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Lower respiratory illness, recurrent wheezing, and day care attendance
M C Marbury1, G Maldonado, L Waller
1Section of Chronic Disease and Environmental Epidemiology, Minnesota Department of Health, Minneapolis 55414, USA.
Insights
Day care attendance significantly increases the risk of lower respiratory illness (LRI) in young children. This increased risk extends to recurrent wheezing illnesses, particularly when a parent has a history of asthma.
Area of Science:
- Pediatrics
- Epidemiology
- Environmental Health
Background:
- Lower respiratory illness (LRI) is a common childhood ailment.
- Day care settings may influence the transmission of respiratory infections.
- Understanding risk factors for pediatric respiratory diseases is crucial for public health.
Purpose of the Study:
- To investigate the association between day care attendance and lower respiratory illness (LRI) in children.
- To identify specific day care characteristics that may modify this risk.
- To examine the relationship between day care and recurrent wheezing illnesses.
Main Methods:
- Prospective cohort study of 1,268 children followed to age 2.
- Data collection via medical records and parental questionnaires on day care, symptoms, and asthma.
- Statistical analysis using rate ratios to assess risk.
Main Results:
- Day care attendance showed a 2.0 rate ratio for LRI (95% CI: 1.7, 2.2).
- Risk was consistent across different day care settings, group sizes, and duration.
- Parental asthma history amplified the day care-associated LRI risk.
- Day care attendance tripled the risk of recurrent wheezing illnesses.
Conclusions:
- Day care attendance is a significant risk factor for LRI in young children.
- The risk of recurrent wheezing illnesses is notably higher in children attending day care.
- Further research into mitigating respiratory infection risks in day care settings is warranted.
Abstract:
We prospectively assessed the relations between various characteristics of day care and lower respiratory illness (LRI) in a cohort of 1,268 Minnesotan children, born between October 1989 and January 1991 and followed to 2 yr of age. Information on LRI was abstracted from medical records and data on day care use, respiratory symptoms, and physician diagnosis of asthma were obtained from questionnaires. We identified a subgroup of 60 children with recurrent wheezing illnesses. The LRI rate ratio for day care attendance was 2.0 (95% confidence interval = 1.7, 2.2). Rate ratios were similar regardless of the day care setting, number of other children present, or the number of hours spent in day care. A parental history of asthma further increased the rate ratio for day care attendance. Day care attendance was associated with a threefold risk of having recurrent wheezing illnesses. We conclude that day care attendance is an important risk factor for LRI in young children, and for recurrent wheezing illnesses.