Choosing an Occupation: Better Guidance Means Better Protection for People with Allergies

Around 30 per cent of adolescents between the ages of 14 and 17 (1) suffer from atopic diseases such as hay fever, atopic eczema, asthma and allergic contact eczema. Each year, 170,000 of them begin an apprenticeship.(1) It is important to assess individual risk through career counselling in order to prevent young people from breaking off an apprenticeship or developing an occupational disease. However, pre-existing atopic diseases were hardly taken into consideration in choosing an occupation.

Only 10 per cent speak to their doctor about this.2 At the same time, there are not enough valid representative scientific data for optimal career counselling. ECARF is therefore appealing to healthcare policy makers to support the launch of broad-based long-term observational studies that would enable individual risk assessment. The participants in the studies would have to receive guidance, from the choice of an occupation through to the initial years on the job.

Asthma and skin diseases most prevalent

According to a recent study3, asthma and pathological skin changes in industrialised countries are the most prevalent occupational diseases. This also includes diseases that are caused by specific influences to which certain groups of people receive significantly more exposure on the job than the rest of the population.

Employees can come into contact with allergens (e.g. flour dust) and irritants (e.g. preservatives) at the workplace. In terms of health, this contact is of particular relevance to two groups. Firstly, there are those who are already sensitised to one or more allergens and therefore predisposed to allergies before starting their occupation, but have not yet experienced any allergy symptoms. This is referred to as a ‘latent’ allergy. Then there are those who have had an atopic disease and developed symptoms before beginning their occupation; extensive contact with allergens at the workplace is of particular concern for these people.

Individual risk assessment counselling

The first few months at work are a critical period in the emergence of such occupational diseases and the worsening of any existing symptoms. Personalised career counselling that takes into account the medical history of adolescents with an atopic disease or predisposition can help reduce the risk of occupational asthma, rhinitis and hand eczema. However, reliable data has been lacking thus far that would aid in the proper assessment of individual risk.

Previous studies have shown that the majority of people with latent sensitivity do not develop occupational asthma or rhinitis. Adolescents with an atopic predisposition therefore need not necessarily be advised not to choose an occupation that would expose them to these risks, as long as they are informed about their individual risk and are able to protect themselves if required.

Such is not the case for those suffering from severe asthma or severe atopic eczema. Experts agree that these people should not engage in an occupation that increases the risk of worsening their disease.

Patients who already experience symptoms in reaction to an allergen that cannot be avoided on the job should choose another occupation

Secondary preventive measures

Adolescents at high risk of developing an occupational respiratory allergy or atopic skin eczema should be examined every six months during the first two years on the job. This will allow secondary preventive measures to be taken immediately, including early treatment or the use of protective clothing.

Youth training programme

Training sessions are available for adolescents to learn more about occupational asthma and allergies. Modern computer-assisted learning methods, such as virtual patients, have shown good results. Consequently, more adolescents are prepared to take preventive measures for skin protection and basic therapy. This makes it less likely for them to discontinue an apprenticeship and allows them to maintain good health.2

Sources:

1 Schmitz R, Thamm M, Ellert U, Kalcklösch M, Schlaud M: Prevalence of common allergies in children and adolescents in Germany. Results of the KiGGS study: first follow-up (KiGGS Wave 1), Bundesgesundheitsblatt-Gesundheitsforschung-Gesundheitsschutz 2014; 57:771-8.

2 Radon k, Nowak D, Vogelberg C, Rueff F: Career advice for young allergy patients – a systematic review. DtschArztebl Int 2016; 113:519-24.

3 Labrecque M, Malo JL, Alaoui KM, RAbhi K: Medical surveillance programme for diisocyanate exposure. Occup Environ Med 2011; 68:302-7.