Risk of respiratory illness associated with day-care attendance : a nationwide study

• Published in: Pediatrics (Evanston) 1991, Vol.87 (1), p.62-69
• Main Authors: HURWITZ, E. S, GUNN, W. J, PINSKY, P. F, SCHONBERGER, L. B
• Format: Article
• Language: English
• Subjects: Biological and medical sciences; Chickenpox - epidemiology; Child care; Child Day Care Centers; Child, Preschool; Communicable Diseases - epidemiology; Day care centers; Family; Health aspects; Humans; Incidence; Infant; Medical sciences; Pediatric respiratory diseases; Pneumology; Regression Analysis; Respiratory tract diseases; Respiratory Tract Infections - epidemiology; Risk Factors; Socioeconomic Factors; Surveys and Questionnaires; United States - epidemiology
• ISSN: 0031-4005; 1098-4275
• DOI: 10.1542/peds.87.1.62

The risk of respiratory and other illnesses in children (age groups: 6 weeks through 17 months, 18 through 35 months, and 36 through 59 months) in various types of day-care facilities was studied. Children considered exposed to day care were those who were enrolled in day care with at least one unrelated child for at least 10 hours per week in each of the 4 weeks before the interview; unexposed children were not enrolled in any regular child care with unrelated children and did not have siblings younger than 5 years of age receiving regular care with unrelated children. Although an increased risk of respiratory illness was associated with attending day care for children in all three age groups, this risk was statistically significant only for children 6 weeks through 17 months of age (odds ratio = 1.6; 95% confidence interval = 1.1 to 2.4) and children 18 through 35 months of age who had no older siblings (odds ratio = 3.4; 95% confidence interval = 2.0 to 6.0). In contrast, day-care attendance was not associated with an increased risk of respiratory illness in children 18 through 35 months of age with older siblings (odds ratio = 1.0). For children aged 6 weeks through 17 months, the exposure to older siblings was associated with an increased risk of respiratory illness; however, for children aged 36 through 59 months, older siblings were protective against respiratory illness. In addition, for the children in each age group currently in day care, increased duration of past exposure to day care was associated with a decreased risk of respiratory illness.