symptoms: the variable CSQ260j (had nasal symptoms from a head cold or flu) was scheduled to be replaced by CSQ260n (had a runny nose). This change could not be immediately implemented, so CSQ260j continued in the field until it could be replaced with CSQ260n. Because CSX 2012 is a restricted access dataset, both variables have been retained in the dataset for potential analytic use. Analysts should be aware that neither question was administered to a full set of 2012 participants. Please note that in the NHANES 2011-2012 Spirometry exam dataset, there is a related question available (ENQ100).

ii. gLMS Scale Format:
The gLMS scale format used for tastant ratings was similar to that used in previously (Cruickshanks et. al, 2009); however, it was modified based on piloting experience. To counter label preference bias, the scale graphic was revised. The scale labels were enlarged and were moved farther to the right of the scale’s left border and the horizontal lines projecting from the scale labels were shortened and no longer intersected with the left sided measurement line. Also, the term “imaginable” was dropped from the scale instruction text as the meaning of phrase “the strongest imaginable sensation” was not immediately transparent and unambiguous for many participants.

iii. Exam Exclusions:
Three women who were pregnant or breastfeeding were excluded from the exam. A history of quinine allergy was reported by nine participants (0.7% of participants) and these were excluded only from quinine taste testing. After completing the training on the use of the gLMS scale, 5% of examinees failed to rate the 3 standard light intensities in the correct relative order and were excluded from taste testing. In comparison, in the recently reported results for taste testing in a Wisconsin community epidemiology study where a different gLMS scale training and testing protocol was employed, 15% of participants were excluded from taste testing on the basis that they could not successfully demonstrate correct scale use (Cruickshanks et al., 2009; Fischer et al., 2013).

iii. Participant Tastant Ratings:

When participants were observed to select a gLMS scale label for a taste intensity rating, they were actively coached to consider the entire scale for the tastant rating. However, if they persisted in choosing a scale label value as the intensity rating, then it was accepted and recorded as the result. Analysts should therefore consider scale label choice frequency in data analysis. For primary set of three whole mouth taste tests, 18% of participants chose an exact scale label value for one of the three tests; and another 3% chose two or more exact scale labels in rating the 3 tests. Using a wider label match criterion of ± 2 adjacent scale values, 37% of participants chose one scale label and an additional 34% chose two or more labels in primary whole mouth tastant ratings.

Some participants rated whole mouth tastants at a maximum (100) corresponding to their strongest perceived sensation of any kind. In the 2012 data, 2.5% of participants rated 1 mM quinine at “100.” The percentages for 1 M NaCl and .32 M NaCl were 1.7% and 0.3%, respectively. Health Technicians asked the participants to verify this type of rating when it occurred, and asked them to verify that they were not rating their dislike for or a sense surprise at experiencing a strong taste. However, if the participant persisted in choosing the “100” value, then it was accepted and recorded.

iv. Odor Identification Testing:

The 8-item NHANES odor identification test used in NHANES 2012 is similar in format to other smell test kits currently available and employed scents supplied by the manufacturer. The 8 odors fielded in NHANES 2012 had been previously used in larger smell test panel studies; however, they been not fielded previously as a separate smaller 8-item test. In piloting and in the 2012 data, some test odors appeared more recognizable to participants than others. For example, in the 2012 data, in the subset of 432 participants who correctly identified 7 out of the 8 odors, there were clear odor misidentification differences: 36% misidentified the chocolate odor and 21% misidentified the grape odor; whereas less than 2% of participants misidentified the soap scent or the onion odor.

A wide variety of natural gas odorants are in current commercial use and natural gas suppliers routinely formulate and sell mixtures of odorants to improve natural gas safety warning properties. Methyl mercaptan is a widely used odorant; however, ethyl mercaptan and thiophane are commonly used by LP gas suppliers serving rural U.S. areas (Cain & Turk, 1985). The composition of the natural gas scent used in the NHANES study was proprietary to the smell test kit manufacturer. This fact and the wide variety of natural gas odorants currently in commercial use should therefore be considered by analysts in assessing comparability to other research and in generalizing the results of their studies.

