Latex allergies

  • Are latex gloves dangerous?
  • What kind of reaction should I look out for when using latex products?
  • How does latex cause such severe reactions?
  • How is latex allergy diagnosed?
  • How is latex allergy treated?
  • So what should be done in the workplace to reduce the risk of latex allergy?

Are latex gloves dangerous?

Reports of allergic reactions to latex have increased in recent years especially among healthcare workers. Anyone with ongoing exposure to natural rubber latex is advised to take the following steps to protect themselves:

  • Learn to recognise the symptoms of latex allergy.
  • Inform work management, your consultant/GP, your colleagues and your dentist that you have latex allergy and take 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.

  • If you develop symptoms of latex allergy, avoid direct contact with latex gloves and products until you can see a consultant experienced in treating latex allergy.

What kind of reaction should I look out for when using latex products?

Three types of reactions can occur in persons using latex products:

• Irritant contact dermatitis.

• Allergic contact dermatitis (delayed hypersensitivity).

• Latex allergy.

Irritant contact dermatitis

The most common reaction to latex products is irritant contact dermatitis — the development of dry, itchy, irritated areas on the skin, usually the hands. This reaction is caused by skin irritation from using gloves and possibly by exposure to other workplace products and chemicals.

The reaction can also result from repeated hand washing and drying; incomplete hand drying, use of cleaners and sanitisers; and exposure to powders added to the gloves. Irritant contact dermatitis is not a true allergy.

Allergic contact dermatitis

Allergic contact dermatitis (delayed hypersensitivity) 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. 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.

Latex allergy

Latex allergy (immediate hypersensitivity) can be a more serious reaction to latex than irritant contact dermatitis or allergic contact dermatitis. Certain proteins in latex may cause sensitisation (positive blood or skin test, with or without symptoms).

Although the amount of exposure needed to cause sensitisation or symptoms is not known, exposures at even very low levels can trigger allergic reactions in some sensitised individuals.

Reactions usually begin within minutes of exposure to latex but they can also 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. Such reactions are similar to those seen in some allergic persons after a bee sting.

How does latex cause such severe reactions?

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. In contrast, work areas where only powder-free gloves are used show low levels or undetectable amounts of the allergy-causing proteins.

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.

How is latex allergy diagnosed?

Latex allergy should be suspected in anyone who develops certain symptoms after latex exposure, including:

  • Nasal, eye or sinus irritation.
  • Hives.
  • Shortness of breath, coughing; wheezing.
  • Unexplained shock.

Anyone who experiences these symptoms should be seen and assessed by a doctor, since further exposure could result in a serious allergic reaction. A diagnosis is made using the results of a medical history, physical examination and tests.

How is latex allergy treated?

Once a person becomes allergic to latex, special precautions are needed to prevent exposures — during work as well as during medical or dental care. Certain medications may reduce the allergy symptoms, but complete latex avoidance (though quite difficult) is the most effective approach.

The following case reports briefly describe the experience of three nurses who developed latex allergy after occupational exposure. These cases are not representative of all reactions to latex but are examples of the most serious types of reactions. They illustrate what has occurred to some individuals:

Case Number 1

A nurse initially suffered hives, nasal congestion and conjunctivitis. Within a year, she developed asthma and two years later she went into shock after a routine gynaecological examination during which latex gloves were used. The nurse also suffered respiratory distress in latex-containing environments when she had no direct contact with latex products. She was unable to continue working.

Case Number 2

A healthcare worker developed hives followed by nasal congestion two years later and asthma a year after that. Eventually she developed severe respiratory symptoms in the healthcare environment, even when she had no direct contact with latex. The worker was forced to leave her occupation because of these health effects.

Case Number 3

An intensive care nurse with a history of runny nose, itchy eyes, asthma, eczema, and contact dermatitis experienced four severe allergic reactions to latex. The first reaction began with asthma severe enough to require treatment in an emergency room. The second and third reactions were similar to the first. The fourth and most severe reaction occurred when she put on latex gloves at work. She went into severe shock and was successfully treated in an emergency room.

Latex allergy in the workplace can result in potentially serious health problems for nurses and other healthcare workers, who are often unaware of the risk of latex exposure. Such health problems can be minimised or prevented by following the recommendations.

So what should be done in the workplace to reduce the risk of latex allergy?

Employers

Latex allergy can be prevented only if employers adopt policies to protect workers from undue latex exposures. It is recommended that employers take the following steps to protect workers from latex exposure and allergy in the workplace:

  • Provide workers with non-latex gloves to use when there is little potential for contact with infectious materials.
  • Appropriate barrier protection is necessary when handling infectious materials. If latex gloves are chosen, provide reduced protein, powder-free gloves to protect workers from infectious materials.
  • Provide all high-risk employees with education programmes and training materials about latex allergy.
  • Periodically screen high-risk employees for latex allergy symptoms. Detecting symptoms early and removing symptomatic workers from latex exposure are essential for preventing long-term health effects.
  • Evaluate current prevention strategies whenever an employee is diagnosed with latex allergy.

High-risk employees

High-risk employees should take the following steps to protect themselves from latex exposure and allergy in the workplace:

  • Use non-latex gloves for activities that are not likely to involve contact with infectious materials.
  • Appropriate barrier protection is necessary when handling infectious materials. If you choose latex gloves, use powder-free gloves with reduced protein content. Such gloves reduce exposures to latex protein and thus reduce the risk of latex allergy (though symptoms may still occur in some workers), while so-called hypoallergenic latex gloves do not reduce the risk. However, they may reduce reactions to chemical additives in the latex (allergic contact dermatitis).
  • Use appropriate work practices to reduce the chance of reactions to latex.
  • When wearing latex gloves, do not use oil-based hand creams or lotions (which can cause glove deterioration) unless they have been shown to reduce latex-related problems and maintain glove barrier protection.
  • After removing latex gloves, wash hands with a mild soap and dry thoroughly.
  • Take advantage of all latex allergy education and training provided by your employer.
  • Become familiar with procedures for preventing latex allergy.
  • Learn to recognise the symptoms of latex allergy:
  • Skin rashes.
  • Hives.
  • Flushing.
  • Itching.
  • Nasal, eye or sinus symptoms.
  • Asthma.
  • Shock.
  • If you develop symptoms of latex allergy, avoid direct contact with latex gloves and other latex-containing products until you can see a physician experienced in treating latex allergy.
  • If you have a latex allergy, consult your doctor regarding the following precautions: avoiding contact with latex gloves and other latex-containing products; avoiding areas where you might inhale the powder from latex gloves worn by other employees.

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(Source: INO leaflet ‘Preventing allergic reactions to natural rubber in the workplace’)