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

To improve estimates of non-dietary ingestion in probabilistic exposure modeling, a meta-analysis of children's object-to-mouth frequency was conducted using data from seven available studies representing 438 participants and approximately 1500 h of behavior observation. The analysis represents the first comprehensive effort to fit object-to-mouth frequency variability and uncertainty distributions by indoor/outdoor location and by age groups recommended by the US Environmental Protection Agency for assessing childhood exposures. Weibull distributions best fit the observed data from studies with no statistical differences, and are presented by study, age group, and location. As age increases, both indoor and outdoor object-to-mouth frequencies decrease. Object-to-mouth frequency is significantly greater indoors (2-32 contacts/h) than outdoors (average 1-9 contacts/h). This paper compares results to a similar hand-to-mouth frequency meta-analysis. Children who tend to mouth hands indoors also tend to mouth hands outdoors; children who tend to mouth objects indoors tend to mouth objects outdoors. However, children who tend to mouth objects do not necessarily have a tendency to mouth hands. Unlike for hand-to-mouth frequency, a statistical difference was found among the various studies for object-to-mouth frequency. This could be due to different definitions for object mouthing across the studies considered. The analysis highlights the need for additional object-to-mouth data (indoors and especially outdoors) for various age groups using standardized collection and analysis.

The fraction of total hand surface area involved in young children's outdoor hand-to-object contacts.

Information on the fraction of total hand surface area touching a contaminated object is necessary in accurately estimating contaminant (e.g., pesticides, pathogens) loadings onto the hands during hand-to-object contacts. While several existing physical-stochastic human exposure models require such surface area data to estimate dermal and non-dietary ingestion exposure, there are very limited data sets. This paper provides statistical distributions of fractional surface areas (FSAs) for children's outdoor hand contacts. These distributions were constructed by combining information collected from two distinct studies exploring children's activity patterns and quantifying hand contact surface area. Results show that for outdoor contacts with "All Objects", a range of 0.13-0.27 captured median FSAs, while a range of 0.12-0.24 captured time-weighted FSAs. Overall, an FSA of 0.31 captured 80-100% of FSAs involved in each child's outdoor hand contacts, depending upon the object of interest. These values are much lower than the often conservative assumptions of up to 1 (i.e., the entire hand) that researchers currently make regarding FSAs involved in indoor and outdoor contacts [USEPA, 1997. Standard operating procedures (SOPs) for residential exposure assessments. Contract no. 68-W6-0030. http://www.epa.gov/pesticides/trac/science/trac6a05.pdf].

Quantified activity pattern data from 6 to 27-month-old farmworker children for use in exposure assessment.

This study was conducted to describe exposure prone behaviors of infants and toddlers in the farmworker community. Analysis of hand and mouth contact frequencies and durations aids understanding of how children interact with their environment and are exposed via contact with surfaces. All 23 participating children (8 female infants, 5 male infants, 5 female toddlers and 5 male toddlers) lived with at least one farmworker. Children were videotaped at home for 2-6 h. Video footage was translated into micro-level activity time series (MLATS) for both hands and the mouth. MLATS were processed to calculate hourly duration in microenvironments, contact frequency, hourly contact duration and median contact duration. The median hourly duration spent indoors was 53 min/h. The median hand-to-mouth frequency was 15.2 events/h and the median object-to-mouth frequency was 27.2 events/h. The hourly mouthing duration was 1.2 and 2.2 min/h with the hands and objects, respectively. The median mouthing duration with hands and objects was 2 s. The median contact frequency for both hands combined was 689.4 events/h with an hourly contact duration of 100.5 min/h and a median contact duration of 3s. Infants had higher mouthing frequencies with non-dietary objects while toddlers had higher mouthing frequencies with objects associated with pica (i.e., paper). Boys had higher contact frequencies while girls had longer contact durations. These sub-group differences indicate factors such as age and gender should be accounted for when conducting exposure assessments. Contact frequencies in this study are higher than current US EPA recommendations, questioning their protective value for infants and toddlers.

