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Published on: August 7, 2017
Risk of respiratory illness associated with day-care attendance: a nationwide study
E S Hurwitz1, W J Gunn, P F Pinsky
1Division of Viral and Rickettsial Diseases, Center for Disease Control, Atlanta, GA 30333.
Insights
Children in day care, especially infants, face a higher risk of respiratory illness. However, prolonged day care exposure may offer protection against illness in older children.
Area of Science:
- Pediatrics
- Epidemiology
- Childcare Research
Background:
- Day care attendance is common for young children.
- The impact of day care on child health, particularly respiratory illnesses, requires further investigation.
- Factors like age and presence of older siblings may influence health risks associated with day care.
Purpose of the Study:
- To assess the association between day care attendance and the risk of respiratory illnesses in children across different age groups.
- To examine the modifying effects of age and sibling presence on day care-related health risks.
- To investigate the relationship between the duration of day care exposure and illness risk.
Main Methods:
- A study was conducted on children aged 6 weeks to 59 months, categorized into three age groups.
- Children were classified as exposed to day care if they attended for at least 10 hours per week for four consecutive weeks.
- Statistical analysis, including odds ratios and confidence intervals, was used to determine the risk of respiratory illness.
Main Results:
- Increased risk of respiratory illness was observed in all age groups attending day care.
- This increased risk was statistically significant for infants (6–17 months) and toddlers (18–35 months) without older siblings.
- Older siblings appeared protective against respiratory illness in children aged 36–59 months, while increasing risk in younger infants.
Conclusions:
- Day care attendance is associated with a significantly increased risk of respiratory illness in younger children and toddlers without older siblings.
- The presence of older siblings has a differential impact on respiratory illness risk depending on the child's age.
- Longer duration of past day care exposure was linked to a reduced risk of respiratory illness across all age groups.
Abstract:
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.(ABSTRACT TRUNCATED AT 250 WORDS)
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