A meta-analysis of children's object-to-mouth frequency data for estimating non-dietary ingestion exposure

Xue, Jianping; Zartarian, Valerie; Tulve, Nicolle S.; Moya, Jacqueline; Freeman, Natalie; AuYeung, Willa; Beamer, Paloma I.

doi:10.1038/jes.2009.42

Cited by 58 publications

(54 citation statements)

References 15 publications

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“…The main sources of lead exposure in these studies were possibly lead-based paint and lead-contaminated house dust, air and soil, which affect younger children more than older ones due to infants and toddlers' mouthing behaviour. As age increases, both indoor and outdoor object-to-mouth frequencies decrease (Xue et al 2010).…”

Section: Discussionmentioning

confidence: 97%

Effect of dietary calcium intake on lead exposure in Inuit children attending childcare centres in Nunavik

O’Brien

Gagné

Vaissière

et al. 2014

International Journal of Environmental Health Research

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High blood lead levels (BLLs) can be found in Inuit from Nunavik. At the same time, various nutrients such as calcium could lower lead absorption and toxicity. We examined the effect of dietary calcium intakes on BLLs in 245 preschool Inuit children attending childcare centres in Nunavik. Calcium intake was assessed with one 24-h dietary recall and BLLs were determined by inductively coupled plasma mass spectrometry in whole blood samples. Multiple imputation was performed to deal with missing data. Median blood lead concentration was 0.08 μmol/L. A high proportion of children did not meet the Estimated Average Requirement for vitamin D intake (73 %) and, to a lower extent, for calcium (20 %). Calcium intake was negatively associated with BLLs (p = 0.0001) while child's age and energy intake were positively associated with BLLs (p = 0.015 and p = 0.024, respectively). Consuming traditional foods rich in calcium as well as milk and alternatives may protect against lead exposure.

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Section: Discussionmentioning

confidence: 97%

Effect of dietary calcium intake on lead exposure in Inuit children attending childcare centres in Nunavik

O’Brien

Gagné

Vaissière

et al. 2014

International Journal of Environmental Health Research

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“…Our team agreed that recording every mouthing contact was possible with reasonable accuracy, since it was a less rapid behavior and thus recorded every object contact with the mouth. Similar to previous methods, observers recorded a contact even if the same portion of the object had previously entered the mouth [21,30]. …”

Section: Methodsmentioning

confidence: 99%

“…Subsequent and frequent hand-to-mouth behaviors result in ingestion of fecal microbes and potentially pathogens, on the hands [21,26,27,28,29]. In addition, children can directly ingest pathogens by placing contaminated objects in their mouth or directly eating soil contaminated by pathogens [21,25,30,31]. Hand-to-mouth contacts in the household may result in even greater ingestion of feces than consuming unclean drinking water [20], indicating non-dietary ingestion during play may be an important pathway for diarrheal disease in young children.…”

Section: Introductionmentioning

confidence: 99%

Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

Medgyesi

Brogan

Sewell

et al. 2018

IJERPH

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Globally, gastrointestinal (GI) infections by enteric pathogens are the second-leading cause of morbidity and mortality in children under five years of age (≤5 years). While GI pathogen exposure in households has been rigorously examined, there is little data about young children’s exposure in public domains. Moreover, public areas in low-income settings are often used for other waste disposal practices in addition to human feces, such as trash dumping in areas near households. If young children play in public domains, they might be exposed to interrelated and highly concentrated microbial, chemical, and physical hazards. This study performed structured observations at 36 public areas in an internally displaced persons community that has transitioned into a formal settlement in Haiti. We documented how often young children played in public areas and quantified behaviors that might lead to illness and injury. Children ≤5 years played at all public sites, which included infants who played at 47% of sites. Children touched and mouthed plastic, metal and glass trash, food and other objects from the ground, ate soil (geophagia) and drank surface water. They also touched latrines, animals, animal feces and open drainage canals. Hand-to-mouth contact was one of the most common behaviors observed and the rate of contact significantly differed among developmental stages (infants: 18/h, toddlers: 11/h and young children: 9/h), providing evidence that children could ingest trace amounts of animal/human feces on hands that may contain GI pathogens. These findings demonstrate that water, sanitation and hygiene interventions could be more effective if they consider exposure risks to feces in public domains. Furthermore, this research highlights the need for waste-related interventions to address the broader set of civil conditions that create unsafe, toxic and contaminated public environments where young children play.

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“…age 26; 28; 31–34; 41; 42 , gender 29; 31; 34 and location 29; 33; 34; 41; 42 may affect children’s mouthing frequency and/or duration. Moreover, the pacifier is a specific object which younger children mouth regardless of time of day.…”

Section: Introductionmentioning

confidence: 99%

Mouthing activity data for children aged 7 to 35 months in Taiwan

Tsou

Özkaynak

Beamer

et al. 2014

J Expo Sci Environ Epidemiol

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Young children’s mouthing activities thought to be among the most important exposure pathways. Unfortunately, mouthing activity studies have only been conducted in a few countries. In the current study, we used videotaping and computer-based translating method to obtain mouthing activity data for 66 children aged 7 to 35 months old in Taiwan. The median indoor hand-to-mouth and object-to-mouth frequencies were 8.91 and 11.39 contacts h−1, respectively. The median indoor hand-to-mouth and object-to-mouth hourly contact durations were 0.34 and 0.46 min h−1, respectively. The indoor object-to-mouth activities were significantly and negatively correlated with age. Children aged 12 to <24 months in the current study had lower indoor hand-to-mouth and object-to-mouth frequencies than children of same age group in the United States. We also found that indoor mouthing duration with pacifier was significantly and negatively correlated with indoor mouthing duration with other non-dietary objects. The results of the current study indicate that the mouthing behaviors might be different between different countries or populations with different ethnic or lifestyle characteristics. We conclude that using hand-to-mouth frequency values from the current literature may not be most reliable for estimating non-dietary exposures of young children living in Taiwan or even in other similar Asian countries.

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A meta-analysis of children's object-to-mouth frequency data for estimating non-dietary ingestion exposure

Cited by 58 publications

References 15 publications

Effect of dietary calcium intake on lead exposure in Inuit children attending childcare centres in Nunavik

Effect of dietary calcium intake on lead exposure in Inuit children attending childcare centres in Nunavik

Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti

Mouthing activity data for children aged 7 to 35 months in Taiwan

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