Report for Defra's Drinking Water Inspectorate (DWI)

Transcription

1 Report for Defra's Drinking Water Inspectorate (DWI)

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3 Executive Summary Research Background Background Research objectives Research methodology Questionnaire and diary design Survey pilot and depth interviews Data processing Weighting and respondent profile Interpretation of data Property characteristics and water use in the home Plumbing Rooms used for making tap water drinks Questions to identify tap water drinks as first draw, random, or flushed Liquid intake estimates Total liquid consumption Total tap water consumption Consumption of boiled and un-boiled tap water Total first draw, random and flushed tap water consumed Types of drinks consumed Total bottled water consumed Appendices A1: Statistical Reliability A2: Recruitment questionnaire A3: Drinking diary A4: Frequently asked question page... 72

4 A5: Example diary screen shots... 77

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7 !" The Department for Environment, Food and Rural Affairs (Defra) Drinking Water Inspectorate, the independent regulator of drinking water quality, commissioned Ipsos MORI to conduct research to measure the tap water and total liquid consumption of children aged under 16 years of age in England and Wales, including the distribution of the volume drunk. This report presents findings from an online survey of the drinking behaviour of 1,241 children aged 0-15 years of age in England and Wales. Fieldwork for the diary was conducted from the 13 th to 19 th May Full details of the background to the research and methodology used can be found in the Research Background chapter. Throughout the report, where differences in results between particular subgroups (for instance, males or a particular age group) are commented on in the text, these are statistically significant, unless otherwise stated. A guide to statistical reliability can be found in Appendix A. Key findings Property characteristics Most parents/guardians of children under 16 (58%) said they live in homes built before It is generally accepted that houses built after 1970 are unlikely to have lead pipes. Indeed, only 18 (4%) of the householders living in properties built after 1970 thought they had lead pipes. While homes built before 1970 are more likely to have lead pipes, very few parents/guardians (6% of all households) said that the pipes which supply their kitchen cold tap are made of lead. However, a third did not know what their pipes are made of (34%), and 18% of all respondents lived in properties built prior to 1970 and did not know the household s plumbing type. This indicates that the proportion of people living in homes with lead pipes (and hence have a greater risk of lead exposure via their tap water) may in fact be higher than 6%. None of the parents/guardians of babies under 12 months of age said they had lead pipes. Use of water in the home The majority of parents/guardians (90%) said their child uses the kitchen cold tap to make drinks or have drinks made for them on a daily basis, while just 2% do not use the kitchen cold tap for making drinks at all. These results are very much in-line with the findings of the 1978, 1995 and 2008 surveys conducted on the subject. One in seven (14%) use the bathroom cold tap daily to make drinks (14%), while a further one in four (23%) do so but less regularly. Slightly fewer (12%) say they use the kitchen hot tap to make drinks every day with a further 9% using the hot tap less frequently. Most parents/guardians (85%) said that, in general, when their child makes drinks or has drinks made for them using tap water in the home, the tap is left running for a period. However, most (61%) say this is just for a few seconds and just 1% run the tap for more than 30 seconds. Households that say they have lead pipes are more likely than those households with pipes made from other materials to run the water for 10 seconds or longer (37%

8 compared to 24%), which may be due to an awareness of the risks posed by lead pipes. A quarter of parents/guardians said the first use of the household s water at the start of the day is for making a drink (25%). These findings are consistent with what was found in the 2008 survey, where around one quarter reported using the first draw water for making drinks (25% in wave one and 23% in wave 2). However, fewer than half (41%) say it is normally the child who consumes this drink. Taken as a proportion of all respondents, in 10% of all households the first use of the home s water is for making a drink for the child 1. Households with children aged 0-5 are most likely to say the first use of water is to make a drink for the child (13% compared to 9% of those aged 6-15). Liquid intake estimates Younger children aged 0-5 consumed the lowest volume of liquid per day, at an average of 800ml. Children aged 6-10 consumed an average of 1,016ml of liquid per day and year olds consumed the most, at 1,333ml. On average, boys consumed more liquid per day than girls (1,124ml compared to 975ml). There was a broad relationship between weight of the child and how much liquid they consumed, with children of a heavier weight generally drinking more. However, it is important to note that there was no direct linear correlation between these two factors, as a relatively high proportion of children fell outside this pattern. There were no significant differences in the mean volume of liquid consumed by children from different regions. Children from social grades C1/C2 consumed the most. Tap water estimates As was the case with total liquid consumption, 0-5 year olds consumed the least tap water per day; an average of 442ml. Children aged 6-10 consumed an average of 560ml of tap water per day and year olds drank the most tap water, at 659ml on average per day. For the sample as a whole, just over half (53%) of the total volume of liquid consumed was formed of tap water. Excluding breast milk, tap water provides the highest proportion of total liquid 2 intake for babies younger than 12 months old (81%). The pattern is more consistent for other age groups, with around half of total liquid intake coming from tap water, ranging from 47% for children aged to 56% of children aged 9 to 11. As with total liquid consumption, on average, boys consumed more tap water per day than girls (591ml compared to 516ml), although the difference is most apparent for children aged 2 to 4 and for children aged between 11 and 13. Children weighing the most, drank the most tap water; those weighing more than 60 kilograms (a sample size of 48) consumed an average of 827 millilitres of tap water 1 It is important to note that the question asked respondents to describe what normally happens in the household, rather than about each individual diary drinking occasion. 2 For children under the age of two, the diary did not record breastfeeding occasions so this is not included in the total liquid consumption figure. It does include cow s milk and formula milk, however. #