Clinical studies indicate that deficits in the ability to detect smoke or natural gas odors are associated with increased risk of injuries (Bonfils et al., 2008, Santos et al., 2004). The ability of adults in the U.S. to smell natural gas odor was previously described in a large survey (Gilbert and Wysocki, 1987; Wysocki and Gilbert 1988), which used a then commercially available mixture of mercaptans.

v. Exam Component Response Rates:

When the Taste and Smell Examination component was introduced in 2012, it was added to an already full examination schedule for the participants, so on any particular day, eligible participants were assigned to the Taste and Smell exam only if there was remaining time during their MEC examination session. These circumstances significantly reduced overall component response rates: of 2,949 adults ages 40 years screened for participation in NHANES 2012, 1912 were interviewed, 1,818 participated in the NHANES MEC examination and of these, 1,351 had either a complete or a partial Taste and Smell exam. Data analysts may need to consider reweighting the data or other adjustment techniques to account for participant non-response.

vi. Statistical Considerations:

Analysis of NHANES examination data should be conducted using NHANES examination weights. The NHANES Taste and Smell data was collected for a single year (2012) rather than the customary 2-year data collection cycle. The single year MEC examination weight, WTSFM should be used for estimating prevalences and testing statistical hypotheses, and the delete 1 Jackknife method (Wolters, 2007) employing the 1-year MEC examination replicate weights, WTSFM01-WTSF15 should be used for variance estimation. The survey strata and primary sampling unit (PSU) variables should be used to calculate the nominal degrees of freedom of the estimated variance, in order to determine the critical value for the Student’s t statistic used to construct confidence intervals. Please refer to the NHANES Analytic Guidelines and the online NHANES Tutorial for further details on the use of sample weights and other analytic issues.

This RDC dataset contains Taste and Smell exam data for participants ages 40+ years of age, however for proper variance estimation with the complex NHANES survey design, the dataset should be merged with the basic demographic data file variables (including sample weights, strata and PSU variables) for the entire set of NHANES 2012 participants. Then in the statistical analysis program used, the domain of interest is specified in a subpopulation statement as the set of adults ages 40+ years. This is to avoid variance underestimation when sampled PSUs contain no observations in a specific analytic domain. Please see the NHANES Online Tutorial and Lohr, 1999 for further discussion.

vii. Related NHANES Datasets

The NHANES 2011-12 Household Interview questionnaire (CSQ) dataset contains data on self-reported symptoms, risk factors, and medical treatment history for taste and smell disorders. Also the AUQ_G Household Interview Audiometry questionnaire collected 2 additional questions: a history of repeated ear infections (AUQ136) and a history of ear tube placement (AUQ138). Other NHANES 2011-2012 datasets that may be pertinent to the analysis of taste and smell data include the datasets on medical conditions (MCQ, KIQ, DIQ, BPQ); blood sugar (BIOPRO, GHB); blood pressure (BPX); body weight (BMQ, WHQ); diet and nutrition (DTQ, DRXDOC, DSQDOC, DBQ); smoking (SMQ, COTNAL); osteoporosis (OSQ, DXX); oral health (OHXDEN, OHXPER); alcohol (ALQ); and prescription medication use (RXQ_RX).

