[Significance of playroom area for morbidity in day care centers in Copenhagen]. / Pladsforholdenes betydning for sygeligheden i københavnske vuggestuer.

Absence due to illness among children in 24 daycare centres in Copenhagen was registered during two periods of one year each with a five year interval. The results from the first period have been reported earlier. In each period, the physical, environmental, hygienic and social conditions of the institutions were assessed, and the playroom area per child was registered. The total number of children increased from 855 in the first period to 921 in the second because 13 of the 24 institutions had increased their capacity in the intervening period. On average, the playroom area per child decreased with 0.27 square metre per child in the 13 institutions with an increased number of children. All children were less than three years of age. Absence due to sickness constituted 7.6% of the days during which the institutions were open. For the second period, where the childrens age had been exactly registered, the effect of age on absence due to sickness was found to be statistically significant. The direction of the effect was a decrease in illness with increasing age. However, due to a high correlation between age and time attending the institution, the effect of age could not be separated from the similar effect of length of time that the child had attended the institution. It was found that sickness will decrease with 7.8% per month that the age of the child and time attending the institution is increased. A statistically significant connection was found between the playroom area per child and absence due to sickness after correction for the influence of age in a multivariate analysis. In conclusion, the sickness will decrease with 10.8% per square metre the playroom area per child is increased.

Respiratory illnesses in children and air pollution in Copenhagen.

The relationship between air pollution and the daily number of contacts (i.e., telephone calls and home visits) with or at Copenhagen Emergency Medical Service for children with and without respiratory illnesses was studied during a 91-d period (i.e., January 14, 1991, to April 14, 1991). A total of 12,132 contacts occurred. Diagnoses, which were recorded on the invoices for 5,307 contacts, revealed that 3,974 contacts were the result of respiratory illnesses. Regression analysis was used to investigate the short-term relationship between pollutants (i.e., carbon monoxide, nitric oxide, nitrogen dioxide, NOx, sulfur dioxide, ozone, and black smoke), measured at monitoring stations, and both the number of all contacts for children and the number of contacts for children with respiratory illnesses. Temperature and systematic effects that were the result of holidays and weekends were controlled for, after which only nitric oxide and NOx were associated significantly with the number of contacts for children who had respiratory illnesses. Nitric oxide and NOx, as indicators of traffic pollution, appeared, at low levels, to slightly exacerbate respiratory illnesses among children.

[Morbidity of children attending day care centers in Copenhagen illustrated by social, physical, environmental and hygienic factors]. / Sygeligheden i københavnske vuggestuer belyst ud fra sociale, fysiske, miljømaessige og hygiejniske faktorer.

Sick leave among the children in 24 day nurseries in Copenhagen was registered during a period of one year. The physical, environmental and hygienic conditions of the institutions were assessed by means of interviews and inspection, supplemented by information from the local authorities. Sick leave constitutes 7.5% of the days during which the institutions were open and the average number of sick days per child varied from 14.6 to 24.4. Comparisons with similar investigations are inclusive on account of variations in the methods of registration and age distributions. It was characteristic of the institutions investigated that these included a number of old institutions in flats, many in streets with considerable traffic and where the conditions of ventilation and space do not conform with present-day standards. In some of the institutions, the hygiene is unsatisfactory, particularly where ventilation, outdoor activities and hand-washing are concerned. A statistically significant connection was found between amount of traffic at the institution, the hygiene and playroom area per child, on one hand, and absence due to sickness, on the other, as assessed by a statistical model for sick leave for child in a given institution. In order to prevent sickness, it is concluded that efforts to improve hygiene and space are desirable and, similarly, further research concerning the effects of atmospheric pollution is relevant.