Morbidity due to acute respiratory infections (ARI) in infants cared for at day care centers and those staying at home

What are Swedes like? Recently, this question received a great deal of attention in the Swedish media, because of an article published in the Daily Mail by an English journalist, Geoffrey Levy. He described Swedes as being lazy, sick, and totally unable to enjoy anything nice in life. In addition, Swedish cars are wrecks, Swedes dress sloppily, and, if you do not want to work, you do not need to—but you are still fully paid. Finally, he described family policy in Sweden: "Just imagine a country where mothers as well as fathers can stay at home 12 months, with almost full pay after a baby is born, or a country where the state pays almost 6000 pounds for every child that goes to a day-care center—this would be totally impossible in Britain." How did the Swedish public react to Geoffrey Levy's article? Surprisingly, most people agreed with his description of the Swedes. Yes, we are lazy, too many people are sick, and we are unable to enjoy the good things in life. There was only one major issue where most people disagreed with Geoffrey Levy. Very few were negative about family policy in Sweden. On the contrary, most people took parental leave, the possibility of staying at home with a sick child, and publicly funded day care for granted. In the first part of this presentation, I will describe family policy in Sweden and, in particular, how the society supports and provides care for children under school age (which in Sweden starts at 6-7).

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The Day Care Center As a Risk Factor for Acute Respiratory Infections

Archives of Medical Research ◽

10.1016/s0188-0128(99)00008-1 ◽

1999 ◽

Vol 30 (3) ◽

pp. 216-223 ◽

Cited By ~ 23

Author(s):

Sergio Flores Hernández ◽

Hortensia Reyes Morales ◽

Ricardo Pérez Cuevas ◽

Héctor Guiscafré Gallardo

Keyword(s):

Risk Factor ◽

Day Care ◽

Respiratory Infections ◽

Care Center ◽

Acute Respiratory Infections ◽

Day Care Center

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Type of Day-Care Setting and Risk of Repeated Infections

PEDIATRICS ◽

10.1542/peds.94.6.997 ◽

1994 ◽

Vol 94 (6) ◽

pp. 997-999

Author(s):

J.-P. Collet ◽

P. Burtin ◽

N. Bossard ◽

T. Ducruet ◽

M. S. Kramer ◽

...

Keyword(s):

Respiratory Tract ◽

Otitis Media ◽

Day Care ◽

Physical Contact ◽

Direct Result ◽

Upper Respiratory Tract ◽

Day Care Centers ◽

Family Day Care ◽

Tract Infections ◽

At Home

As a direct result of demographic and sociologic changes, increasing numbers of children are attending day care in all industrialized countries. Unfortunately, the close physical contact among children in day care favors the transmission of infectious diseases. Previous studies have focused mainly on the risk of upper respiratory tract infection (URTI) and otitis media, which are reported to occur two to three times more frequently in children attending day care centers than in those cared for at home.1-7 Similarly day-care attendance has been found to be associated with an increased risk of lower respiratory tract infections (LRTI),8 gastroenteritis,9 as well as with the dissemination of infections caused by hepatitis A,10 cytomegalovirus,11 and H. influenzae type b.12 Despite convincing evidence for a higher risk of infection in day-care centers, most parents do not have an acceptable alternative to day care. It may be more useful, therefore, to identify the types of day-care structures associated with lower infectious risks. Family day care, in which several children are cared for in another family setting, offers a viable alternative to group day care, but previous studies have provided conflicting information on the risk of respiratory infections and otitis media in this setting. In four studies, the risks observed in family day care were very close to those of children who remained at home3-5,8; in two, they were intermediate between the risks at home and those in formal day-care centers6,7; while in two others, they were very close to those in day-care centers.13 These conflicting results can be explained by several factors including the lack of strict definitions for the different types of day-care settings and failure to control for the potentially important confounding differences in the number of children attending each type, the age range (from 2 to 60 months), and the time per week spent in the setting.

