title: Hygienic practices and acute respiratory illness in family and group day care homes.
abstract: OBJECTIVE
  To describe hygiene practices in licensed group day care and family day care homes and the association between these practices and the prevalence of respiratory illnesses in the children in attendance.
  
  
  METHODS
  Self-administered surveys were mailed to 137 group and 204 family day care providers.
  
  
  RESULTS
  Wearing diapers and being younger than age three were associated with a higher frequency of respiratory illness. Children attending family day care homes had more respiratory illness than children attending group day care homes. Infrequent washing of children's or providers' hands after nose wiping, after diapering, before meals, and before food preparation was significantly associated with a higher frequency of respiratory illness. Use of shared cloth towels instead of individual paper towels and washing of sleeping mats less than once a week were also associated with a higher frequency of respiratory illness.
  
  
  CONCLUSIONS
  The findings underscore the importance of handwashing and other hygiene practices in reducing the spread of disease in day care settings.
authors.affiliation: Dept. of Epidemiology, School of Public Health, Ann Arbor, MI 48109, USA. stsauver@umich.edu
authors.forename: J
authors.initials: J
authors.lastname: St Sauver
authors.forename: M
authors.initials: M
authors.lastname: Khurana
authors.forename: A
authors.initials: A
authors.lastname: Kao
authors.forename: B
authors.initials: B
authors.lastname: Foxman
mesh_terms: D000208:Acute Disease; D000328:Adult; D002648:Child; D002656:Child Day Care Centers / Q000706:statistics & numerical data*; D002675:Child, Preschool; D005260:Female; D016352:Group Homes / Q000706:statistics & numerical data*; D006235:Hand Disinfection; D006801:Humans; D006920:Hygiene; D007223:Infant; D007231:Infant, Newborn; D008004:Licensure; D016015:Logistic Models; D008824:Michigan; D008875:Middle Aged; D012140:Respiratory Tract Diseases / Q000209:etiology / Q000517:prevention & control*; D011795:Surveys and Questionnaires