9 each day. However, as with liquid consumption, overall there is only a weak correlation between child s weight and volume of tap water consumed. There were no significant differences in the mean volume of tap water consumed by social grade. Those living in the South West of England drank the highest proportion of tap water per day on average, while children living in Greater London drank the least (645ml and 485ml respectively, compared to a total average for all children of 554ml). There were no statistically significant differences between homes with different types of plumbing; children in households with lead pipes consumed an average of 532ml of tap water compared with 554ml for all children. Un-boiled tap water Consumption of un-boiled tap water in the home is much lower for babies aged less than one year of age than any other age group; the daily mean volume consumed among babies aged 0-11 months was 77ml, whereas all other age groups drank at least 300ml per day (rising to 443ml for children aged 14-15). It is worth noting that half (49%) of babies aged 0-11 months drank no un-boiled water. However, if we consider all tap water drinks consumed both inside and outside the home the average volume of un-boiled tap water increases; babies aged under 12 months of age consumed 87ml., while children aged 9-11 and consumed the most (541ml. and 527ml. respectively, compared to 458ml. for all children). First draw water Of the total volume of all tap water drinks consumed over the course of the online diary, 1% were flushed 3, 3% were first draw and the remainder (96%) were random. There are no significant differences in first draw consumption by age group, region, or social grade. One in eleven (9%) of all children drank a first draw drink during the seven days. Again, this does not differ by age or gender. Of those children who did consume a drink containing first draw water, the mean consumption per day of first draw water was 161ml. Children living in properties with lead pipes were more likely to drink first draw water; 17% drank some, compared to 10% of households with other types of pipes 4. The mean consumption of children in homes with lead pipes was 21ml per day, compared to 16ml in households with other types of plumbing. Babies under 12 months old were more likely than other age groups to have consumed more than 201ml of first draw tap water (8% compared to 3% overall). It is worth noting, however, that this represents only 4 babies under 12 months of age (or 8% of the 48 in this age group). 3 Based on the tap having been left to run for at least 30 seconds. 4 This does not include the 34% who say they do not know what material their pipes are made from. $

10 Tap water substitutes (bottled water) Bottled water was much less commonly consumed than tap water. Less than half of all children drank bottled water over the seven-day period (44%). This refers to bottled water as a specific drink, rather than when used to make other drinks year olds were the most likely to drink bottled water (55% compared to 43% of 6-10 year olds and 37% of 1-5 year olds), as were children from social grades A/B (48%) compared to D/E (38%). 5 For instance, for a drink like tea or fruit juice, the diary recorded how much tap water was used but did not ask whether bottled water was used.

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12 )&' In November 2010 the Department for Environment, Food and Rural Affairs (Defra) Drinking Water Inspectorate commissioned Ipsos MORI to conduct research to measure the tap water and total liquid consumption of children aged less than 16 years of age in England and Wales, including the distribution of the volume drunk. This report presents the findings and conclusions from this research. 1.1 Background The Drinking Water Inspectorate (DWI) was formed in 1990 and is the independent regulator of drinking water quality and is responsible for providing guidance on, and enforcing the requirements of the legislation on public water supplies. Among other responsibilities, the Inspectorate aims to build a sound evidence base on drinking water quality and assess any risks posed to the population. The setting of standards and guideline values for drinking water rests on knowledge of the quantities of tap-water that people drink. Information on intakes is equally important when making risk assessments. Certain risks are associated with drinking tap water, which children are particularly sensitive to. It is therefore important that accurate estimates of children s tap water intakes are available to allow a robust estimation of the risks posed. Surveys of tap water consumption have been conducted in , and, most recently, in The 2008 study (a national study of tap water consumption for England and Wales), provided robust data on the consumption patterns of tap water amongst the adult population, but excluded consumption of children under the age of 16 years of age. The 1995 and 1978 surveys, while they included children in their samples, were not designed to measure the drinking habits of children specifically (rather, children were only a small part 9 of the overall sample which aimed to be representative of the overall population). There is therefore a need for an up-to-date and representative survey of children s (aged under 16 years of age) drinking behaviour. The intake of lead is especially important when examining any risk associated with tap water consumption in children. The concentration of lead within a sample of water depends on many factors, two of the most important being whether the plumbing is made of lead and how long the water had been standing in the pipes before the water was drawn. For these reasons, total or average volume of tap water drunk may not be the most useful measure when estimating lead intake. It also needs to be understood how much first draw water from properties with lead pipes is consumed. In this context, first draw water is any water consumed that has been standing overnight in the pipes. The previous study 6 Drinking water consumption in Great Britain - WRc Report TR 137 (Hopkin and Ellis, 1980) 7 Tap Water Consumption in England and Wales : Findings from the 1995 National Survey (see DWI0771 at Pre 2000 research reports) 8 National tap water consumption survey for England and Wales (see pdf DWI 70/2/217 at Research since 2000 DWI UK) 9 The 1995 study included 201 children from a total sample size of 1031 individuals, while the 1978 survey included 842 children under 15 years old from a total sample size of 3,564. (

