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  Latex Allergy

Powdered latex gloves risky | Latex Gloves and Allergies  | 10 Myths about Latex Allergy


Dental India
What is latex?

Natural rubber latex comes from a liquid in tropical rubber trees. This liquid is
processed to make many rubber products we use at home and at work. Many household
products contain latex, including the following items:

Balloons
Rubber toys
Pacifiers and baby-bottle nipples
Rubber bands
Adhesive tape and bandages
Diapers and sanitary pads
Condoms

In addition, many medical and dental supplies contain latex, including gloves, urinary
catheters, dental dams and material used to fill root canals, as well as tourniquets
and equipment for resuscitation. Nonlatex substitutes can be found for all of these
latex-containing items.

What is natural rubber latex?

Natural rubber latex is a processed plant product derived almost exclusively from the
tree hevea braziliensis found in Africa and Southeast Asia. Natural rubber latex should
not be confused with butyl- or petroleum-based synthetic rubbers. Synthetic products,
including latex house paints, have not been shown to pose any hazard to latex-sensitive
individuals.

What products contain latex?

Latex is a common component of many medical supplies, including disposable gloves, airway
and intravenous tubing, syringes, stethoscopes, catheters, dressings and bandages.
Many of these medical devices come into contact with mucous membranes, which enhances
the absorption of latex proteins that can trigger an allergic reaction. Latex gloves also
frequently are implicated in allergic reactions due to the repeated direct exposure of the
wearer’s hands to latex proteins or due to airborne latex proteins that are absorbed by
powders used to line some latex gloves.

While latex also is found in as many as 40,000 consumer products, including condoms,
balloons, athletic shoe soles, tires, underwear leg and waist bands, rubber toys,
nipples and pacifiers, these rarely cause problems except to the most sensitive patients.

What is latex allergy?

The protein in rubber can cause an allergic reaction in some people. The thin, stretchy
rubber in gloves, condoms and balloons is high in this protein. It causes more allergic
reactions than products made of hard rubber (like tires). Also, because some rubber
gloves are coated with cornstarch powder, the rubber protein particles stick to the
cornstarch and fly into the air when the gloves are taken off. In places where gloves
are being put on and removed frequently, the air may contain many latex particles.

Latex allergy can be mild, with symptoms such as itchy, red, watery eyes, sneezing or
runny nose, coughing, rash or hives. It can also be very severe, with symptoms like
chest tightness, shortness of breath and shock. It may even cause death. A latex-sensitive
person can have a life-threatening allergic reaction with no previous warning or symptoms.

Latex allergy, or hypersensitivity, occurs when the body’s immune system reacts to proteins
found in natural rubber latex. The immune system launches a defense that can cause a host
of unpleasant and, in some cases, life-threatening symptoms. It is the same type of
generalized allergic reaction seen when individuals who are allergic to bee venom receive
a bee sting.

What are the symptoms of latex allergy?

Allergy to latex proteins is a new medical problem with symptoms similar to those seen in
individuals who are allergic to bee venom or cat dander. Reactions on exposure to the allergen
are generally acute and may mimic hay fever or asthma, with symptoms such as nasal congestion,
hives or difficulty breathing. The most severe cases can result in anaphylaxis, a potentially
fatal reaction that affects many parts of the body at once. Symptoms are usually immediate,
progress rapidly and may include a dangerous drop in blood pressure, flushed skin, difficulty
breathing, swelling of the throat, tongue and nose, and loss of consciousness. Emergency
medical attention should be sought at the first sign of an anaphylactic reaction.

Skin problems resulting from the use of latex and non-latex gloves are frequently confused
with latex allergy. Contact dermatitis is a frequent problem in glove wearers which can be
due to an irritant contact dermatitis caused by frequent hand-washing and drying with irritating
soaps, skin abrasions from donning and removing gloves and maceration of skin covered by an
impermeable barrier. It can also be due to a “chemical sensitivity” dermatitis caused by a
contact allergy to one of the chemicals used in the production of rubber gloves. These local
skin problems are virtually never a result of true latex allergy.

How do the symptoms develop?

In most cases, latex allergy develops after repeated exposures to latex. It should be noted,
however, that direct physical contact with latex-containing products is not needed to trigger
the allergic reaction. Cases of anaphylaxis have resulted from inhaling latex proteins, which
can be absorbed by the powder that is used to line some latex gloves. When the gloves are
snapped on and off, the proteins become airborne and can pose a risk to some individuals
with latex hypersensitivity.

What triggers the immune system’s reaction to latex?

Some individuals have specific antibodies, called IgE antibodies, that make them hypersensitive
to the proteins in natural rubber latex. IgE-mediated reactions to latex proteins are responsible
for most and for the most severe allergic reactions to latex. Also, various chemicals that are
added to latex during processing may be responsible for some local skin reactions, but these
additives have not been implicated in the more generalized, potentially fatal allergic reactions
associated with latex.

What are some other reactions to latex? 

Some people who work in latex gloves get bumps, sores, cracks or red, raised areas on
their hands, over days or weeks. These reactions can be caused by frequent hand washing,
antiseptics, constant covering of the hands, or chemicals in gloves. Changing to
non-latex gloves helps. It also helps to use glove liners and pay more attention to
hand care.

How common is latex allergy?

It is difficult to say how widespread the problem of latex allergy may be. Approximately
1,000 cases of allergic or anaphylactic reactions to latex-containing medical products
have been reported to the U.S. Food and Drug Administration (FDA) since 1988. It is assumed
that many other cases go unreported. In one 1994 study, 6 percent of volunteer blood donors
were found to have increased levels of anti-latex IgE antibodies, although many of the
volunteers did not show symptoms of latex allergy. Other research suggests that more than
100,000 health care workers may be at risk for developing latex allergy.

Why is the incidence of latex allergy increasing?

The introduction of universal precautions in health care settings including the widespread
use of latex gloves to prevent the spread of AIDS and hepatitis B is believed to be the
primary cause of the increased prevalence of latex allergy. Also, there is greater awareness
and reporting of latex allergy than in the past.

Who is at risk for latex allergy?

Latex products are everywhere. Anyone can become allergic to latex. People with
the highest risk are those who have had many operations, especially in childhood.
People with spina bifida and urologic abnormalities are also at risk. Health care
workers and rubber industry workers are at risk. Health care workers with hay fever
seem to have an even higher chance of becoming allergic to latex. A quarter of all
health care workers with hay fever show signs of being latex sensitized.

Who is at greatest risk for latex allergy?

The greatest risk is to individuals who are repeatedly exposed to products containing
latex, particularly:

    * Patients with a history of early and/or recurrent surgical or medical procedures,
      such as children with spina bifida.
    * Health care personnel and others who wear latex gloves.
    * Individuals with occupational exposure, such as workers involved in the manufacture
      of latex gloves or catheters.

Other risk factors are less defined but appear to include:

    * A history of hay fever or other allergic problems.
    * A history of food allergies to tropical fruits, hazelnuts, chestnuts or stone fruits,
      particularly if progressive in scope or severity.
    * Hand dermatitis that is severe or has changed in severity in an individual
      who wears latex gloves.

Who is most at risk of developing a life-threatening anaphylactic reaction to latex?

The risk of anaphylaxis appears to be greatest in individuals with prior allergic reactions
to latex-containing objects or prior, unexplained reactions or anaphylaxis during a medical
or surgical procedure. Health care providers with a history of severe or worsening
latex-glove-induced eczema, hives or work-related rhinitis or asthma-like symptoms
should be especially cautious.

Is there a connection between latex allergy and foods? 

Because some proteins in rubber are similar to some food proteins, some foods may
cause an allergic reaction in people who are allergic to latex. The most common of these
foods are banana, avocado, chestnut, kiwi fruit and tomato. Although many other foods
can cause an allergic reaction, avoiding all of them might cause nutrition problems.
Therefore, it's recommended that you avoid only the foods that have already given you
an allergic reaction.

Preventing Latex Allergy
How can latex allergy be prevented?

All products and medical devices that come in contact with individuals at risk should be
reviewed for possible latex content. A label of  hypoallergenic does not mean that a
product is latex-free.

In general, only low allergen, preferably non-powdered latex gloves should be used.
The powders that are used in some latex gloves can absorb latex proteins and carry
them into the air where they may be inhaled by latex-sensitive individuals.

How can health care workers who must wear rubber gloves to protect themselves from
transmissible disease protect themselves from developing latex hypersensitivity?

Health care workers with a history of latex sensitivity must stop wearing latex gloves
and their co-workers must not use powdered gloves. Care should be exercised in the choice
of substitutes, since all synthetic or non-latex products are not equally impermeable
to blood-borne pathogens.

Health care workers with a history of glove-associated skin irritations, or contact
dermatitis, should use alternative gloves (which may include latex gloves) and topical
treatments to relieve their symptoms. Some petroleum-based products have been shown
to compromise the barrier function of latex gloves, and care should be taken in the
choice of treatments used to relieve contact dermatitis.

What else can be done to protect against latex allergy?

The FDA in June 1996 proposed mandatory labeling of latex rubber in medical devices and
banning of the term hypoallergenic on latex-containing medical devices, requirements that
have been urged by the American College of Allergy, Asthma & Immunology. The College also
has proposed that the FDA and other government agencies:

    * establish maximum levels of extractable latex allergen in gloves
    * fast track the approval process of diagnostic tests for latex allergy
    * conduct or fund epidemiologic studies to identify causes of latex allergy and minimize
      risk factors
    * address issues of patient-worker safety in the medical setting
    * consider content labeling for consumer products that contain latex rubber

Diagnosis and Treatment
How is suspected latex allergy confirmed?

A skin prick test may be done for latex allergy, but there are currently no licensed reagents
commercially available for the test. Because of the potential for a life-threatening anaphylactic
reaction to the test itself, skin prick tests for latex allergy should be performed only under
the close supervision of an allergy specialist. An allergist-immunologist also can perform a
blood test to confirm the presence of IgE anti-latex antibodies. Skin patch tests are used
to evaluate the cause of skin irritations, or contact dermatitis, caused by rubber gloves.

How are latex allergies treated?

There are a number of medications available to treat the symptoms of latex allergy once it
develops. However, because there is no cure yet, the best treatment is prevention.
An allergy specialist can provide more information on how to manage allergic reactions to latex.

What should I do if I think I have a latex allergy?

See a doctor, preferably one with experience in treating latex allergy. Your doctor will
take a detailed history and may confirm the diagnosis with a blood test. Skin testing is
done in some specialized centers. It's not used everywhere, because it can cause severe
reactions if it isn't done by an experienced person.

What should I do if I find out I have a latex allergy? 

Although there is no treatment for latex allergy, you can reduce your risk of reaction
by avoiding direct contact with latex. Take steps to find out which products in your
environment contain latex and the substitutes you can use for those products. It's also
important to avoid breathing in latex particles from powdered gloves.

If you are a health care worker or a patient, everyone around you should wear
powder-free latex gloves or non-latex gloves. If you are a health care worker,
compare different kinds of non-latex gloves to find the ones that are best for you.

Always wear a Medic-Alert bracelet or necklace. Talk to your doctor about getting a
prescription for an epinephrine self-injection pen, to use in case of a serious reaction.
You may wish to carry non-latex gloves with you all the time for use by emergency
personnel if you need medical attention.

If you are exposed to latex at your job, tell your employer and co-workers about your
latex allergy. Avoid latex gloves completely if you're not at risk for blood and body
fluid contamination. Use powder-free gloves if latex gloves are preferable.
These measures will help keep others from becoming allergic to latex.

How can I learn more about latex allergy? 

Take steps to educate yourself and others by joining the following resource networks
and support groups. Work to support workplace policies, industry practices and
government legislation that will support the safe use of latex and non-latex
alternatives.

Latex Allergy News: The Information Sharing Vehicle of ELASTIC
(Education for Latex Allergy Support Team and Information Coalition)
Telephone: 860-482-6869
Internet address: http://www.latex-allergy.org

Delaware Valley Latex Allergy Support Network
Telephone: 800-LATEX-NO (800-528-3966)

Spina Bifida Association of America
(Can supply updated list of latex products and substitutes)
Telephone: 800-621-3141
Internet address: http://www.sbaa.org

Information about latex allergy: http://pw2.netcom.com/~nam1/latex_allergy.html

ACAAI
American College of Allergy, Asthma & Immunology
85 West Algonquin Road, Suite 550
Arlington Heights, IL 60005

Latex Allergy Links Message Board

Potential for Sensitization and Possible Allergic Reaction To Natural Rubber Latex
Gloves and other Natural Rubber Products
PDF
OSHA Safety and Health Information Bulletin Jan 28 2008

Dry Natural Rubber (“Latex”) Content of Flu Vaccines (2007–08 Formula, US only)
Sep 04 2007

Printable Latex Allergy Signs
For personal, non-commercial use only

Toys & Baby Products — Manufacturers’ Contact Info

Latex Allergy-Related Videos
Posted to YouTube 2007

Latex Gloves in Food Operations PDF
Wisconsin Department of Health and Family Services Sep 07 2001

Ever more complex;
Lawsuits and increasing regulation mount as argument over NR latex policies rages

Miles Moore Rubber & Plastics News Jul 30 2001

Living With Latex: Where to be alert for latex
Medical University of South Carolina Children’s Hospital

Handle with care
Ben Van Houten Restaurant Business Aug 01 2000

Allergenic Cross-Reactivity of Latex and Foods
Greer Labs Technical Bulletin #10 Jan 05 2000

Latex Allergy: Another Real Y2K Issue
Lisa M. Jennings, RN CRRN Rehabilitation Nursing Jul/Aug 1999

Potential for Allergy to Natural Rubber Latex Gloves and other Natural Rubber Products
OSHA Technical Information Bulletin Apr 12 1999

Looking Out for Latex
Sandra A. Holmes Science and Children Feb 1999

The Vow of Silence
Marianne McAndrew Journal of Nursing Administration Feb 1999

The legal implications of latex allergy
Peter Kohn RN Jan 1999

Latex Allergy: Everyone’s Concern
Lawrence D. Duffield, DDS Journal of the Michigan Dental Association Jun 1998

Allergen Content of Latex Gloves.
A Market Surveillance Study of Medical Gloves Used in Finland in 1997

Palosuo, Turjanmaa, & Reinikka-Railo

User Facility Reporting Bulletin
selected articles FDA Fall 1997

Latex Allergy Alert
Christine Ozment Exceptional Parent Oct 1997

Latex gloves hand health workers a growing worry
Margaret Veach American Medical News Oct 13 1997

Living with Latex
Lisa Legge Nursing Minnesota Aug 1997

Research Review:
Association between latex sensitization and repeated latex exposure in children

Victoria M. Steelman RN, PhD(c), CNOR AORN Journal Jul 1997

Latex allergy: How safe are your gloves?
Kenneth K. Meyer, MD, FACS and Donald H. Beezhold, PhD
American College of Surgeons Bulletin Jul 1997

User Facility Reporting Bulletin
FDA Spring 1997

Latex allergy among staff poses major headache for hospitals
Meredith Goad Press Herald Portland, ME May 06 1997

Oregon picks up latex glove controversy
Patrick O’Neill The Oregonian Portland, OR Apr 21 1997

Facilities react to growing number of allergies to latex
Linda L. Mullen South Bend Tribune South Bend, IN Apr 13 1997

Growing number of HCW’s developing dangerous reactions to latex
Liz Kowalczyk The Patriot Ledger Quincy, MA Apr 01 1997

Shriners Hospital Stops Using Latex
Pat Cahill Springfield Union Springfield, MA Mar 07 1997

Latex Allergy and Contraception
The Contraception Report Patient Update Mar 1997

Is Latex Paint Hazardous To Latex Allergy Sufferers?
Don Groce Latex Allergy News Oct 1996

Cotton, Nylon, Lycra Spandex and Allergies
Don Groce Latex Allergy News Sep 1996

Paving, Asphalt, Tires & Latex Allergies
Don Groce Latex Allergy News Aug 1996

Special Bulletin: Latex Allergy
American College of Allergy, Asthma & Immunology

Q & A: Latex Allergies
American College of Allergy, Asthma & Immunology

Preguntas y Respuestas: Alergias al Látex
Asociación Americana de Alergia, Asma e Inmunología

Latex Allergy Survival Kit
Nancy Mitchell 1996

Archives
Pre-1996 FDA documents
Miscellaneous legislative and other documents
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