Otitis media in childhood. Sociomedical aspects with special reference to day-care conditions

To assess the effect of day-care conditions on the occurrence of middle ear infection, 681 children, aged 3-4 yr, were investigated. The investigation comprised an interview with one of the parents, a case history was taken, and a physical examination including tympanometry. At that time 76% of the children had been in day-care away from their homes and half of these were younger than 6 months old. The two groups of children, those in day-care and those looked after at home, were comparable with respect to sex, housing conditions, parents’ social status and smoking habits. An increased occurrence of otitis media was found among children in day-care Measurements of middle ear pressure revealed a significantly larger number of children with flat curves (secretory otitis) and thus poorer hearing among those in day-care than those at home. Among the children in day-care there was also a significantly larger number with a history of adenoidectomy than among those looked after at home. These differences could not be explained by sex, housing conditions, social status or parents’ smoking habits. It is concluded that the apparently greater occurrence of middle ear infection among children in day-care, compared to those looked after at home is due to an increased risk of contamination from children of their own age.