References

Codebook and Frequencies

SEQN - Respondent sequence number

Variable Name:
SEQN
SAS Label:
Respondent sequence number
English Text:
Respondent sequence number.
Target:
Both males and females 40 YEARS - 150 YEARS

CSXEXSTS - Overall Taste & Smell Exam Status

Variable Name:
CSXEXSTS
SAS Label:
Overall Taste & Smell Exam Status
English Text:
Overall Status for the MEC Taste & Smell Examination
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Complete 1175 1175
2 Partial 176 1351
3 Not done 467 1818
. Missing 0 1818

CSXEXCMT - Taste & Smell Exam Status Comment Code

Variable Name:
CSXEXCMT
SAS Label:
Taste & Smell Exam Status Comment Code
English Text:
Comment Code for the MEC Taste & Smell Examination
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
2 Refused 10 10
3 No Time 63 73
4 Physical Limitation 7 80
5 Communication Problem 8 88
6 Equipment problem 2 90
7 SP ill/emergency 6 96
49 Urine not Collected 5 101
56 Came Late/Left Early 303 404
84 SP with Child 29 433
99 Other 13 446
122 Language Barrier 28 474
. Missing 1344 1818

CSQ245 - Ever had quinine allergy?

Variable Name:
CSQ245
SAS Label:
Ever had quinine allergy?
English Text:
Have you ever had a skin rash or allergy caused by quinine?
English Instructions:
If Yes, DK, Refused, Exclude from quinine
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 9 9
2 No 1307 1316
7 Refused 2 1318
9 Don't know 33 1351
. Missing 467 1818

CSQ241 - Currently pregnant or breast feeding?

Variable Name:
CSQ241
SAS Label:
Currently pregnant or breast feeding?
English Text:
Are you currently pregnant or breast feeding a baby?
English Instructions:
If Yes, DK, Refused, End Exam
Target:
Females only 40 YEARS - 59 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 3 3
2 No 337 340
7 Refused 0 340
9 Don't know 0 340
. Missing 1478 1818

CSQ260a - Sneeze Frequently?

Variable Name:
CSQ260a
SAS Label:
Sneeze Frequently?
English Text:
Do you now have any of the following problems with your nose? Sneeze Frequently?
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 76 76
7 Refused 1 77
9 Don't know 0 77
. Missing 1741 1818

CSQ260d - Have Discolored Nasal Mucus?

Variable Name:
CSQ260d
SAS Label:
Have Discolored Nasal Mucus?
English Text:
Do you now have any of the following problems with your nose? Green, Yellow or Brown Mucus Discharge?
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 36 36
. Missing 1782 1818

CSQ260g - Have Nasal Blockage?

Variable Name:
CSQ260g
SAS Label:
Have Nasal Blockage?
English Text:
Do you now have any of the following problems with your nose? Completely blocked up nose
English Instructions:
If checked, Enable CSQ270
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 96 96
. Missing 1722 1818

CSQ260i - Have Sinus Pain?

Variable Name:
CSQ260i
SAS Label:
Have Sinus Pain?
English Text:
Do you now have any of the following problems with your nose? Sinus Pain?
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 40 40
. Missing 1778 1818

CSQ260j - Have Head Cold or Flu?

Variable Name:
CSQ260j
SAS Label:
Have Head Cold or Flu?
English Text:
Do you now have any of the following problems with your nose? A head cold or flu?
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 20 20
. Missing 1798 1818

CSQ260n - Runny Nose?

Variable Name:
CSQ260n
SAS Label:
Runny Nose?
English Text:
A Runny Nose?
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 126 126
. Missing 1692 1818

CSQ260m - None of the above?

Variable Name:
CSQ260m
SAS Label:
None of the above?
English Text:
Do you now have any of the following problems with your nose? None of the above?
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Checked 1068 1068
. Missing 750 1818

CSQ270 - Type of Nasal Blockage

Variable Name:
CSQ270
SAS Label:
Type of Nasal Blockage
English Text:
Was {your/SPs} nose blocked up on both sides, or on just one side?
English Instructions:
Disabled unless CSQ260g checked
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Yes 44 44
2 No 52 96
7 Refused 0 96
9 Don't know 0 96
. Missing 1722 1818

CSQ450 - Low intermediate light (85 candelas/m2)

Variable Name:
CSQ450
SAS Label:
Low intermediate light (85 candelas/m2)
English Text:
First practice light 85 candelas/ m2 (low intermediate light)
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 1293 1293
. Missing 525 1818

