Childrens' touching and mouthing behaviors during outdoor play in urban residential yards were measured using video observations. Descriptions were made of childrens' outdoor residential play environments. Behaviors assessed were used to examine (1) validity of parental responses to questions on childrens' oral behaviors and outdoor play and (2) relationships of mouthing behaviors to blood lead levels (BLLs). Thirty-seven children aged 1–5 years were recruited for 2 h of video recording in their yard and blood lead measurement. Video assessments included hourly rates of hand touches to ground/walking-level surfaces (cement/stone/steel, porch floor/steps, grass, and bare soil) and oral behaviors. Parental questionnaires assessed their child's outdoor activities, behaviors, and home environment. The children were: mean 39 months; 51% male; 89% Hispanic; and 78% Medicaid or uninsured. Twenty-two children had a blood lead measured (mean 6 μg/dl). During taping, all children had access to cement, 92% to grass, 73% to bare soil, and 59% to an open porch. Children had frequent touching and mouthing behaviors observed (median touches/h: touches to surfaces 81; hand-to-mouth area (with and without food) 26; hand-in-mouth 7; and object-in-mouth 17). Blood lead was directly correlated with log-transformed rates of hand-in-mouth (Pearson's correlation, r=0.564, n=22, P=0.006) and object-in-mouth (Pearson's correlation, r=0.482, n=22, P=0.023) behaviors. Parental questionnaire responses did not accurately reflect childrens' observed oral behaviors, play habits, or play environment. These data confirm the direct relationship between hand-to-mouth activities and BLLs and fail to validate parental perceptions of their child's mouthing behaviors or outdoor play environment.
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We thank Mavis Brown, Erie Family Health Center, Chicago, IL, for assistance with community recruitment and follow-up and Edwin H. Chen, PhD, University of Illinois at Chicago, School of Public Health, for statistical review. We also thank Fenner Sutton, BS, Supervisor, Illinois Department of Public Health Blood Lead Testing Laboratory, for his assistance with laboratory proficiency testing information. This project was funded by a grant from the US Department of Housing and Urban Development, Grant ILLHR0067-99. Additional research support was provided by the Society for Pediatric Research and American Pediatric Society in the form of a Medical Student Research Program Grant for Dr. Ko.
Dr. Ko is now with the Department of Preventive Medicine, Stony Brook University, Stony Brook, NY and Columbia University School of Public Health, New York, NY. Mr. Schaefer is now with the Department of Communication Studies, University of Iowa, Iowa City, IA. Ms Vicario is now with Consoer Townsend Envirodyne Engineers Inc., Chicago, IL.
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Ko, S., Schaefer, P., Vicario, C. et al. Relationships of video assessments of touching and mouthing behaviors during outdoor play in urban residential yards to parental perceptions of child behaviors and blood lead levels. J Expo Sci Environ Epidemiol 17, 47–57 (2007). https://doi.org/10.1038/sj.jes.7500519
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