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Influence of Attendance at Day Care on the Common Cold From Birth Through 13 Years of Age
Thomas M. Ball, MD, MPH;
Catharine J. Holberg, PhD;
Michael B. Aldous, MD, MPH;
Fernando D. Martinez, MD;
Anne L. Wright, PhD
Arch Pediatr Adolesc Med. 2002;156:121-126.
Objective To describe trends in the occurrence of the common cold during the first
13 years of life among children who attended different childcare settings
early in life.
Design The Tucson Children's Respiratory Study involves 1246 children enrolled
at birth and followed up prospectively since May 1980 through October 1984.
Children with data regarding day care use during the first 3 years of life
were included in this investigation (n = 991). Parents reported the occurrence
of frequent ( 4) colds during the past year by questionnaire when each
child was 2, 3, 6, 8, 11, and 13 years of age. Child care at home (no unrelated
children), at small day care (1-5 unrelated children), or at large day care
(6 unrelated children) was reported retrospectively by parental questionnaire
when the children were approximately 6 years old.
Results After adjusting for potential confounding variables, compared with children
at home those in large day care had more frequent colds at year 2 (odds ratio
[OR], 1.9, 95% confidence interval [CI], 1.0-3.4; P = .04), less
frequent colds at years 6 (OR, 0.3, 95% CI, 0.1-0.9; P
= .02) through 11 (OR, 0.4, 95% CI, 0.1-1.2; P =
.09), and the same odds of frequent colds at year 13 (OR,1.0, 95% CI, 0.3-3.8; P = .95). In addition, compared with children in large
day care for 1 year or less those attending large day care for more than 2
years had more frequent colds at year 2 (OR, 1.7, 95% CI, 1.0-3.0; P = .04), less frequent colds at years 6 (OR, 0.5, 95% CI, 0.2-1.1; P = .08), 8 (OR, 0.2, 95% CI, 0.1-1.0; P = .04), and 11 (OR, 0.3, 95% CI, 0.1-1.0; P
= .05); and the same odds of frequent colds at year 13 (OR, 0.9, 95% CI, 0.3-2.9; P = .80).
Conclusions Attendance at large day care was associated with more common colds during
the preschool years. However, it was found to protect against the common cold
during the early school years, presumably through acquired immunity. This
protection waned by 13 years of age.
From the Department of Pediatrics (Drs Ball, Holberg, Aldous, Martinez,
and Wright), Respiratory Sciences Center (Drs Holberg, Martinez, and Wright),
and Steele Memorial Children's Research Center, University of Arizona College
of Medicine (Drs Ball, Holberg, Aldous, Martinez, and Wright), Tucson.
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