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LATEX ALLERGIES – Are You at Risk?

What do you think of when you hear latex allergy? Most of us probably think of the health care industry and the use of latex gloves to help protect workers against infectious disease. However, there are many other occupations that have an increased risk of developing a latex allergy, including:

  • Ambulance Attendants
  • Animal Control Officers
  • Bridge/Toll Booth Operators
  • Corrections Officers
  • Dentists/ Doctors
  • Firefighters
  • Food Service Workers
  • Housekeepers
  • Lab Workers
  • Law Enforcement Personnel
  • Nurses/ Aides/ Caretakers
  • Teachers
  • Social Workers

Latex is a natural form of rubber derived from the sap of the rubber tree, Hevea brasiliensis (Reddy, 1998). The latex protein found in the natural rubber can cause an allergic reaction in some people. Some research has shown that dipped or very soft rubber products, like disposable gloves and balloons, have the highest concentration of latex proteins and, therefore, have the greatest allergic potential (Reddy, 1998).

Latex allergy is caused by repeated exposures to latex from skin contact and inhalation. For example, some rubber gloves are coated with a cornstarch powder to prevent stickiness and to give the gloves a smooth feel (Reddy, 1998). Latex protein particles have been shown to adhere to the surface of these cornstarch particles and to aerosolize (become air borne) on removal of the gloves (Reddy, 1998). Latex allergy is increasing because latex is used more frequently in today’s work environment due to its inexpensive price and durability. Here is a list of common items that may contain latex (Bonvino, 1997; Gold, 1994; Reddy, 1998):

Latex products:

  • Art supplies
  • Adhesive tape
  • Balloons
  • Balls
  • Buttons on electronic equipment
  • Carpet backings
  • Computer and mouse pads
  • Diapers
  • Dishwashing gloves
  • Disposable/ Surgical gloves
  • Erasers
  • Food handler gloves
  • Gum
  • Gym floors
  • Hand tools
  • Hot water bottles
  • Infant feeding tubes
  • Mattresses on beds
  • Newsprint
  • Pacifiers
  • Rubber bands
  • Sanitary pads
  • Selected toys
  • Shoe soles
  • Slick ad inserts
  • Swimming equipment/water toys
  • Telephone cords
  • Zippered plastic storage bags

There are three major types of sensitivities or reactions to latex:

  • Contact Dermatitis (Non-allergic) Contact dermatitis, sometimes known as irritant contact dermatitis, is the least threatening type of latex sensitivity and is classified as a non-allergic skin reaction (Shymko, 1997). This is a skin irritation caused by residue from antibacterial soap left on the hands after washing, sweating or rubbing of the skin under the gloves, drying of the hands from wearing gloves too long; and chemicals added to the gloves during manufacturing (Shymko, 1997).Irritant contact dermatitis is not a true latex reaction, but continuous irritation of the hands by the latex can lead to latex hypersensitivity (Kim, l997). The common symptoms of irritant contact dermatitis include redness, dryness, itching, burning, scaling, and lesions (Personius, 1995). Anyone who wears latex gloves is susceptible to this type of reaction (Shymko, 1997).
  • Allergic Contact Dermatitis The second type of reaction to latex is known as allergic contact dermatitis or Type IV (delayed hypersensitivity). This is the most common type of latex allergy. Its onset takes six to forty-eight hours after contact with the latex (Reddy, 1998). This type of reaction is caused by sensitization to the chemicals added to latex during the manufacturing process (Personius, 1995). This reaction is characterized by burning, swelling, and the development of debilitating rashes with itching and cracking of the hands (Personius, 1995).
  • Type I Hypersensitivity The third and most serious reaction to latex is known as Type I immediate hypersensitivity or anaphylaxis. This type of reaction is the least common but the most severe, even life threatening. The onset of symptoms is within minutes and causes a drop in blood pressure, watery eyes, edema, nausea, vomiting, diarrhea, sneezing, abdominal cramps, chest tightness, shortness of breath, runny nose, wheezing, and, ultimately, anaphylactic shock (Kim, 1997; Shymko, 1997; Personius, 1995; Reddy, 1998).

Latex allergy can cross over into food groups. This is of particular concern for those individuals who may already have a food allergy. True food allergies are relatively rare, affecting less than one percent of the population (Schwade, l995). The shocking aspect is if you are allergic to certain foods, your potential to be allergic or develop an allergy to latex is relatively high (Shymko, 1997).