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How Safe Are Day Care Centers? Day Care Versus Home Injuries Among Children in Norway

PEDIATRICS ◽

10.1542/peds.97.1.43 ◽

1996 ◽

Vol 97 (1) ◽

pp. 43-47

Author(s):

Branko Kopjar ◽

Thomas Wickizer

Keyword(s):

Day Care ◽

Injury Rate ◽

Great Majority ◽

Incidence Rates ◽

Injury Rates ◽

Day Care Centers ◽

Parent Questionnaire ◽

Injury Control ◽

Adjusted Incidence ◽

At Home

Objectives. The study's objective was to examine and compare injury rates of children ages 6 months to 6 years in day care centers and homes. More specifically, we tested the hypothesis that the injury rate is lower in day care centers than at homes, as suggested by previous studies. Methods. A comprehensive prospective injury registration was carried out in Stavanger, Norway, during 1992. We obtained data from this system to identify injuries occurring in day care centers, homes, and other places during 1992. Exposure-adjusted incidence rates were calculated to compare the risk of injury at day care centers, homes, and other places. We also obtained data from medical records on use and costs of medical care. In addition, a parent questionnaire was developed and used to gather data on the amount of injury-related restricted activity. Results. Among 9454 children ages 6 months to 6 years in Stavanger, 770 injuries occurred during 1992: 96 in day care centers, 472 at home, and 202 at other places. For children ages 6 months to 2 years, the rate of injuries was significantly lower in day care centers than at home (1.2 and 2.5, respectively, per 100 000 children-hours), but for children ages 3 to 6, the rates of injuries were similar in day care centers and at home (1.3 and 1.5, respectively, per 100 000 children-hours). The great majority of children attending day care centers were from 3 to 6 years of age. No significant differences were found in the severity of the injuries. Conclusions. For children ages 3 to 6 years, which included most of the children attending day care centers in Stavanger, Norway, day care centers were not found to be safer than homes. We think continuing attention should be paid to injury control in day care centers.

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Acute Respiratory Infections in Day Care

Clinical Infectious Diseases ◽

10.1093/clinids/8.4.524 ◽

1986 ◽

Vol 8 (4) ◽

pp. 527-532 ◽

Cited By ~ 72

Author(s):

F. W. Denny ◽

A. M. Collier ◽

F. W. Henderson

Keyword(s):

Day Care ◽

Respiratory Infections ◽

Acute Respiratory Infections

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Mortality Associated With Acute Respiratory Infections Among Children at Home

The Journal of Infectious Diseases ◽

10.1093/infdis/jiy517 ◽

2018 ◽

Vol 219 (3) ◽

pp. 358-364 ◽

Cited By ~ 12

Author(s):

Mauricio T Caballero ◽

Alejandra M Bianchi ◽

Alejandra Nuño ◽

Adrian J P Ferretti ◽

Leandro M Polack ◽

...

Keyword(s):

Respiratory Infections ◽

Acute Respiratory Infections ◽

At Home

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Prevention of respiratory infections at day care centers: recommendations and systematic review of the evidence

Archivos Argentinos de Pediatria ◽

10.5546/aap.2014.eng.323 ◽

2014 ◽

Vol 112 (4) ◽

Keyword(s):

Systematic Review ◽

Day Care ◽

Respiratory Infections ◽

Day Care Centers

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Duration of day-care attendance and acute respiratory infection

Cadernos de Saúde Pública ◽

10.1590/s0102-311x1996000300002 ◽

1996 ◽

Vol 12 (3) ◽

pp. 291-296 ◽

Cited By ~ 13

Author(s):

Sandra Costa Fuchs ◽

Rita de Cássia Maynart ◽

Lenara Ferreira da Costa ◽

Adriana Cardozo ◽

Rejane Schierholt

Keyword(s):

Respiratory Infection ◽

Day Care ◽

Acute Respiratory Infection ◽

Respiratory Infections ◽

Care Center ◽

Respiratory Illness ◽

Cross Sectional Study ◽

Cross Sectional ◽

Day Care Center ◽

At Home

Day-care attendance accounts for an increased frequency of acute respiratory infections (ARI), in numbers of both episodes and hospitalizations. In addition to day-care exposure, risk factors include age, siblings, and crowding. The purpose of this study was to investigate a possible association between duration of day-care exposure and ARI. A cross-sectional study was carried out to compared ARI rates for children exposed to day care and children cared for at home. Children with at least one parent working in a hospital were sampled from the hospital-run day-care center and those cared for at home. An acute respiratory infection was defined as the presence of two or more signs or symptoms in the previous two weeks. Children exposed to the day-care center for 12 to 50 hours a week had a three to five times greater risk of developing ARI than those staying at home. This risk was assessed independently, taking socioeconomic status, age, and number of siblings into account. Risk of respiratory illness and day-care attendance has been described elsewhere, but this study presents original findings related to duration of exposure. With a view towards reducing risk of ARI, improvements should be made in institutional day-care centers in Brazil, where family day care is still not available.

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