Young children's hand contact activities: an observational study via videotaping in primarily outdoor residential settings.

Microlevel activity time series (MLATS) data were gathered on hand contact activities of 38 children (1-6 years old) by videotaping in primarily outdoor residential environments. The videotape recordings were then translated into text files using a specialized software called VirtualTimingDevicetrade mark. Contact frequency (contacts/h), duration per contact (s/contact), and hourly contact duration (min/h) were summarized for outdoor hand contacts with 15 distinct object/surface categories ("Animal", "Body", "Clothes/Towels", "Fabric", "Floor", "Food", "Footwear", "Metal", "Non-dietary Water", "Paper/Wrapper", "Plastic", "Rock/Brick", "Toys", "Vegetation/Grass", and "Wood") and two aggregate object/surface categories ("Non-dietary objects/surfaces" and "Total objects/surfaces"). For outdoor both hand contacts with "Total objects/surfaces", contact frequencies ranged from 229.9 to 1517.7 contacts/h, median durations/contact ranged from < 1 to 5 s, and hourly contact durations ranged from 42.6 to 102.2 m/h. The data were analyzed for significant differences in hand contact activities as a function of (1) age, (2) location, (3) gender, and (4) hand. Significant differences (P < or = 0.05) were found for all four factors analyzed. Hourly contact durations with "Non-dietary objects/surfaces" and "Total objects/surfaces" increased with age (P = 0.01, rs = 0.42 and P = 0.005, rs = 0.46, respectively), while contact frequencies and hourly contact durations with "Wood" decreased with age (P = 0.02, rs = -0.38 and P = 0.05, rs = -0.32, respectively). Location was found to affect contact frequencies and hourly contact durations with certain objects/surfaces. For example, contact frequencies and hourly contact durations with "Fabric" were higher indoors (P = 0.02 for both), while contact frequencies and hourly contact durations with "Vegetation/Grass" were higher outdoors (P = 0.02 and P = 0.04, respectively). Girls had longer hourly contact durations with "Footwear" (P = 0.02), "Non-dietary objects/surfaces" (P = 0.03), and "Total objects/surfaces" (P = 0.01) than boys. The right hand had longer hourly contact durations with objects that are often manipulated with the hand (e.g., "Toys" (P = 0.0002)), while the left hand had longer hourly contact durations with passively touched objects/surfaces (e.g., "Clothes/Towels" (P = 0.003) and "Floor" (P = 0.04)).

Video methods in the quantification of children's exposures.

In 1994, Stanford University's Exposure Research Group (ERG) conducted its first pilot study to collect micro-level activity time series (MLATS) data for young children. The pilot study involved videotaping four children of farm workers in the Salinas Valley of California and converting their videotaped activities to valuable text files of contact behavior using video-translation techniques. These MLATS are especially useful for describing intermittent dermal (i.e., second-by-second account of surfaces and objects contacted) and non-dietary ingestion (second-by-second account of objects or hands placed in the mouth) contact behavior. Second-by-second records of children contact behavior are amenable to quantitative and statistical analysis and allow for more accurate model estimates of human exposure and dose to environmental contaminants. Activity patterns data for modeling inhalation exposure (i.e., accounts of microenvironments visited) can also be extracted from the MLATS data. Since the pilot study, ERG has collected an immense MLATS data set for 92 children using more developed and refined videotaping and video-translation methodologies. This paper describes all aspects required for the collection of MLATS including: subject recruitment techniques, videotaping and video-translation processes, and potential data analysis. This paper also describes the quality assurance steps employed for these new MLATS projects, including: training, data management, and the application of interobserver and intraobserver agreement during video translation. The discussion of these issues and ERG's experiences in dealing with them can assist other groups in the conduct of research that employs these more quantitative techniques.