CSQ460 - High intermediate light(439 candelas/m2)

Variable Name:
CSQ460
SAS Label:
High intermediate light(439 candelas/m2)
English Text:
Second practice light 493 candelas/ m2 (high intermediate light)
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Soft Edit: If CSQ430 >= CSQ440, Verify that rating'.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
4 to 100 Range of Values 1293 1293
. Missing 525 1818

CSQ470 - Medium test light (193 candelas/m2)

Variable Name:
CSQ470
SAS Label:
Medium test light (193 candelas/m2)
English Text:
First test light 193 candelas/ m2 (medium light level)
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 1290 1290
. Missing 528 1818

CSQ480 - Low test light (4.3 candelas/m2)

Variable Name:
CSQ480
SAS Label:
Low test light (4.3 candelas/m2)
English Text:
Second test light 4.3 candelas/ m2 (low light level)
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 95 Range of Values 1290 1290
. Missing 528 1818

CSQ490 - High test light (1000 candelas/m2)

Variable Name:
CSQ490
SAS Label:
High test light (1000 candelas/m2)
English Text:
Third test light 1000 candelas/ m2 (high light level)
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 to 100 Range of Values 1290 1290
. Missing 528 1818

CSXQUIPG - Tongue Tip Test: 1 mM Quinine gLMS

Variable Name:
CSXQUIPG
SAS Label:
Tongue Tip Test: 1 mM Quinine gLMS
English Text:
gLMS rating for bitter when 1 mM quinine solution is painted on the tongue tip.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXQUIPT=1,2,3, or 5 and CSXQUIPG = 0, not valid data entry. Hard Edit: if CSXQUIPT = 4 and CSXQUIPG > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 99 Range of Values 1189 1189
. Missing 629 1818

CSXQUIPT - Tongue Tip 1mM Quinine: What Was Taste?

Variable Name:
CSXQUIPT
SAS Label:
Tongue Tip 1mM Quinine: What Was Taste?
English Text:
Name of substance examinee tasted when 1mM quinine was painted on the tongue tip.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 47 47
2 Bitter 492 539
3 Something else 187 726
4 No Taste 389 1115
5 Sour 74 1189
. Missing 629 1818

CSXNAPG - Tongue Tip Test: 1M NaCl gLMS

Variable Name:
CSXNAPG
SAS Label:
Tongue Tip Test: 1M NaCl gLMS
English Text:
gLMS rating when 1M NaCl solution is painted on the tongue tip.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXNAPT=1,2,3, or 5 and CSXNAPG = 0, not valid data entry. Hard Edit: if CSXNAPT = 4 and CSXNAPG > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 1223 1223
. Missing 595 1818

CSXNAPT - Tongue Tip 1M NaCl: What Was Taste?

Variable Name:
CSXNAPT
SAS Label:
Tongue Tip 1M NaCl: What Was Taste?
English Text:
Name of substance examinee tasted when 1M NaCl was painted on the tongue tip.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 1037 1037
2 Bitter 47 1084
3 Something else 45 1129
4 No Taste 24 1153
5 Sour 70 1223
. Missing 595 1818

CSXQUISG - Whole Mouth Test: 1 mM Quinine gLMS

Variable Name:
CSXQUISG
SAS Label:
Whole Mouth Test: 1 mM Quinine gLMS
English Text:
gLMS rating for bitter when 1 mM quinine solution is sampled with the whole mouth.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXQUIST=1,2,3 or 5 and CSXQUISG = 0, not valid data entry. Hard Edit: if CSXQUIST = 4 and CSXQUISG > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 1182 1182
. Missing 636 1818

CSXQUIST - Whole Mouth 1 mM Quinine: What Was Taste

Variable Name:
CSXQUIST
SAS Label:
Whole Mouth 1 mM Quinine: What Was Taste
English Text:
Name of substance examinee tasted when bitter taste 1 (1 mM quinine) was sampled in the whole mouth.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 9 9
2 Bitter 990 999
3 Something else 117 1116
4 No Taste 8 1124
5 Sour 58 1182
. Missing 636 1818

