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

Danielle N. Medgyesi, John M. Brogan, Daniel K. Sewell, Jean Philippe Creve-Coeur, Laura H. Kwong and Kelly K. Baker
Additional contact information
Danielle N. Medgyesi: Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
John M. Brogan: Terre des Hommes, 1006 Lausanne, Switzerland
Daniel K. Sewell: Department of Biostatistics, College of Public Health, University of Iowa, Iowa City, IA 52242, USA
Jean Philippe Creve-Coeur: Terre des Hommes, Port-au-Prince 6111, Haiti
Laura H. Kwong: Department of Civil and Environmental Engineering, Stanford University, Stanford, CA 94305, USA
Kelly K. Baker: Department of Occupational and Environmental Health, College of Public Health, University of Iowa, Iowa City, IA 52242, USA

IJERPH, 2018, vol. 15, issue 8, 1-21

Abstract: 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.

Keywords: children’s health; environmental exposure; diarrheal disease; sanitation; solid waste; quantitative behavioral research; non-dietary ingestion; mouthing; public domains; Haiti (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (4)

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