title: Day care center characteristics and children's respiratory health.
abstract: Day care centers provide an important exposure arena with potential harmful health effects for children. This study has linked health effect data from a survey among 942 3-5-year-old Oslo children with information on day care center characteristics collected during inspection of the 175 day care centers these children attended. The aim of the study was to estimate associations between dampness problems and other building characteristics and several respiratory health outcomes. Dampness problems (sign of molds, water leakage, damage to floor/wall) were observed in 51% of the day care centers. In multiple logistic regression analyses none of the studied symptoms and diseases (nightly cough, blocked or runny nose without common cold, wheeze, heavy breathing or chest tightness, the common cold, tonsillitis/pharyngitis, otitis media, bronchitis, pneumonia, asthma, and allergic rhinitis) were systematically associated with dampness problems or type of ventilation in day care centers. None of the studied indicators of day care center exposures were found to have a clear effect on day care children's respiratory health. Even so this study does not rule out negative health effects of day care center exposures. The study demonstrates that population-based studies of these relations are demanding with regard to assessment of exposure and health outcomes.
  
  
  CONCLUSIONS
  Simple and easy-to-register indicators of exposures like dampness problems and type of ventilation assessed in 175 day care centers were not related to respiratory health among 3-5-year-old Norwegian children attending the day care centers. The study does not rule out negative health effects of day care center exposures, but demonstrates methodological challenges needed to be addressed in studies of health effects of the day care environment.
authors.affiliation: Department of General Practice and Community Medicine, The Medical Faculty, University of Oslo, Oslo, Norway. per.nafstad@samfunnsmed.uio.no
authors.forename: P
authors.initials: P
authors.lastname: Nafstad
authors.forename: J J K
authors.initials: JJ
authors.lastname: Jaakkola
authors.forename: A
authors.initials: A
authors.lastname: Skrondal
authors.forename: P
authors.initials: P
authors.lastname: Magnus
mesh_terms: D016902:Air Pollution, Indoor / Q000009:adverse effects* / Q000032:analysis*; D002656:Child Day Care Centers; D002675:Child, Preschool; D003625:Data Collection; D004781:Environmental Exposure; D004784:Environmental Monitoring; D005260:Female; D006801:Humans; D008297:Male; D009664:Norway; D012044:Regression Analysis; D012140:Respiratory Tract Diseases / Q000209:etiology*; D014867:Water
chemical_list: D014867:Water