CSXSLTSG - Whole Mouth Test: 1 M NaCl gLMS

Variable Name:
CSXSLTSG
SAS Label:
Whole Mouth Test: 1 M NaCl gLMS
English Text:
gLMS rating for salty taste when 1M NaCl is sampled with the whole mouth.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXSLTST=1,2,3, or 5 and CSXSLTSG = 0, not valid data entry. Hard Edit: if CSXSLTST = 4 and CSXSLTSG > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
3 to 100 Range of Values 1218 1218
. Missing 600 1818

CSXSLTST - Whole Mouth 1 M NaCl: What Was Taste?

Variable Name:
CSXSLTST
SAS Label:
Whole Mouth 1 M NaCl: What Was Taste?
English Text:
Name of substance examinee tasted when 1 M NaCl was sampled in the whole mouth.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 1178 1178
2 Bitter 17 1195
3 Something else 11 1206
4 No Taste 0 1206
5 Sour 12 1218
. Missing 600 1818

CSXNASG - Whole Mouth Test: .32 M NaCl gLMS

Variable Name:
CSXNASG
SAS Label:
Whole Mouth Test: .32 M NaCl gLMS
English Text:
gLMS rating when .32 M NaCl is sampled with the whole mouth.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXNAST=1,2,3, or 5 and CSXNASG = 0, not valid data entry. Hard Edit: if CSXNAST = 4 and CSXNASG > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 1219 1219
. Missing 599 1818

CSXNAST - Whole Mouth .32 NaCl: What Was Taste?

Variable Name:
CSXNAST
SAS Label:
Whole Mouth .32 NaCl: What Was Taste?
English Text:
Name of substance examinee tasted when .32 M NaCl was sampled in the whole mouth.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 1062 1062
2 Bitter 46 1108
3 Something else 54 1162
4 No Taste 26 1188
5 Sour 32 1220
. Missing 598 1818

CSXTSEQ - Whole Mouth Taste Test Sequence

Variable Name:
CSXTSEQ
SAS Label:
Whole Mouth Taste Test Sequence
English Text:
Sequence in which whole mouth taste tests were administered.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
A 1M NaCl, 1mM quinine, 0.32M NaCl 606 606
B 0.32M NaCl, 1mM quinine, 1M NaCl 618 1224
< blank > Missing 594 1818

CSXCHOOD - Smell Test: Chocolate Scent

Variable Name:
CSXCHOOD
SAS Label:
Smell Test: Chocolate Scent
English Text:
Forced Choice Odor Selection, Chocolate Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Lemon 64 64
2 Chocolate 966 1030
3 Smoke 234 1264
4 Black pepper 81 1345
. Missing 473 1818

CSXSBOD - Smell Test: Strawberry Scent

Variable Name:
CSXSBOD
SAS Label:
Smell Test: Strawberry Scent
English Text:
Forced Choice Odor Selection, Strawberry Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Strawberry 1050 1050
2 Garlic 17 1067
3 Leather 242 1309
4 Gasoline 35 1344
. Missing 474 1818

CSXSMKOD - Smell Test: Smoke Scent

Variable Name:
CSXSMKOD
SAS Label:
Smell Test: Smoke Scent
English Text:
Forced Choice Odor Selection, Smoke Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Garlic 65 65
2 Grass 91 156
3 Smoke 1143 1299
4 Peach 44 1343
. Missing 475 1818

CSXLEAOD - Smell Test: Leather Scent

Variable Name:
CSXLEAOD
SAS Label:
Smell Test: Leather Scent
English Text:
Forced Choice Odor Selection, Leather Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Mint 72 72
2 Flower 131 203
3 Leather 1079 1282
4 Apple 61 1343
. Missing 475 1818

