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Background: Few studies have examined whether childhood asthma/allergies prevented young adults entering jobs with exposure to asthmagens. Aims: To determine whether history of asthma/allergies in childhood was associated with avoidance of exposed jobs in early adulthood. Methods: The Melbourne Atopic Cohort Study recruited 620 children at high risk of allergic diseases at birth (1990-94). Asthma, hay fever and eczema were evaluated by questionnaires at ages 6-7 and 12 years. A follow-up in early adulthood (mean age: 18 years) collected information on the current job. Occupational exposure to asthmagens was evaluated by a revised asthma specific job-exposure-matrix. The association between history of asthma/allergies in childhood and working in a job with exposure to asthmagens (vs. not working or non-exposed job) was evaluated by logistic regression, adjusted for age, sex and parental education. Results: Among 363 participants followed-up until early adulthood, 17% worked in a job with exposure to asthmagens. History of asthma (35%) was not associated with working in an exposed job (adjusted OR: 1.16, 95%CI: 0.65-2.09). Subjects with history of hay fever (37%) and eczema (40%) were more likely to enter exposed jobs (significant for hay fever: 1.87, 1.05-3.33; but not eczema: 1.65, 0.93-2.93). The association for hay fever was more pronounced in those with less parental education (2.97, 1.06-8.38; p for interaction: p=0.24). Conclusion: In this Australian cohort, young adults with history of allergies were more likely to enter exposed jobs, suggesting no asthmagen avoidance. Improved counseling against high risk jobs may be needed for young adults with these conditions.

International audience; Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire. Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991-1995), who reported a training period or a job at follow-up in 2003-2007 (aged 17-29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire. In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41-1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11-0.63) and OR 0.49 (95% CI 0.25-0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29-1.04) but not in the others (OR 0.98, 95% CI 0.44-2.22), with consistent results for all asthma characteristics. Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.

Information on the healthy worker hire effect in relation to asthma is scant. We aimed to assess whether and how childhood asthma-related characteristics (before hire) relate to occupational exposures at first hire. Analyses were conducted in 298 children examined at the first survey of the Epidemiological Study on the Genetics and Environment of Asthma (1991-1995), who reported a training period or a job at follow-up in 2003-2007 (aged 17-29 yrs; 53% males). Exposure likelihood to dust, gases and/or fumes in their first occupation was estimated by the ALOHA job exposure matrix. Asthma before the first occupation and two asthma classifications for severity (Global Initiative for Asthma 2002 guidelines) and symptoms were defined by questionnaire. In their first job, 47% of subjects were exposed. After adjustment (age, sex and education), pre-hire onset asthmatics (59%) were nonsignificantly less likely to be exposed (OR 0.67, 95% CI 0.41-1.11). Associations were stronger when considering those with severe asthma or high symptom score in childhood (OR 0.27 (95% CI 0.11-0.63) and OR 0.49 (95% CI 0.25-0.99), respectively). The association was observed in those who completed a university degree (OR 0.55, 95% CI 0.29-1.04) but not in the others (OR 0.98, 95% CI 0.44-2.22), with consistent results for all asthma characteristics. Results suggest a healthy worker hire effect in subjects with more severe or more symptomatic asthma in childhood. Education may modulate self-selection.