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Vol. 2, No. 2 April 1994 |
Latex Allergy - Who Is At Risk?
Latex appears everywhere in the daily environment and can be found in everything from balloons to medical gloves. It is particularly prevalent in hospitals in such items as IV tubing, multi-dose vials, syringes, catheters and blood pressure cuffs. Latex allergy ranges from various types of contact dermatitis with symptoms of pruritus, eczematous dermatitis and rhinoconjunctivitis, to true anaphylaxis with symptoms ranging from flushing, bronchospasm, hypotension to cardiac arrest. Identified groups at increased risk are persons with spina bifida, congenital urinary anomalies, multiple surgeries (i.e.>5), health care workers, rubber plant workers, or persons with a history of rubber sensitivity (i.e. condoms), or allergy to bananas, avocados, or chestnuts. Current research indicates that allergic response may be due to proteins found in latex but may also be caused by accelerators and antioxidants used in the manufacturing process.
With the advent of body substance precautions (BSP), there has been an increase in glove usage and a surge of new glove products have flooded the market. It is speculated that the perceived increase in reported latex allergies noted by many health care institutions is due to this increased usage, and possible increased amounts of sensitizing protein in latex due to changes in the manufacturing process with gloves of inferior quality being produced. Proteins found in gloves may also be aerosolized in the glove powder.
It is important to note that continued sensitization (i.e. contact dermatitis) may lead to severe latex allergy. Employees who are experiencing symptoms with a temporal relationship to latex exposure should report to the Occupational Health Department, and may be referred to an allergist for testing.
As well, transmission of micro-organisms (i.e. Hepatitis B) via non-intact skin poses a significant threat to both patient and staff. Hand washing of non-intact skin may not remove many transient or commensal organisms found on the skin. The best defense against disease transmission is healthy, intact skin and good hand washing technique. Appropriate glove usage is essential, and BSP guidelines should be observed carefully. Gloves are not required for picking up trays, transporting enclosed specimens or transporting patients but are needed for contact with blood, body fluids, or non-intact skin.
Health and Welfare Canada, in conjunction with various industries and medical communities, is currently developing guidelines for improved glove standards, and care of the patient and employee with latex allergy.
To this end, the Health Protection Branch's Latex Allergy Task Force, the Canadian Society of Allergy and Clinical Immunology, the Medical Devices Bureau, Health Canada, and Ansell Medical Company are cosponsoring an international symposium on Latex Allergy scheduled for September 19,1994 at the Metro Toronto Convention Centre, Toronto.
References:
Stephens, P.C. Latex Allergy. Curr Rev Clin Anesth 14 (2): 9-16; 1993.
Sussman, G. L. Latex Allergy: Its Importance In Clinical Practice. Allergy Proc 13(2): 67-9; 1992.
Saner, D.; Dolovich, J.; Tarlo, S.; Sussman, G.; Buttoo, K. Hypersensitivity to natural latex. Jrnl Allergy Clin Immunol 83(6) : 1135-37; 1989.
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