CSXSOAOD - Smell Test: Soap Scent

Variable Name:
CSXSOAOD
SAS Label:
Smell Test: Soap Scent
English Text:
Forced Choice Odor Selection, Soap Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Soap 1262 1262
2 Black Pepper 15 1277
3 Leather 34 1311
4 Peanut 32 1343
. Missing 475 1818

CSXGRAOD - Smell Test: Grape Scent

Variable Name:
CSXGRAOD
SAS Label:
Smell Test: Grape Scent
English Text:
Forced Choice Odor Selection, Grape Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Gasoline 71 71
2 Grape 987 1058
3 Rose 245 1303
4 Peanut 40 1343
. Missing 475 1818

CSXONOD - Smell Test: Onion Scent

Variable Name:
CSXONOD
SAS Label:
Smell Test: Onion Scent
English Text:
Forced Choice Odor Selection, Onion Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Chocolate 32 32
2 Strawberry 9 41
3 Onion 1260 1301
4 Fruit Punch 42 1343
. Missing 475 1818

CSXNGSOD - Smell Test: Natural Gas Scent

Variable Name:
CSXNGSOD
SAS Label:
Smell Test: Natural Gas Scent
English Text:
Forced Choice Odor Selection, Natural Gas Scent
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Orange 65 65
2 Cinnamon 71 136
3 Cola 90 226
4 Natural Gas 1117 1343
. Missing 475 1818

CSXSLTRT - Whole Mouth Repeat: 1M NaCl gLMS

Variable Name:
CSXSLTRT
SAS Label:
Whole Mouth Repeat: 1M NaCl gLMS
English Text:
gLMS rating for salty taste when replicate 1M NaCl is sampled with the whole mouth.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXSLTRG=1,2,3, or 5 and CSXSLTRT = 0, not valid data entry. Hard Edit: if CSXSLTRG = 4 and CSXSLTRT > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 615 615
. Missing 1203 1818

CSXSLTRG - Repeat 1M NaCl: What Was Taste?

Variable Name:
CSXSLTRG
SAS Label:
Repeat 1M NaCl: What Was Taste?
English Text:
Name of substance examinee tasted when replicate 1M NaCl was sampled with the whole mouth.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 595 595
2 Bitter 7 602
3 Something else 7 609
4 No Taste 2 611
5 Sour 4 615
. Missing 1203 1818

CSXNART - Whole Mouth Repeat: 0.32M NaCl gLMS

Variable Name:
CSXNART
SAS Label:
Whole Mouth Repeat: 0.32M NaCl gLMS
English Text:
gLMS rating for salty taste when replicate .32 M NaCl is sampled with the whole mouth.
English Instructions:
Hard Edit: if < 0 or > 100, not valid data entry. Hard Edit: if CSXNARG=1,2,3, or 5 and CSXNART = 0, not valid data entry. Hard Edit: if CSXNARG = 4 and CSXNART > 6, not valid data entry.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
0 to 100 Range of Values 603 603
. Missing 1215 1818

CSXNARG - Repeat .32M NaCl: What Was Taste?

Variable Name:
CSXNARG
SAS Label:
Repeat .32M NaCl: What Was Taste?
English Text:
Name of substance examinee tasted when replicate .32 M NaCl was sampled with the whole mouth.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Salty 533 533
2 Bitter 14 547
3 Something else 29 576
4 No Taste 15 591
5 Sour 12 603
. Missing 1215 1818

CSAEFFRT - Participant's Understanding of Test

Variable Name:
CSAEFFRT
SAS Label:
Participant's Understanding of Test
English Text:
MEC Technician's overall rating for participant's understanding of and cooperation with exam procedures.
Target:
Both males and females 40 YEARS - 150 YEARS
Code or Value Value Description Count Cumulative Skip to Item
1 Very good 744 744
2 Good 382 1126
3 Fair 154 1280
4 Poor 62 1342
5 Unable to Cooperate 3 1345
. Missing 473 1818

Appendix A. NHANES Taste and Smell Examination Protocol Flow Diagram

NHANES Taste and Smell Examination Protocol Flow Diagram