13 conducted in 1978, explored the volume of first draw tap water consumed and this survey has therefore attempted to provide comparable measures. Surveys in 1995 and 2008 only studied this issue in terms of the numbers of households using first draw water. Of importance to conducting a microbiological risk assessment is to understand how much of the volume of tap water consumed is un-boiled, because boiled water does not present a microbiological risk. 1.2 Research objectives The overall aim of the research is to provide an accurate estimate of tap water and total liquid intake by children under 16 years of age, including the distribution of the volume drunk. The specific objectives of the research are to: Provide an accurate and robust measure of the average total daily liquid intake among children under the age of 16 in England and Wales; Explore whether there has been a change 10 in average tap-water consumption since previous surveys; Provide an estimate of extreme intakes (the upper and lower 5 percentiles); Provide reliable information on differences in consumption patterns across the following sub groups: age, gender, region, socio-economic grade and weight; Understand how much of the total volume consumed is un-boiled; Measure the proportion of water that is first draw water (whether drawing water for a drink was the first use of the day) from properties with lead pipes; Estimate the relative significance of tap water substitutes consumed, with particular attention to bottled water; and Comment on the significance of any trends or changes observed and discuss possible reasons for them. This 2011 study provides a robust evidence-base for the average total daily liquid intake and average tap water consumption of children under the age of 16 living in England and Wales. It also details how much of the total volume consumed is un-boiled and measures the proportion that is first draw, random, or flushed 11. Where possible, any changes from previous studies will be commented on. However, it is important to note that the 1978, 1995 and 2008 studies do not provide a comparable sample and any differences will be indicative only. This is due to the previous surveys using a different methodology (selfcompletion, paper) as well as there being 1.3 Research methodology This study was conducted using Ipsos MORI s online panel (Ipsos Interactive Services IIS) to administer a self-completion seven-day diary. This methodology was chosen as an innovative and cost effective approach to meeting the research objectives, whilst also 10 Differences in survey methodology and sample profiles of these surveys, and the limitations this places on making direct comparisons should be noted. 11 Definitions of first draw, random and flushed are given in the section headed Data processing *

14 providing robust and accurate data. An online approach provided a number of strengths including: An online diary minimised the opportunity for inaccurate and incomplete data, (particularly important given that the target audience was children). o Automatic routing in an online script helped to prevent incomplete responses and ensured that only the correct questions were answered again important when some of the respondents are of a young age. o Limits on the minimum and maximum values for the number of drinks consumed per day and container sizes were also set for what would be an acceptable response. The online-diary also meant that visuals could be shown to provide prompts on the type and size of drink consumed, which helped children to recall what they had drunk whilst also presenting the survey in an interesting and appealing visual appearance suitable for children. Some example drinking diary screen shots are included in the appendix. Additional information was provided in the form of a FAQ page explaining how the diary should be completed and answering any common questions. An online survey allowed response rates to be monitored in real-time, providing immediate feedback on fieldwork progress. In addition to the previous point, using the online panel meant it was easy to send reminders to respondents to complete the diary. Demographic data is held for all panel members, allowing stratification of the sample by key variables (e.g. child s age, gender and region) ensuring a representative sample. 1.4 Questionnaire and diary design The online survey was administered in two stages; firstly an online recruitment questionnaire was completed by the parent/guardian before the online seven day drinking diary was sent to those who completed the recruitment questionnaire. The initial recruitment questionnaire was completed by 3,112 panel members and, of these, 1,241 (40% of all recruited respondents) went on to successfully complete the seven-day diary. In compliance with the Market Research Society (MRS) code of conduct 12, the initial invite to take part in the research was sent to the parent/guardian of the child. The parent or guardian then had the choice of completing the diary on behalf of their child, allowing their child to complete it themselves, or accompanying them while they did so. The initial invite gave the name of the individual child in the home that we wished to take part in the research (rather than allowing the parent select which child would take part). Just one person per household was allowed to take part in the research. This allowed the stratification of the sample by age and gender. 12 The Code states that research with children under the age of 16 years of age must first request the permission of the parent or guardian. +

15 Fieldwork for the initial questionnaire took place between 3 rd and 12 th May 2011, while the diary was conducted from the 13 th to 19 th May The recruitment questionnaire, completed by the adult, collected information on: the year the family home was built; the type of plumbing in the household; which rooms within the home are used to make drinks using tap water; whether the first daily use of tap water in the home ( first draw ) is for making drinks or other uses; the weight and height of the child; and whether or not the adult, child or both would be completing the diary. To aid recall of the drinks consumed each day, respondents were provided with a simplified paper version of the diary (included in the appendices of this report) which could be used outside of the home to record key details of the drinks consumed, before the details were entered into the online diary. At the end of the recruitment questionnaire, respondents were offered the opportunity to have a printed copy of this posted to them in advance of the diary commencing. 1,288 people requested the paper version and this was posted to them before the link to the online diary was sent out. A link to the paper version was also provided at the start of the online diary, so that respondents could print this out themselves to use if they wished. The online diary followed the initial questionnaire as a separate link, ed to the adult (as required by MRS guidelines). This recorded details of every drink consumed each day for seven days, including: day and time the drink was consumed; type of drink consumed (e.g. tap water, squash, tea etc); how much of the drink was tap water (all of it, three quarters etc); whether the tap water was taken from the home or somewhere else; if the drink contained tap water taken from the home, whether the tap water was boiled or not; size of drink container (both in terms of type - i.e. large mug etc as well as giving the size in millilitres); how full the container was; and how much of the drink was consumed. Examples of the initial questionnaire and the diary questions are shown in the appendix along with a FAQ information page. The FAQ page was provided as a link throughout the

