title: Are children attending child play areas at risk of infectious diseases? What can be done?
abstract: OBJECTIVE
  Child play areas can pose a risk to children of infectious diseases. The prolonged presence of micro-organisms in the environment has already been established. In order to quantify this risk, specific studies are required when carrying out a risk assessment.
  
  
  METHODS
  In order to assess the microbiological hazard in play areas in Malta, a study was performed during 2005, which consisted of an examination of the hygienic practices carried out in play areas by means of face-to-face interviews; inspections of the premises; environmental sampling and testing, and a study on the awareness and attitudes of parents to risk factors (face-to-face interviews). Follow up studies were performed after recommendations on risk management were provided.
  
  
  RESULTS
  Overall, the hygienic practices in play areas were satisfactory. Of the premises 66% were licensed, 55% of the food handlers were registered, appropriate cooking and cooling facilities were available for most of the premises, temperature control records were available at 80% of premises, 60% were using disinfectant for cleaning play area surfaces and monitoring of refrigerated vehicles was carried out by 60%. There was an overall improvement after recommendations were given. At the first inspection, 67% of the premises were categorized as being fair and 33% as being good. On repeat inspection, after recommendations were made, the grading of the premises were: excellent 7%, satisfactory 33%, good 53% and fair 7%. The results of the environmental swabs taken had low counts of indicator organisms indicating a good overall hygienic condition. Parents stated that 58% of the areas were in good hygienic condition but lacked adequate hand-washing facilities for children. All parents agreed with the importance of hand hygiene and that infectious diseases can be transmitted via contaminated objects and from one person to another.
  
  
  CONCLUSIONS
  An effective control strategy needs to be implemented involving all stakeholders to ensure that effective hygienic practices in play areas are available to protect children from infectious diseases.
authors.affiliation: Disease Surveillance Unit, 37-39 Rue D'Argens, Msida, Malta. charmaine.gauci@gov.mt
authors.forename: Charmaine
authors.initials: C
authors.lastname: Gauci
authors.forename: Doreen
authors.initials: D
authors.lastname: Borg
mesh_terms: D016022:Case-Control Studies; D002648:Child; D002669:Child Welfare; D003141:Communicable Diseases / Q000453:epidemiology* / Q000635:transmission; D004781:Environmental Exposure; D006801:Humans; D006920:Hygiene; D007407:Interviews as Topic; D008319:Malta / Q000453:epidemiology; D010988:Play and Playthings; D011446:Prospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires