Baker and confectioner apprentices have been included in a prospective follow-up study in the region of East Thuringia, to evaluate risk factors for the development of hand dermatitis. Starting in August 1996, the apprentices have been interviewed and examined in a standardized way right at the beginning (n = 91) of their vocational training, 6 (n = 79) and 12 months (n = 63) later. To gain objective data, TEWL score was also assessed at 3 standardized sites on the hands. In their case histories, 3.3% (n = 3) of the apprentices reported hand dermatitis. The 1st assessment after 2 to 4 weeks vocational training revealed hand eczema in 17.5% (n = 16) of the individuals. At the follow-up after 6 months of training 29.1% (n = 23), and after 12 month of training 27.0% (n = 17), of the apprentices had hand dermatitis of mild to moderate severity. Within 6 months, the TEWL scare rose significantly (p < 0.001) from 11.9 g m-2 h-1 (± 5.4) to 16.8 g m-2 h-1 (± 9.5). After 12 months, the TEWL score was 14.9 g m-2 h-1 (± 4.6). For the atopic skin diathesis (> 10 points of Diepgen's atopy score), there was a significant tendency to be a predictive factor for the development of occupational hand dermatitis. TEWL score failed to correlate with the development of skin damage in our study. The same was true for respiratory atopy and metal sensitization.
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