title: Career Advice for Young Allergy Patients.
abstract: BACKGROUND
  One-third of all young persons entering the work force have a history of atopic disease. Occupationally induced allergy and asthma generally arise in the first few months on the job, while pre-existing symptoms tend to worsen. Young persons with a history of an atopic disease should receive evidence-based advice before choosing a career.
  
  
  METHODS
  We systematically searched PubMed for cohort studies investigating the new onset of asthma, rhinitis, or hand eczema among job trainees from before the start of training and onward into the first few years on the job. The search revealed 514 articles; we read their abstracts and selected 85 full-text articles for further analysis. 24 of these met the inclusion criteria.
  
  
  RESULTS
  According to present evidence, atopy and a history of allergic disease (allergic rhinitis, atopic dermatitis) are the main risk factors for occupationally induced disease. The predictive value of a personal history of allergic diseases for the later development of an occupationally induced disease varies from 9% to 64% in the studies we analyzed. It follows that only young people with severe asthma or severe atopic eczema should be advised against choosing a job that is associated with a high risk of allergy, e.g., hairdressing or working with laboratory animals. Young people with a history of other atopic diseases should be counseled about their individual risk profile.
  
  
  CONCLUSIONS
  In view of the relatively poor predictive value of pre-existing atopic disease, secondary prevention is particularly important. This includes frequent medical follow-up of the course of symptoms over the first few years on the job. If sensitization or allergic symptoms arise, it should be carefully considered whether exposure reduction will enable the apprentice to stay on the job.
authors: Institute and Outpatient Clinic for Occupational, Social and Environmental Medicine, AllergieZENTRUM, Klinikum der Universität München, Comprehensive Pneumology Center, DZL, Deutsches Zentrum für Lungenforschung, München, Department of Pediatrics, University Hospital Carl Gustav Carus, Dresden, Department of Dermatology and Allergology, AllergieZENTRUM, Klinikum der Universität München.
authors: Katja
authors: K
authors: Radon
authors: Dennis
authors: D
authors: Nowak
authors: Christian
authors: C
authors: Vogelberg
authors: Franziska
authors: F
authors: Ruëff
mesh_terms: D000328:Adult; D059366:Asthma, Occupational / Q000453:epidemiology* / Q000517:prevention & control*; D002321:Career Choice; D015331:Cohort Studies; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology* / Q000517:prevention & control*; D006801:Humans; D015994:Incidence; D038622:Internationality; D008297:Male; D016273:Occupational Exposure / Q000517:prevention & control*; D012307:Risk Factors; D055815:Young Adult