Infections in child day care centers and later development of asthma, allergic rhinitis, and atopic dermatitis: prospective follow-up survey 12 years after controlled randomized hygiene intervention

Arch Pediatr Adolesc Med. 2007 Oct;161(10):972-7. doi: 10.1001/archpedi.161.10.972.

Abstract

Objective: To evaluate the effect of successful prevention of common infections in child day care centers on the later development of allergic diseases.

Design: Prospective follow-up survey with a questionnaire administered 12 years after a controlled randomized hygiene intervention.

Setting: Twenty municipal child day care centers in Oulu, Finland.

Participants: A questionnaire was sent to 1354 prior participants (98%) in the intervention trial. The response rate was 68% (928 of 1354 participants). MAIN INTERVENTION: Hygiene intervention from March 1, 1991, to May 31, 1992.

Main outcome measures: The number of respondents who had a diagnosis of asthma, allergic rhinitis, and/or atopic dermatitis made by a physician, and the number of those who reported symptoms of atopic diseases.

Results: Asthma was diagnosed by a physician in 48 of the 481 respondents (10%) from the intervention child day care centers, with markedly fewer infections, and in 46 of the 447 controls (10%) (relative risk, 1.0; 95% confidence interval, 0.7-1.4). Similarly, no differences were found in the numbers of children who had a diagnosis of other atopic diseases or who had reported such symptoms.

Conclusion: The prevention of common respiratory tract and enteric infections during early childhood does not change later allergic morbidity.

Publication types

  • Clinical Trial
  • Randomized Controlled Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Asthma / epidemiology
  • Asthma / etiology*
  • Bacterial Infections / complications
  • Bacterial Infections / epidemiology*
  • Bacterial Infections / prevention & control
  • Child
  • Child Day Care Centers / statistics & numerical data*
  • Child, Preschool
  • Confidence Intervals
  • Dermatitis, Atopic / epidemiology
  • Dermatitis, Atopic / etiology*
  • Female
  • Finland / epidemiology
  • Health Education
  • Health Surveys
  • Humans
  • Hygiene / education*
  • Male
  • Prospective Studies
  • Rhinitis, Allergic, Seasonal / epidemiology
  • Rhinitis, Allergic, Seasonal / etiology*
  • Risk Factors
  • Surveys and Questionnaires
  • Time Factors
  • Virus Diseases / complications
  • Virus Diseases / epidemiology*
  • Virus Diseases / prevention & control