These foods can trigger a latex-like allergic reaction because the proteins in the foods mimic the latex proteins as they break down in the body (Shymko, 1997). The following foods are known to mimic latex proteins: Bananas, avocados, potatoes, carrots, kiwis, papaya, figs, pineapples, peaches, plums, cherries, strawberries, melons, nectarines, grapes, tomatoes, celery, rye, wheat, hazelnuts, and chestnuts (Shymko, 1997; Shusterman, 1996).

If latex allergy is suspected, medical testing can confirm the diagnosis. Once confirmed, it is important to keep the allergy from developing by modifying the exposure to latex (Schwade, 1995). It is important to remember that an allergy to latex does not go away, they simply get worse with each exposure.

Here are some tips from the National Institute for Occupational Safety and Health (NIOSH) to help reduce the risk of allergic reactions to latex:

  1. Use non-latex gloves for activities that are not likely to involve contact with infectious materials (food preparation, routine housekeeping, maintenance, etc.)
  2. Appropriate barrier protection is necessary when handling infectious materials. If you choose latex gloves, use powder-free gloves. Such gloves reduce exposures to latex proteins and reduce the risk of latex allergy. So-called hypoallergenic latex gloves do not reduce the risk of latex allergy. However, they may reduce reactions to chemical additives in the latex (allergic contact dermatitis).
  3. Use appropriate work practices to reduce the chance of reactions to latex:
    1. When wearing latex gloves, do not use oil-based hand creams or lotions (which can cause glove deterioration).
    2. After removing latex gloves, wash hands with a mild soap and dry thoroughly.
    3. Practice good housekeeping: frequently clean work areas contaminated with latex dusts (upholstery, carpets, ventilation ducts).
    4. Frequently change ventilation filters and vacuum bags used in latex contaminated areas.
  4. Learn to recognize the symptoms of latex allergy: Skin rashes; hives; flushing; itching; nasal, eye or sinus symptoms; asthma and shock.
  5. If symptoms associated with latex allergy develop, avoid direct contact with latex gloves and products until a physician experienced in treating latex allergies is seen.

If your agency requires the use of latex products in the work environment, take the following proactive steps to help avoid sensitizing employees to latex:

  • Develop a policy on latex use in your agency.
  • Implement a purchasing policy that clearly defines the type of glove to be ordered for each task that requires gloves.
  • Provide employees with educational programs and training materials about latex allergy.
  • Discontinue the use of latex gloves if appropriate and safe to do so. Consider alternative glove products such as nitrile and vinyl.
  • If latex gloves must be used, provide reduced-protein, powder-free gloves.
  • If powered latex gloves must be used, make sure that good housekeeping practices are in place.
    • Identify areas contaminated with latex dust for frequent cleaning.
    • Make sure that ventilation filters and vacuum bags are replaced frequently.

If you are an employer and have been notified that someone in your agency has a latex sensitivity, here are a few steps you can take:

  • Follow your latex policy.
  • Provide employees with educational programs and training materials about latex allergy.
  • Consider making accommodations for individuals on a case-by-case basis.
  • If possible, reassign the employee to another job task that does not involve exposure to latex items.

If you have a latex allergy, consult a physician regarding the following precautions:

  • Avoid contact with latex gloves and products.
  • Avoid areas where you might inhale the powder from the latex gloves worn by others.
  • Tell your employers, physicians, nurses and dentist that you have an allergy to latex.
  • Wear a medical alert bracelet.

For more information on latex allergies, the following websites are a good source of information:

http://www.osha.gov/SLTC/latexallergy/index.html

http://www.cdc.gov

References:

Bonvino, J., 1997. Latex allergy alert. The Exceptional Parent. 28(10):32-35.

Gold, J.,1994. Ask about Latex. RN. 57(6):32-35.

Gold, M., Swartz, J., Braude, B., et al. 1991. Intraoperative anaphylaxis: an association with latex sensitivity. Journal Allergy Clin. Immunol. 87:662-666.

Personius, C., 1995. Patients, health care workers, and latex allergy. Medical Laboratory Observer. 27(3):30-33.

Reddy, S., 1998. Latex allergy. American Family Physician. 57(1):93-103.

Schwade, S., 1995. Do you have a latex allergy? Prevention. 47(7):74-80.

Shusterman, D., 1996. Latex allergy. The Western Journal of Medicine. 165(3):141-143.

Shymko, M., Shymko, T., 1997. Latex allergies can affect any of us. Radiologic Technology. 68(6):552-554.

Sussman, G., Beezhold, D., 1995. Allergy to latex rubber. Annals of Internal Medicine. 122(1):43-47.

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