ACUTE RESPIRATORY ILLNESS IN THE FIRST YEAR OF PRIMARY-SCHOOL RELATEDTO PREVIOUS ATTENDANCE AT CHILD-CARE

The aim of this study was to assess the relationship between previous child care outside the home (day care or family care) and acute respir atory illness in the first year at primary school. Participants were 4 45 Adelaide school children (mean age 5 years 2 months), 73 per cent o f those eligible. Information about early childhood, family, child car e arrangements and illness history was obtained from a questionnaire c ompleted by parents. A respiratory illness score was calculated from t he parental reports of respiratory illness experience in the winter mo nths of the second school term in 1992. Absences from school owing to respiratory illness were counted from school records. Children who had attended child care before commencing school had fewer episodes of ac ute respiratory illness and had fewer absences from school than childr en with no child care experience. Children who had attended child care prior to commencing school experienced half as many episodes of asthm a as those children who had never attended child care. Children who at tend day care before age five tend to experience less acute respirator y illness than their peers on school entry. Possible explanations incl ude selection of illness-prone children into home care, protection aga inst respiratory illness as a result of early exposure, and a shift in the age-related peak of illness.