title: Lower respiratory illness, recurrent wheezing, and day care attendance.
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.
authors.affiliation: Section of Chronic Disease and Environmental Epidemiology, Minnesota Department of Health, Minneapolis 55414, USA.
authors.forename: M C
authors.initials: MC
authors.lastname: Marbury
authors.forename: G
authors.initials: G
authors.lastname: Maldonado
authors.forename: L
authors.initials: L
authors.lastname: Waller
mesh_terms: D002656:Child Day Care Centers; D002675:Child, Preschool; D015987:Effect Modifier, Epidemiologic; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011446:Prospective Studies; D012008:Recurrence; D012135:Respiratory Sounds / Q000209:etiology; D012140:Respiratory Tract Diseases / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires