Latex allergy: Difference between revisions
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Workers in the health care industry (physicians, nurses, dentists, technicians, etc.) are at risk for developing latex allergy because they use latex gloves frequently. Also at risk are workers with less frequent glove use (hairdressers, housekeepers, food service workers, etc.) and workers in industries that manufacture latex products. | Workers in the health care industry (physicians, nurses, dentists, technicians, etc.) are at risk for developing latex allergy because they use latex gloves frequently. Also at risk are workers with less frequent glove use (hairdressers, housekeepers, food service workers, etc.) and workers in industries that manufacture latex products. | ||
== | ==Levels and Route of Exposure== | ||
Studies of other allergy-causing substances provide evidence that the higher the overall exposure in a population, the greater the likelihood that more individuals will become sensitized [Venables and Chan-Yeung 1997]. The amount of latex exposure needed to produce sensitization or an allergic reaction is unknown; however, reductions in exposure to latex proteins have been reported to be associated with decreased sensitization and symptoms [Tarlo et al. 1994; Hunt et al. 1996]. | Studies of other allergy-causing substances provide evidence that the higher the overall exposure in a population, the greater the likelihood that more individuals will become sensitized [Venables and Chan-Yeung 1997]. The amount of latex exposure needed to produce sensitization or an allergic reaction is unknown; however, reductions in exposure to latex proteins have been reported to be associated with decreased sensitization and symptoms [Tarlo et al. 1994; Hunt et al. 1996]. | ||
Revision as of 15:32, 8 March 2009
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Overview
Latex allergy is a medical term encompassing a range of allergic reactions to natural rubber latex.
Types
Latex is known to cause 2 of the 4 (or 5) types of hypersensitivity:
Type I
Latex allergy (immediate hypersensitivity) can be a more serious reaction (the most serious and rare form) to latex than irritant contact dermatitis or allergic contact dermatitis. Certain proteins in latex may cause sensitization (positive blood or skin test, with or without symptoms). Although the amount of exposure needed to cause sensitization or symptoms is not known, exposures at even very low levels can trigger allergic reactions in some sensitized individuals.
Reactions usually begin within minutes of exposure to latex, but they can occur hours later and can produce various symptoms. Mild reactions to latex involve skin redness, hives, or itching. More severe reactions may involve respiratory symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma (difficult breathing, coughing spells, and wheezing). Rarely, shock may occur; but a life-threatening reaction is seldom the first sign of latex allergy. Reactions are similar to those seen in some allergic persons after a bee sting.
Such reactions account for a significant proportion of perioperative anaphylactic reaction, especially in children with myelomeningocele.
Type IV
Allergic contact dermatitis (delayed hypersensitivity, also sometimes called chemcial sensitivity dermatitis) results from exposure to chemicals added to latex during harvesting, processing, or manufacturing.
These chemicals can cause skin reactions similar to those caused by poison ivy (see urushiol-induced contact dermatitis). As with poison ivy, the rash usually begins 24 to 48 hours after contact and may progress to oozing skin blisters or spread away from the area of skin touched by the latex.
This type is caused by chemicals used in the processing of rubber products.
Irritant contact dermatitis
The most common type of reaction. This causes dry, itchy, irritated areas on the skin, most often on the hands. It can be caused by the irritation of using gloves, or it can also be caused by exposure to other workplace products. Frequent washing of the hands, incomplete drying, exposure to hand sanitizers, and the talc-like powder coatings (zinc oxide, etc) used with gloves can aggravate symptoms. Irritant contact dermatitis is not a true allergy.
Testing for type I natural rubber latex allergy is through blood testing, such as RAST (radioallergosorbent test) identifies what types of IgE proteins trigger allergic reactions. While the standard for allergen testing is the skin prick test, there is no approved skin testing reagent for latex in the United States at this time. Some other countries do have approved skin testing reagents for natural rubber latex. Some people who are allergic to latex are also allergic to clothes, shoes and other things that contain natural rubber latex - for example elastic bands, rubber gloves, condoms, pacifiers and baby-bottle nipples, balloons, cars and clothing containing natural rubber based elastic. Synthetic elastic such as elastane or neoprene do not contain the proteins that trigger type I reactions. Type I natural rubber latex allergy is caused from IgE (immune) mediated reactions to proteins found in the Hevea brasiliensis tree, a type of rubber tree. Synthetic latex products do not contain the proteins from the Hevea brasiliensis tree and will not cause this type of reaction. Products made from guayule natural rubber emulsions also do not contain the proteins from the Hevea rubber tree and have only trace amounts of other proteins, indicating a very low potential for causing sensitization to this material.
Type IV reactions are caused by the chemicals used to process the rubber. Patch testing needs to be done to verify which type of chemical triggers the reaction. Once the chemical is identified, then the person can choose products that are not processed with that chemical. Both natural rubber and synthetic rubber products may cause type IV reactions.
Products Containing Latex
A wide variety of products contain latex: medical supplies, personal protective equipment, and numerous household objects. Most people who encounter latex products only through their general use in society have no health problems from the use of these products. Workers who repeatedly use latex products are the focus of this Alert. The following are examples of products that may contain latex:
Emergency Equipment
- Blood pressure cuffs
- Stethoscopes
- Disposable gloves
- Oral and nasal airways
- Endotracheal tubes
- Tourniquets
- Intravenous tubing
- Syringes
- Electrode pads
Personal Protective Equipment
- Gloves
- Surgical masks
- Goggles
- Respirators
- Rubber aprons
Office Supplies
- Rubber bands
- Erasers
Hospital Supplies
- Anesthesia masks
- Catheters
- Wound drains
- Injection ports
- Rubber tops of multidose vials
- Dental dams
Household Objects
- Automobile tires
- Motorcycle and bicycle handgrips
- Carpeting
- Swimming goggles
- Racquet handles
- Shoe soles
- Expandable fabric (waistbands)
- Dishwashing gloves
- Hot water bottles
- Condoms
- Diaphragms
- Balloons
- Pacifiers
- Baby bottle nipples
Individuals who already have latex allergy should be aware of latex-containing products that may trigger an allergic reaction. Some of the listed products are available in latex-free forms.
Latex in the Workplace
Workers in the health care industry (physicians, nurses, dentists, technicians, etc.) are at risk for developing latex allergy because they use latex gloves frequently. Also at risk are workers with less frequent glove use (hairdressers, housekeepers, food service workers, etc.) and workers in industries that manufacture latex products.
Levels and Route of Exposure
Studies of other allergy-causing substances provide evidence that the higher the overall exposure in a population, the greater the likelihood that more individuals will become sensitized [Venables and Chan-Yeung 1997]. The amount of latex exposure needed to produce sensitization or an allergic reaction is unknown; however, reductions in exposure to latex proteins have been reported to be associated with decreased sensitization and symptoms [Tarlo et al. 1994; Hunt et al. 1996].
The proteins responsible for latex allergies have been shown to fasten to powder that is used on some latex gloves. When powdered gloves are worn, more latex protein reaches the skin. Also, when gloves are changed, latex protein/powder particles get into the air, where they can be inhaled and contact body membranes (see Figure 1) [Heilman et al. 1996]. In contrast, work areas where only powder-free gloves are used show low levels or undetectable amounts of the allergy-causing proteins [Tarlo 1994; Swanson et al. 1994].
Wearing latex gloves during episodes of hand dermatitis may increase skin exposure and the risk of developing latex allergy. The risk of progression from skin rash to more serious reactions is unknown. However, a skin rash may be the first sign that a worker has become allergic to latex and that more serious reactions could occur with continuing exposure [Kelly et al. 1996].
Those at greatest risk
- Children with myelomeningocele Spina bifida. Between 40% to 100% will have a reaction.
- Industrial rubber workers, exposed for long periods to high amounts of latex. About 10% have an allergic reaction.
- Healthcare workers. Given the ubiquitous use of latex products in health care settings, management of latex allergy presents significant health organizational problems. Healthcare workers who frequently use latex gloves and other latex-containing medical supplies such as physicians, nurses, aides, dentists, dental hygienists, operating room employees, laboratory technicians, and hospital housekeeping personnel are at risk for developing latex allergy.[1] Between about 4% to 17% of healthcare workers have a reaction, this usually presents as Irritant Contact Dermatitis, and can develop through allergic sensitivity to a status of full anaphylaxis shock; with health workers losing their vocation.[2] In the surgical setting, however, the risk of a potentially life-threatening allergic reaction by a patient has been deemed by Johns Hopkins Hospital to be sufficiently high to replace all latex surgical gloves with synthetic alternatives.[3]
- People who have had multiple surgical procedures, especially in childhood.
Estimates of latex sensitivity in the general population range from 0.8% to 8.2%[4], although not all will ever develop a noticeable allergic reaction.
Latex and foods
Some people who have latex allergy may also have an allergic response to any of a number of plant products, usually fruits. This is known as the latex-fruit syndrome.[5] Fruits (and seeds) involved in this syndrome include banana, pineapple, avocado, chestnut, kiwi fruit, mango, passionfruit, strawberry, and soy. Some but not all of these fruits contain a form of latex. The Asthma and Allergy Foundation of America estimates that nearly 6 percent of the United States population have some type of food allergy and up to 4 percent have an allergy to latex.[6] It can also cause reactions from foods touched by latex products in the most severe cases. There are some known cases of latex allergies being provoked from genetically modified foods such as tomatoes with latex proteins.
Some individuals who are highly allergic to latex have had allergic reactions to foods that were handled or prepared by people wearing latex gloves.
References
- ↑ "NIOSH Alert:Preventing Allergic Reactions to Natural Rubber Latex in the Workplace". United States National Institute for Occupational Safety and Health. Retrieved 2008-01-20.
- ↑ Latex Allergy
- ↑ Associated Press (2008-01-15). "Hopkins ceases use of latex gloves during surgery". delawareonline. Baltimore: The News Journal. Retrieved 2008-01-21.
- ↑ Grzybowski, M., Ownby, D., Rivers, E., Ander, D., Nowak, R. (October 2002). “The Prevalence of Latex-Specific IgE in Patients Presenting to an Urban Emergency Department”. Annals of Emergency Medicine 40(4), 411-419.
- ↑ Brehler R, Theissen U, Mohr C, Luger T (1997). ""Latex-fruit syndrome": frequency of cross-reacting IgE antibodies". Allergy. 52 (4): 404–10. PMID 9188921. Unknown parameter
|month=ignored (help) - ↑ “Allergy Facts and Figures,” Asthma and Allergy Foundation of America http://www.aafa.org/display.cfm?id=9&sub=30
See also
External links
- The American Latex Allergy Association
- Latex Allergy Resources
- Latex Allergy Information
- NIOSH Latex Allergy Alert
- Asthma and Allergy Foundation of America
- Links to pictures of latex allergy (Hardin MD/Univ of Iowa)
- Latex Allergy Support Group