Do young adults with atopic dermatitis avoid harmful workplace exposure at their first job? A prospective cohort study

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. 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. 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. 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.