Development of occupational skin diseases during vocational training in baker and confectioner apprentices: a follow-up study

Baker and confectioner apprentices have been included in a prospective foll ow-up study in the region of East Thuringia, to evaluate risk factors for t he development of hand dermatitis. Starting in August 1996, the apprentices have been interviewed and examined in a standardized way right at the begi nning (n 91) of their vocational training, 6 (n=79) and 12 months (n=63) la ter. 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 Ist assessment after 2 to 4 weeks vocational training revealed hand eczema in 17.5% (n=16) of the individuals. At the f ollow-up after 6 months of training 29.1% (n=23), and after 12 month of tra ining 27.0% (n=17), of the apprentices had hand dermatitis of mild to moder ate severity. Within 6 months, the TEWL score rose significantly (p<0.001) from 11.9 g m(-2) h(-1) (+/-5.3) to 16.8 g m(-2) h(-1) (+/-9.5). After 12 m onths, 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 te ndency to be a predictive factor for the development of occupational hand d ermatitis. TEWL score failed to correlate with the development of skin dama ge in our study. The same was true for respiratory atopy and metal sensitiz ation.