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Injuries in Day-care Centers

Frederick P. Rivara, MD, MPH
Am J Dis Child. 1987;141(9):938. doi:10.1001/archpedi.1987.04460090015002.
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article by Landman and Landman1 on injuries to children in day-care centers was an interesting one, which unfortunately reached an erroneous conclusion. The authors state that, "comparison of the present injury rates to those found in non-day-care use is difficult." However, the authors go on to try to make such a comparison and there run into trouble. As their comparison, they use the studies by Gallagher et al2 on injuries treated in the emergency room. It is erroneous to compare these emergency room–treated injuries with the medically attended injuries documented in their study. Emergency room–treated injuries probably represent only approximately half of all medically attended injuries in children. Therefore, a more comparable rate would be twice that of the 16.11% figure used by the authors in the comparison. In addition, the authors are basing their figure of 7.02% from medically attended injuries on the reports of the day-care


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