Approximately one-third of apprentices in Germany are at elevated risk of occupational asthma, allergies, and dermatitis. In this edition of Deutsches Ärzteblatt International, Katja Radon et al. use a systematic search of the literature as the basis for investigating the advice doctors should give to young people with allergic sensitization or a manifest prior allergic disorder, regarding their future careers (Dtsch Arztebl Int 2016; 113: 519-24).
Internationally, approximately 16% of asthma cases and probably a high percentage of hand eczema cases in adulthood are attributed to occupational exposure. However, the predictive value of a personal history of allergic diseases for the later development of an occupationally induced disease is limited, so only young people with severe asthma or allergic eczema should be advised against higher-risk occupations. These include work as hairdressers, zookeepers, bakers/pastry chefs, nurses, and others.
The authors believe it is important that young people predisposed to allergies be informed of their individual risk and appropriate preventive measures. They should receive follow-up at regular intervals for 2 to 3 years after the beginning of occupational exposure, so that any early treatment and individual protection measures can be implemented. If sensitization or allergic symptoms arise, it should be carefully considered whether exposure reduction will enable the apprentice to stay on the job.