title: Do young adults with atopic dermatitis avoid harmful workplace exposure at their first job? A prospective cohort study.
abstract: OBJECTIVE
  Patients with atopic dermatitis (AD) are at high risk of chronic hand eczema. In this prospective cohort study, we assessed the influence of pre-hire-onset AD on the first job choice. We also analysed the potential association between AD and usage of preventive measures in high-risk occupations.
  
  
  METHODS
  Subjects (aged 19-24 years) who were followed from childhood until the second Study on Occupational Allergy Risks and indicated a job were included (n = 1566). We defined AD as doctor-diagnosed AD and symptoms of an itchy rash during the past 12 months before the study. Pre-hire-onset AD was having AD prior to the first job. Preventive measure usage was self-reported gloves use or use of ointment or moisturizer. We performed multiple imputations to deal with missing values and analysed associations using logistic regression models adjusted for several potential confounders.
  
  
  RESULTS
  Risk categories of the first job did not differ between participants with pre-hire-onset AD and those without (odds ratio 1.05, 95 % confidence interval 0.59-1.87). AD status was not statistically significantly associated with usage of preventive measures (1.22, 0.56-2.64). Conversely, having received job counselling (2.76, 1.15-6.63) and a family history of AD (2.09, 1.01-4.31) were associated with a higher use of such measures.
  
  
  CONCLUSIONS
  We could not confirm a healthy hire effect in this cohort of young adults. Although subjects with AD in high-risk occupations do not seem to use more preventive measures than their non-affected peers, job counselling seems to be an effective approach to encourage secondary prevention.
authors.affiliation: Occupational and Environmental Epidemiology and Net Teaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Junxiang
authors.initials: J
authors.lastname: Wei
authors.affiliation: Occupational and Environmental Epidemiology and Net Teaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany. Jessica.Gerlich@med.lmu.de.
authors.forename: Jessica
authors.initials: J
authors.lastname: Gerlich
authors.affiliation: Pediatric Department, University Hospital Carl Gustav Carus Dresden, TU Dresden, Dresden, Germany.
authors.forename: Christian
authors.initials: C
authors.lastname: Vogelberg
authors.affiliation: Dr. v. Haunersches Kinderspital, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Erika
authors.initials: E
authors.lastname: von Mutius
authors.affiliation: Occupational and Environmental Epidemiology and Net Teaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany.|Dr. v. Haunersches Kinderspital, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Doris
authors.initials: D
authors.lastname: Windstetter
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Jon
authors.initials: J
authors.lastname: Genuneit
authors.affiliation: Institute of Epidemiology and Medical Biometry, Ulm University, Ulm, Germany.
authors.forename: Gudrun
authors.initials: G
authors.lastname: Weinmayr
authors.affiliation: Occupational and Environmental Epidemiology and Net Teaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Dennis
authors.initials: D
authors.lastname: Nowak
authors.affiliation: Occupational and Environmental Epidemiology and Net Teaching Unit, Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, University Hospital of Munich (LMU), Munich, Germany.
authors.forename: Katja
authors.initials: K
authors.lastname: Radon
mesh_terms: D000328:Adult; D003876:Dermatitis, Atopic / Q000150:complications*; D004485:Eczema / Q000209:etiology / Q000517:prevention & control*; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D017575:Gloves, Protective / Q000706:statistics & numerical data; D006225:Hand; D006801:Humans; D016015:Logistic Models; D008297:Male; D009784:Occupational Diseases / Q000209:etiology / Q000517:prevention & control*; D016273:Occupational Exposure / Q000517:prevention & control*; D009790:Occupations; D016017:Odds Ratio; D011446:Prospective Studies; D012307:Risk Factors; D063465:Skin Cream / Q000627:therapeutic use; D017132:Workplace; D055815:Young Adult
keywords: Atopic dermatitis; Healthy hire effect; Longitudinal study; Preventive measure