How Safe Are Day Care Centers? Day Care Versus Home Injuries Among Children in Norway

Objectives. The study's objective was to examine and compare injury rates of children ages 6 months to 6 years in day care centers and homes. More specifically, we tested the hypothesis that the injury rate is lower in day care centers than at homes, as suggested by previous studies. Methods. A comprehensive prospective injury registration was carried out in Stavanger, Norway, during 1992. We obtained data from this system to identify injuries occurring in day care centers, homes, and other places during 1992. Exposure-adjusted incidence rates were calculated to compare the risk of injury at day care centers, homes, and other places. We also obtained data from medical records on use and costs of medical care. In addition, a parent questionnaire was developed and used to gather data on the amount of injury-related restricted activity. Results. Among 9454 children ages 6 months to 6 years in Stavanger, 770 injuries occurred during 1992: 96 in day care centers, 472 at home, and 202 at other places. For children ages 6 months to 2 years, the rate of injuries was significantly lower in day care centers than at home (1.2 and 2.5, respectively, per 100 000 children-hours), but for children ages 3 to 6, the rates of injuries were similar in day care centers and at home (1.3 and 1.5, respectively, per 100 000 children-hours). The great majority of children attending day care centers were from 3 to 6 years of age. No significant differences were found in the severity of the injuries. Conclusions. For children ages 3 to 6 years, which included most of the children attending day care centers in Stavanger, Norway, day care centers were not found to be safer than homes. We think continuing attention should be paid to injury control in day care centers.