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Occupational risks for child-care providers and teachers.

Exposure to large numbers of preschool children in out-ofhome child-care settings is associated with an increased frequency of acquiring a variety of communicable diseases. 1,2 This increase in frequency exists not only for the children but also for their parents and for their adult care givers. 3 Although one might assume such exposure merely accelerates the process of acquiring natural immunity to a variety of unavoidable communicable diseases, an increased risk for significant morbidity due to several infectious agents has been identified among both preschool children and adults in the day-care setting. Infants and toddlers attending day care are at greater risk for chronic or recurrent otitis media, for bacterial meningitis, for dehydration due to diarrheal disease, and for serious lower respiratory tract infection. 4-6 Parents and care givers exposed to children attending day care are at increased risk for illness due to shigellosis and hepatitis A, which is usually