title: [The impact of selected environmental factors on the morbidity of children in day care centers].
abstract: The purpose of this review was to present the existing evidence of the relation between children's absence from day-care centres caused by disease and environmental factors, such as hygienic standard, space per child, and indoor climate in day-care centres. The review is based on results from cohort studies and randomised, controlled studies identified through literature searches. There is good evidence that improved hand hygiene may reduce the morbidity and absence among children attending day-care centres. The effect of the efforts varies from a few to 50 per cent. On the background of cohort studies there is some evidence that available space per child in the day-care centres is also correlated to the rate of absence caused by diseases. The impact of noise and indoor climate in day-care centres and the time spent outdoors has so far only been sparsely investigated but seems to be of some importance.
authors.affiliation: Statens Institut for Folkesundhed, Svanemøllevej 25, DK-2100 København ø.
authors.forename: Birgitte Gade
authors.initials: BG
authors.lastname: Koefoed
authors.forename: Anne Margrethe
authors.initials: AM
authors.lastname: Nielsen
authors.forename: Lis M
authors.initials: LM
authors.lastname: Keiding
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects; D001424:Bacterial Infections / Q000453:epidemiology* / Q000517:prevention & control; D002656:Child Day Care Centers / Q000592:standards; D002675:Child, Preschool; D004781:Environmental Exposure / Q000009:adverse effects; D006235:Hand Disinfection; D006801:Humans; D006920:Hygiene; D017053:Infection Control; D008834:Microclimate; D009622:Noise / Q000009:adverse effects