16 online diary and gave information about the study and instructions on how to complete the diary. 1.5 Survey pilot and depth interviews A pilot survey was conducted between 2 nd and 8 th March 2011, in order to test the response rates and content, structure and design of the initial questionnaire and the diary. 318 Panel members completed the initial recruitment questionnaire and 130 went on to complete the draft diary (41% of total respondents recruited). This was followed with a series of 12 telephone depth interviews, half of which were with respondents who completed the questionnaire and diary and the other half with people who completed the questionnaire but started and did not complete all seven days of the diary. The depth interviews discussed the content of the recruitment questionnaire, the diary and all other materials provided, such as the FAQ page and paper version of the diary. The interviews discussed comprehension of the questions, recall of behaviour and how respondents went about completing the diary information. For those who did not complete the diary, the interview also covered the reasons why they did not complete it and if anything could have helped them to complete it. The insight gained from these interviews was used to make improvements to the survey design for the main fieldwork. The key findings from the pilot and depth interviews are outlined below: Respondents tended to find the questions in both the questionnaire and diary straightforward and said it was clear what they had to do. In most cases the parent/guardian completed the diary, either on behalf of their child (if very young) or with them. Most parents of very young children knew what their children drank from being with them all day. The paper version of the diary was most useful for parents of children aged 4-8 where the child would generally be at school but might not remember what they had drunk. People tended to fill the diary in on a daily basis before they went to bed or the following day. Although the letter received with the paper diary stated that it should not be completed before respondents received the link to the online diary, one or two respondents were confused and were not sure when they should start completing the diary. An instruction was therefore added in bold at the top of the paper diary for the main fieldwork, asking people not to fill anything in until they had received their link. A limited number of respondents thought they had completed the diary even though they had only completed 6 of the 7 days, as they were unclear about how to submit their final entry (and therefore, the final diary). To rectify an option was added to allow respondents to close out of the link and enter more drinks for that day later, if needed. This helped prevent people from closing the day accidentally and missing some drinking occasions. A clear indicator of when each day had been completed was also added. While all respondents found it straightforward to select a container that best matched the one they used, some were unsure of whether the container they selected was

17 completely accurate, in terms of the size. To help minimise any level of subjectivity, and to allow more accurate measurement of the container type, an example of the size of each container was added. In addition, a text box beside each container type was added so respondents could add the exact size (in millilitres) if they knew it.

18 1.6 Data processing To minimise the length of time it took to complete the diary and so as not to place too considerable a burden on respondents, the diary routing and subsequent data is based on a number of default assumptions, as outlined below: Fizzy drinks, sports drinks and milk-based drinks (not including formula milk) were assumed not to contain tap water, and respondents selecting these drinks were not asked about water content of these drinks The diary measured drinks only and did not include foods to which water is added Bottled water was assumed to be un-boiled Water used to make tea, coffee or hot chocolate was assumed to have been boiled If the respondent selected don t know or can t remember in response to the question asking whether or not the water was boiled, the default assumption was that it was not boiled Standard sizes of containers were set as follows, but respondents also had the option of entering in the exact container size if they knew it and it didn t match any of the measures shown: o Baby/toddler beaker 250ml o Glass/plastic cup (Small 120ml, Medium 350ml, Large 550ml) o Mug/tea cup (Cup 200ml, Mug 275ml) o Carton (Normal size drinks carton (e.g. Ribena carton) 250ml, Large carton (e.g. orange juice) 1,000ml) o Can (Mini 200ml, Normal 300ml) o Baby bottle (Small 115ml or 4 fl oz, Medium 170ml or 6 fl oz, Large 250ml or 9 fl oz) o Bottle (Small (e.g. Fruit Shoot) 200ml, Medium 500ml, Large 1,000ml) Given that plastic bottles may well be re-filled, respondents were instructed to complete a new drink entry if they re-filled their bottle. If bottles were continuously re-filled throughout the day, we advised that respondents should give their best estimate of the number of bottles and to give separate entries for each. Children under 2 years of age were not presented with the options for fizzy drinks, sports drinks, tea, coffee or hot chocolate. They were, however, able to add drinks such as these under the other category. The location of the tap water consumed (i.e. whether the tap water was taken from home or elsewhere) was asked only to dictate whether the first draw question in the initial questionnaire should be applied. It was therefore only asked for drinks containing tap water First draw calculations were taken from the initial questionnaire and diary. For a drink to be considered first draw, the following conditions had to be met: #

