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Open AccessArticle

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

1
Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
2
Terre des Hommes, 1006 Lausanne, Switzerland
3
Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
4
Terre des Hommes, Port-au-Prince 6111, Haiti
5
Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(8), 1646; https://doi.org/10.3390/ijerph15081646
Received: 25 May 2018 / Revised: 31 July 2018 / Accepted: 31 July 2018 / Published: 3 August 2018
(This article belongs to the Special Issue Water, Sanitation and Hygiene Related Disease)
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. View Full-Text
Keywords: children’s health; environmental exposure; diarrheal disease; sanitation; solid waste; quantitative behavioral research; non-dietary ingestion; mouthing; public domains; Haiti children’s health; environmental exposure; diarrheal disease; sanitation; solid waste; quantitative behavioral research; non-dietary ingestion; mouthing; public domains; Haiti
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Medgyesi, D.N.; Brogan, J.M.; Sewell, D.K.; Creve-Coeur, J.P.; Kwong, L.H.; Baker, K.K. Where Children Play: Young Child Exposure to Environmental Hazards during Play in Public Areas in a Transitioning Internally Displaced Persons Community in Haiti. Int. J. Environ. Res. Public Health 2018, 15, 1646.

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