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Am J Respir Crit Care Med. 1997 Jan;155(1):156-61.

Lower respiratory illness, recurrent wheezing, and day care attendance.

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Section of Chronic Disease and Environmental Epidemiology, Minnesota Department of Health, Minneapolis 55414, USA.


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.

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