19 o The child (or parent) does not normally leave the tap running for at least 30 seconds before making a drink of tap water (code 1-4 at Q7 in recruitment questionnaire) o The first use of the household s water is for a drink (code 1 at Q8 in recruitment questionnaire) o It is normally the child who first uses the household s water (code 1 at Q9 in recruitment questionnaire) o It is the first drink of the day (Q1 in diary) o The drink involved tap water and was consumed at home (code 1 at diary Q4) For a drink to be considered random, the following conditions had to be met: o Any drink of tap water outside the home (diary code 2 at Q4) is random OR The drink involved tap water and was consumed in the home (diary code 1 at Q4) AND the child does not normally leave the tap running for at least 30 seconds (codes 1-4 at Q7 in recruitment questionnaire) AND it is not first draw For a drink to be considered flushed, the following conditions had to be met: o The drink involved tap water and was consumed in the home (diary code 1 at Q4) AND the child normally leaves the tap running for at least 30 seconds (code 5 at Q7 in recruitment questionnaire) It is important to note that the measures of first draw, random and flushed only relate to normal behaviour for each respondent. Rather than asking the questions about running the tap and use of the home s water for every single drinking event (which on average would have been 4 drinks per day and around 30 for the week), the recruitment questionnaire asked about what normally happens in the respondent s home. This approach was taken in order to reduce burden on the respondent and maximise response rate Data cleaning Once the diary fieldwork was complete, a process of data cleaning was carried out and the data was checked for any anomalies in the way it was entered by respondents. For instance, the total liquid consumed for each day was checked to ensure that extreme values were acceptable and that measures were relatively consistent throughout the week. Any respondents aged over two years of age with a total daily liquid consumption of below 100 millilitres (ml.) were removed from the dataset. Of the 1,282 respondents which completed the diary, 41 were removed from the final sample for this reason (leaving a total sample of 1,241). 1.7 Weighting and respondent profile Demographic information held on panel members was used to stratify the sample by key variables including the child s age, gender and region. Quotas were also set on these variables, as well as social grade, before the final data was weighted to the profile of the known population. This ensured that the sample was representative of children under the age of 16 living in England and Wales. $

20 The information below presents the profile - by gender, age, region and social grade - of all 1,241 respondents who completed both the initial questionnaire and the seven-day diary. The charts in this section illustrate both the un-weighted and weighted data to give a picture of how the survey sample differs from the target population. As can be seen from these charts, the profile of the research sample largely reflects the profile of the population of England and Wales. As is standard practice, figures reported in the text of this report are from the weighted data. Gender / age, -. Unweighted Male Female Weighted 49% 50% 51% 50% Under 12 months 12 months - 2 years 3-5 years old 6-8 years old 9-11 years old years old years old 4% 4% 11% 10% 22% 20% 21% 21% 17% 18% 11% 13% 13% 14% Base: 1,241 children aged 0-15 living in England and Wales, diary fieldwork dates 13 th 19 th May

21 Region, Wales North East North West Yorks West Mids East Mids East Anglia South West South East London Unweighted 5% 6% 4% 5% Weighted 13% 13% 10% 10% 10% 10% 9% 8% 12% 11% 8% 10% 16% 15% 12% 14% Base: 1,241 children aged 0-15 living in England and Wales, diary fieldwork dates 13 th 19 th May Social grade, - A/B C1/C2 D/E Refused Unweighted 24% 16% 24% 8% 8% Weighted 33% 43% 45% Base: 1,241 children aged 0-15 living in England and Wales, diary fieldwork dates 13th 19th May %

22 1.8 Interpretation of data Throughout the report, where differences in results between particular subgroups (for instance, males or a particular age group) are commented on in the text, these are statistically significant, unless otherwise stated. A guide to statistical reliability can be found in Appendix A. In table and charts where percentages do not add up to 100 percent, this is due to multiple answers, or to rounding. An asterisk (*) denotes a value greater than zero, but less than 0.5 percent. (

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24 )/ This section of the report presents the findings from the household recruitment questionnaire, completed by parents/guardians. Specifically, this section reports on the questions about plumbing and use of water within the home. 2.1 Plumbing As explained in the Background section of this report, lead is a particularly important aspect of any risk assessment of tap water intakes, particularly when the subjects of the study are children. Some types of water, particularly soft water, can pick up lead from pipes. Infants and children are at particular risk from lead because it can adversely affect their mental development 13. It is therefore important to assess, where possible, the type of material that respondents plumbing is made out of so that the drinking behaviour of children living in properties with lead pipes can be explored. Parents/guardians were asked about the pipes that supply their kitchen cold tap and to consider what sort of material they are made of. As plumbing in some households is made of more than one type of material, respondents were asked to select any that apply for their home. Very few respondents said that the pipes which supply their kitchen cold tap were made of lead (6%). Just under half (46%), on the other hand, said their pipes were made of copper and one in five believe they were made from plastic (22%). Only 3% said their pipes were made from iron. While just 6% say their plumbing uses pipes made from lead, a third of parents/guardians (34%) did not know what the pipes supplying their kitchen cold tap were made from

