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[Day care attendance: impact on acute lower respiratory disease in children under 2 years old]
N A Vargas Catalán1, P Díaz Amor, A Zuleta Quiroz
1Departamento de Salud Pública y de Pediatría (Campus Occidente), Facultad de Medicina, Universidad de Chile, Santiago de Chile.
Insights
Day care attendance increases lower respiratory infections in children in areas with low air pollution. In highly polluted cities, day care does not significantly increase infection rates for children under two.
Area of Science:
- Environmental Health
- Pediatrics
- Epidemiology
Background:
- Lower respiratory tract infections (LRTIs) are a significant health concern in young children.
- Day care attendance is a known risk factor for infectious diseases in children.
- Air pollution levels vary significantly between urban and rural settings, potentially influencing infection risk.
Purpose of the Study:
- To evaluate the effect of day care attendance on the incidence of LRTIs in children under two years old.
- To compare this effect in two urban settings with distinct air pollution levels.
Main Methods:
- A 26-week follow-up study was conducted during 1991-1992.
- 98 children from a high-pollution city (Santiago) and 95 from low-pollution areas (San Felipe and Los Andes) were monitored.
- Children were categorized into day care attendees and controls; LRTI incidence was recorded.
Main Results:
- Children attending day care in low-pollution areas had the highest LRTI incidence (31.2 episodes/100 weeks).
- Children in high-pollution areas (Santiago), whether in day care or controls, showed lower incidence (28.7 episodes/100 weeks).
- Control children in low-pollution areas had the lowest LRTI incidence (18.2 episodes/100 weeks).
Conclusions:
- Day care attendance is associated with an increased risk of LRTIs in environments with low air pollution.
- In highly polluted urban areas, day care attendance does not appear to further elevate LRTI rates.
- Air pollution levels may modulate the impact of day care on respiratory infection risk in young children.
Aim:
To measure the impact of day care attendance on lower respiratory tract infections in children under two years old in two urban settings with different degrees of air pollution.
Subjects And Methods:
A 26 week follow up, during fall and winter of 1991 and 1992, was performed to 98 children (48 attending day care and 50 controls) coming from Santiago, a city affected by severe air pollution and 95 children (46 attending day care and 49 controls) coming from San Felipe and Los Andes (villages with low air pollution). The incidence of lower respiratory infections was recorded by trained personnel and expressed as rates per 100 weeks of follow up. Day care settings in San Felipe and Los Andes were state funded whereas those from Santiago were private. All premises had wooden or plastic floors and smoking was forbidden. During the follow up years, no respiratory epidemics were recorded.
Results:
The socioeconomic level of children from San Felipe and Los Angeles was better. Children from Santiago were more exposed to tobacco smoke. The highest incidence of lower respiratory infections was found in children attending day care in San Felipe and Los Andes (31.2 episodes/100 weeks of observation), closely followed by control and day care attending children from Santiago (28.7 respectively) and control children from San Felipe and Los Andes (18.2).
Conclusions:
Day care attendance in areas with low air pollution increases the risk of lower respiratory infections. Instead, in highly polluted areas, the infection rates do not increase.