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

With the increased use of day-care for children, there is concern about possible health-related risks. A study was undertaken to evaluate the risk of contracting respiratory illness in children of various ages who are cared for in day-care facilities. The age groups studied were six weeks through 17 months, 18 through 35 months, and 36 to 59 months. A day-care child (exposed child) was one who spent a minimum of 10 hours per week for the last four weeks with one or more unrelated child. A child was considered unexposed if neither he nor a sibling aged five or younger was receiving day care. A nationwide phone survey of 35,000 households was undertaken; 3,475 children of the right ages were identified, and 29 percent were classified as exposed while 60 percent were considered unexposed (the remaining 11 percent did not meet the criteria for either group). All age groups of exposed children showed an increased risk of respiratory illness, but this was statistically significant only in the youngest group, and in those aged 18 to 35 months with no older siblings. Children aged 18 to 35 months with older siblings were not at increased risk. The presence of older siblings in the home increased the risk of respiratory illness in the youngest age group, but provided older children some protection from respiratory illness. In each age group, increased duration of past day care was associated with a decreased risk of respiratory illness. It was estimated that about 10 percent of all respiratory illnesses that occurred in the United States during the period of this study in children of these age groups could be attributed to the child's being in a day-care setting. It is also suggested that smaller day-care centers involve a lower risk of respiratory illness for children in the 18- through 35-month age group than larger centers. (Consumer Summary produced by Reliance Medical Information, Inc.)