25 / Q. We would now like to ask you about the pipes which supply your kitchen cold tap. To the best of your knowledge, what sort of material are they made of? Copper 46% Plastic 22% Lead 6% Iron 3% Don t know 34% Base: 1,241 All parents/guardians, fieldwork dates 3rd -12th May 2010 Source: Ipsos MORI None of the parents/guardians of babies under 12 months old said they had lead pipes. Those living in Greater London were more likely than average to have lead pipes (13% compared to 6% overall). Given that it was expected that a significant proportion of people would be unsure what their pipes were made out of, respondents were also asked for the age of their home. Homes built before 1970 and which have not been modernised are more likely to have lead pipes than those built after The majority of parents/guardians said their home was built before 1970 (58%). One in five (19%) said their home was built between 1970 and 1987, and the same proportion (18%) said it was built in 1988 or more recently. Just 6% did not know when their home was built.

26 0 Q. To the best of your knowledge, when was your home built? Don t know 6% 1988 or later 18% % 58% Before 1970 Base: 1,241 All parents/guardians, fieldwork dates 3rd -12th May 2010 Children aged are more likely than average to live in homes built before 1970 (66% compared to 58%). Those living in the North East of England are also more likely to live in homes built before 1970 (73% compared to 58% on average). 18% of all respondents lived in properties built before 1970 and did not know what material their pipes were made out of. This means there is a further proportion of the population beyond the 6% that say they definitely do - that potentially have lead pipes.

27 2.2 Rooms used for making tap water drinks The vast majority of parents/guardians (90%) say their child drinks water taken from the kitchen cold tap on a daily basis, while 7% do so less regularly and just 2% do not use the kitchen cold tap for making drinks at all. These results are very much in-line with the findings of the previous surveys 14 in 1978, 1995 and 2008 (the kitchen cold tap was used by 95%, 95% and 97% respectively). Babies under the age of 12 months are least likely to drink water taken from the kitchen cold tap (7%, compared to 2% of children aged one or older). One in seven (14%) use the bathroom cold tap for this purpose every day, while a further one in four (23%) do so but less regularly. Slightly fewer (12%) say they use the kitchen hot tap to make drinks every day with a further 9% using the hot tap less frequently. For cold and hot taps in other rooms, at least nine in ten say they never use these to make drinks for their child. The results for the kitchen hot tap suggest a slightly higher figure than was found in previous surveys; the proportion using this tap to make drinks was 21% in this survey, compared to 8% in 1978, 10% in 1995, 11% in wave one of the 2008 survey and 12% in wave 2. Over one in five (22%) respondents reported living in a household with a tap which provides boiling water without having to boil it in a kettle. While this may appear a high proportion, it may be that some respondents misunderstood the exact meaning of the question and took it to mean any tap which produces very hot water; as a proportion of all respondents, just 7% have a boiling water tap and use it to make drinks. & Q. Please indicate in which rooms [child] uses the taps to make drinks or drink water from (or has drinks made for him/her). 100% 7 80% 60% 40% 20% 0% Kitchen - cold tap 90 Kitchen - hot tap Kitchen - boiling tap Bathroom- cold tap Bathroom- hot tap Bedroom- cold tap Bedroom- hot tap Utility room - cold tap Utility room - hot tap Other room - cold tap Other room - hot tap Never/not applicable Less than daily Daily (7 days per week) Base: 1,241 All parents/guardians, fieldwork dates 3rd -12th May It should be noted that the previous surveys used different methodologies so the results cannot be considered directly comparable.

28 2.3 Questions to identify tap water drinks as first draw, random, or flushed First use of home s water One of the objectives of this research was to measure the proportion of tap water consumed that is first draw, as well as the proportions that can be considered random and flushed. First draw water is the first water drawn from the tap in the morning after the water has been standing in the pipes overnight 15. This is to assess the extent of the risk posed by any contamination of water though use of lead pipes. The first element of establishing if a tap water drink is first draw, random or flushed is to consider the first use of the home s water supply each day and if it is for drinking or alternative uses. If the household s first use of water is for drinking then the first drink will be classified as first draw, unless the tap was flushed; if the first use is for other purposes (such as washing and cleaning) then the first drink will not be classified first draw. Three quarters of parents/guardians said that, in general 16, when the first person in the house gets up at the start of the day, the first use of the household s water is for a purpose other than making a drink, such as to shower, use the toilet, or to use the washing machine. The remaining quarter use the tap to make a drink first. 1 Q. Thinking about the start of the day when the first person in the house gets up, would you say, in general, the first use of the household s water is for making a drink or other uses? 25% Use the tap to make a drink (before showering, using the toilet/washing machine etc) Use for another purpose first e.g. to shower, use the toilet, washing machine etc 75% Base: 1,241 All parents/guardians, fieldwork dates 3rd -12th May There may be other circumstance where water has been standing in the pipes for a long time (for example, at the end of a working day) but a simpler approach was used for this study in order not to over-burden the respondent. 16 It is important to note that the questions on first use of the home s water and leaving the tap running before making a drink were both asked in a general sense i.e. what normally happens in the home. The responses to these questions are used as a basis for what happens for the diary drinks involving tap water if the respondent answered that the tap is normally left running for 10 seconds, that is considered to be the case for all diary tap water drinks for that individual. #

