Healthy worker effect in hairdressing apprentices.

Area of Science:

• Occupational dermatology
• Epidemiology
• Public health

Background:

• Hairdressers face high rates of occupational hand eczema due to wet work and chemical exposure.
• Hairdressing apprentices are particularly vulnerable to developing hand eczema.
• Prior hand eczema and atopic dermatitis are known risk factors for occupational hand eczema.

Purpose of the Study:

• To determine the prevalence of hand eczema, wrist/forearm eczema, and atopic dermatitis in hairdressing apprentices at the start of their training.
• To investigate a potential healthy worker effect among these apprentices.

Main Methods:

• A cohort of 382 hairdressing apprentices completed a self-administered questionnaire on skin conditions.
• A matched control group from the general population (n=1870) also completed the questionnaire.
• Data collected included previous and current hand eczema, wrist/forearm eczema, and atopic dermatitis.

Main Results:

• Response rates were high: 99.7% for apprentices and 68.3% for controls.
• Apprentices reported lower rates of previous/present hand eczema (8.0% vs. 12.5%) and wrist/forearm eczema (5.3% vs. 11.9%) compared to controls.
• Fewer apprentices were classified as having atopic dermatitis (21.4% vs. 29.8%) than controls.

Conclusions:

• The study identified a healthy worker effect in hairdressing apprentices.
• Lower reported incidence of hand and wrist/forearm eczema, and atopic dermatitis, suggests a protective selection into the occupation.
• This implies individuals with a predisposition to these conditions may be less likely to become hairdressing apprentices.