29 There are no statistically significant differences in first use of household water by different demographic factors. These findings are consistent with what was found in the 2008 survey, where around three quarters reported using the first draw water for purposes other than making drinks (73% in wave one and 74% in wave 2). $

30 Among those who live in a household where the first use of water is to make a drink, two in five (41%) say that it is the child or someone on his or her behalf who normally uses the home s water for the first time to make a drink. When taken as a proportion of all respondents, this equates to 10% of all households where the first use of the home s water is for making a drink and it is the child that normally has the drink. Households where the child is aged 0-5 are most likely to say this use of the water is for the child (50%), followed by households where the child is aged (43%). Those where the child is aged 6-10 are more likely to say that the first use of water for a drink is not for the child (70% compared to 54% of other age groups). 2 Q. And is it [child] (or someone on his/her behalf) who normally uses the home s water for the first time to make a drink? % Yes % No Aged 0-5 Aged 6-10 Aged % 50% 50% 70% 57% 43% Base: 313 parents/guardians where first use of water is to make a drink (121 aged 0-5, 103 aged 6-10, 89 aged 11-15), fieldwork dates 3rd -12th May Leaving the tap running before making drinks The second element of establishing whether a tap water drink is first draw, random or flushed is to consider whether the water has been left to run so that it has not been standing in the pipes for a prolonged period of time. Where there is a confirmed or expected risk of lead in a household s drinking water, the Drinking Water Inspectorate (DWI) state that water should not be drunk that has been standing in the pipes for long periods, such as overnight, or if no one has been at home during the day. In this case, the Inspectorate advises that, before water is drawn for drinking and cooking, the tap should be left running for long enough to fill a kitchen bowl 17. For the purposes of this survey, the water is therefore considered to be flushed only if the tap from which the water was drawn for the drink has been left to run for at least 30 seconds. However, relating this to the Inspectorate s guidance will depend on water pressure, pipework of the particular home and how far the tap is open, so we have also presented alternative measures of consumption of flushed water, based on different periods of time. The majority of parents/guardians (85%) said that, in general, when their child has a drink using tap water in their home the tap is left running for a period of time. Three in five (61%) 17

31 said the tap is left running for just a few seconds. One in five (19%) said it is run for about 10 to 20 seconds and 3% for between 20 and 30 seconds. Only 1% said the tap is left to run for over 30 3 Q. In general, when [child] makes drinks, or has drinks made for him/her using tap water in your home, is the tap left running before making it? Yes - for about seconds Yes - for about seconds Yes - for over 30 seconds 19% 3% 1% 15% No 61% Yes - just for a few seconds seconds. Base: 1,241 All parents/guardians, fieldwork dates 3rd -12th May 2010 The last time this type of question was asked was in the 1978 survey when only 23% reported flushing the tap before use. It is unclear from the 1978 report exactly how the question was phrased (i.e. whether it specified for how long the tap was left to run) and we therefore cannot make a direct comparison. However, the 1978 finding is very similar to the proportion that run the tap for more than 10 seconds in this survey (24%). Those living in the North East (23%) and East Anglia (22%) are the most likely to say that the tap is not left running before it is used to make drinks for the child (compared to 15% overall). Residents of Greater London (32%) and Wales (33%) are more likely than average (24%) to say that the tap is run for 10 seconds or more. Households that say they have lead pipes are more likely than those households with pipes made from other materials to run the water for 10 seconds or longer (37% compared to 24%, which may be due to an awareness of the risks posed by lead pipes. %

32 34 (

33 #)34 This chapter discusses the findings of the drinking diary responses and presents total liquid consumption of children before detailing total tap water consumed and as a proportion of total liquid intake. It goes on to present findings for the volume of un-boiled tap water consumed. Throughout this section any significant differences in findings by age, gender, region and social grade are highlighted. 3.1 Total liquid consumption Based on the responses to the diary, the mean daily volume of total liquid consumed was calculated for each child in millilitres (ml.). The following chart shows how these mean liquid consumption values are distributed for all 1,241 children who took part in the research, broken down into three age groups; 0-5, 6-10 and The mean daily liquid consumed - across all ages - was 1,050ml. Intake rose with age; children aged 0-5 years old consuming the least, with an average of 800ml per day. Children aged 6-10 consumed an average of 1,016ml of liquid per day while year olds consumed the most at an average of 1,333ml. Of children aged under six years of age, the single largest proportion (31%) drank between 501 and 750ml per day. Of children aged six to ten, just over a quarter (26%) consumed between 751 and 1,000ml per day. Liquid consumption among those aged 11 to 15 was more evenly distributed; the highest proportion (22%) drank between 1,001 and 1,250ml of liquid per day )7- Aged 0-5 Aged 6-10 Aged % 30% 25% 20% 15% 10% 5% 0% 4% ml. 18% 8% 1% 2% ml. 31% 18% 10% ml. 20% 26% 751-1,000 ml. 16% 14% 22% 22% 1,001-1,250 ml. 7% 18% 15% 1,251-1,500 ml. 15% 10% 8% 6% 4% 2% 2% 1% 2% 1,501-1,750 ml. 1,751-2,000 ml. 2,001+ ml. Base: 1,241 children aged 0-15 living in England and Wales (471 aged 0-5, 412 aged 6-10, 358 aged 11-15), diary fieldwork dates 13 th -19 th May *

34 Babies under the age of 12 months consumed an average of 559ml of liquid per day 18. Just over half of this age group (53%) drank between 501 and 750ml per day while no-one drank more than 1,000ml of liquid. The following three charts show the average volume of liquid consumed by each of the three age groups in further detail. As indicated by the chart below, the majority (83%) of children aged 0-5 years old consumed between 301 and 1,200ml per day. The 95th percentile of 0-5 year olds consumption was 1,497ml and the 5th percentile was 302ml )7- Aged % 14% 12% 10% 8% 6% 4% 2% 0% 1% 1% 2% ml ml. 8% 9% ml ml ml ml. 14% 11% 10% 9% 8% 7% 7% ml ml ml ,000 ml. 1,001-1,100 ml. 1,101-1,200 ml. 1,201-1,300 ml. 3% 2% 3% Base: 471 children living in England and Wales aged 0-5, diary fieldwork dates 13 th -19 th May 1,301-1,400 ml. 1,401-1,500 ml. 1,501-1,600 ml. 1,601-1,700 ml. 1% 1% 1% 1% 1% 1% 1,701-1,800 ml. 1,801-1,900 ml. 1,901-2,000 ml. 2,001+ ml. 18 It should be noted that, for children under the age of two, the diary did not record breastfeeding occasions so this is not included in the total consumption figure. It does include cow s milk and formula milk, however. +

35 As shown by the following chart, a third (34%) of children aged 6-10 drank between 801 and 1,100ml of liquid per day. None of this age group drank less than 201ml of liquid per day. It should be noted that, as part of the data cleaning exercise described on page 14, 41 children aged over 2 were excluded from the analysis because their reported daily intake was less than 100ml. One in ten (10%) drank more than 1,500ml per day. The extreme intakes for this age group were 1,790ml (95th percentile) and 459ml (5th percentile) )7- Aged % 12% 10% 8% 6% 4% 2% 0% ml ml. 1% 2% 6% ml ml ml ml. 8% 7% 8% 11% 11% 12% ml ml ml ,000 ml. 1,001-1,100 ml. 1,101-1,200 ml. 6% 7% 6% 5% Base: 412 children living in England and Wales aged 6-10, diary fieldwork dates 13 th 19 th May 1,201-1,300 ml. 1,301-1,400 ml. 1,401-1,500 ml. 1,501-1,600 ml. 1,601-1,700 ml. 3% 1% 2% 1% 1% 2% 1,701-1,800 ml. 1,801-1,900 ml. 1,901-2,000 ml. 2,001+ ml. Lastly, year olds were a bit more varied in the volumes they consumed. The most extreme intake for year olds was 2,310ml (the 95th percentile), with the least being 567ml (the 5th percentile). #

36 5 4 6 )7- Aged % 10% 8% 6% 4% 2% 0% ml ml. 1% 2% 1% 2% ml ml ml ml. 6% 5% 4% 7% 10% 9% 4% ml ml ml ,000 ml. 1,001-1,100 ml. 1,101-1,200 ml. 1,201-1,300 ml. Base: 358 children living in England and Wales aged 11-15, diary fieldwork dates 13 th -19 th May 9% 8% 7% 1,301-1,400 ml. 1,401-1,500 ml. 1,501-1,600 ml. 1,601-1,700 ml. 1,701-1,800 ml. 1,801-1,900 ml. 5% 4% 3% 4% 1,901-2,000 ml. 2,001+ ml. 10% #

37 On average, boys consumed more liquid per day than girls (1,124ml compared to 975ml). The most extreme level of intake (95th percentile) for boys was 2,138ml, compared to 1,802ml for girls. The lower level extreme intake (5th percentile) for boys was 361ml compared to 386ml for girls )7- Male Female 25% 20% 15% 10% 5% 0% 1% 2% ml. 9% 9% ml. 17% 23% ml. 18% 22% 751-1,000 ml. 19% 20% 1,001-1,250 ml. 14% 13% 1,251-1,500 ml. 10% 5% 1,501-1,750 ml. 6% 6% 3% 2% 1,751-2,000 ml. 2,001+ ml. Base: 1,241 children aged 0-15 living in England and Wales (612 males, 629 females), diary fieldwork dates 13 th -19 th May While there are clearly differences in consumption by gender, it is useful to explore patterns by gender within each age group, given the broad range of ages included in the research sample. The following chart shows the mean daily liquid consumed for each age group split between each gender. As can be seen, boys consumed marginally more than girls at each age group )7- Male Female Under 2 years years old 5-7 years old 8-10 years old years old years old Base: 1,241 children aged 0-15 living in England and Wales (aged <2: 51 male, 70 female; 2-4 yrs: 138 M, 135 F; 5-7 yrs: 127 M, 124 F; 8-10 yrs: 112 M, 126 F; yrs: 105 M, 97 F; yrs: 79 M, 77 F), diary fieldwork dates 13 th 19 th May #