Latex Allergy Affects Mostly Healthcare Workers

Latex rubber has been used in the healthcare industry for such things as catheters and gloves for decades. However, it wasn't until the late 1980s, when the US Occupational Safety and Health Administration required that healthcare workers wear gloves to prevent transmission of AIDS and hepatitis, that latex allergy became a hot topic.

Gloves are most often used in a healthcare setting to examine patients and these gloves are most often made of latex from the Hevea brasilienisis tree. Cornstarch powder is usually used to lubricate the gloves so they can be put on and taken off easily. It is believed that latex allergens bind to the cornstarch powder, but allergy may develop from chemicals used to process latex as well as from the latex itself.

Because latex gloves are manufactured under proprietary processes and manufacturers have not shared these processes with allergy researchers, it is not clear precisely what causes the allergy and how it happens. However, glove companies have changed their manufacturing processes and latex allergies in new healthcare workers may be waning.

There are two basic types of latex allergies: contact dermatitis and a systemic allergy similar to asthma. Contact dermatitis is a poison-ivy like rash that develops 24-48 hours after direct contact with latex. Latex allergy that affects the entire body may include hayfever and asthma symptoms and usually develops from breathing latex allergens bound to the cornstarch powder. Hives may also develop and spread from the hands after contact with latex gloves. In very rare occasions, an acute systemic reaction may cause shock and death.

The risk of developing allergic symptoms increases the more often a person is exposed to latex. About 50% of healthcare workers with systemic latex allergy have asthma that requires medication. They may be forced to leave their occupation if their asthma and environmental exposure can not be controlled. The latex sensitivity and damage done may never go away.

Up to 30% of healthcare workers may develop contact dermatitis from latex gloves at some time. However, it is estimated that less than one percent of the general population and perhaps 6-12% of healthcare workers have chronic latex allergies. Nearly half of spina bifida patients may have latex allergies, although the cause is uncertain. One possibility is repeated exposure to latex through frequent catheterization and undergoing many operations. In one day, the typical operating room houses scores of people wearing latex gloves, plus equipment such as intravenous tubing and medical devices made of latex. Some spina bifida patients have a valve implanted in their brain to control spinal fluid flow. It is only made of latex.

Diagnosis and Treatment

There is no reliable skin test to determine latex allergy, but a blood test is available. It is usually used to confirm the condition after a detailed medical history of symptoms and exposure is completed. Some patients with latex allergies are also sensitive to certain fruits and nuts, such as banana, avocado, kiwi, peach, pineapple and chestnut. Scuba gear, balloons and condoms are also causes of latex allergies, but latex paint is not, since it does not contain natural latex. Patients with latex skin rashes will be treated at the time with topical creams. If exposure is not reduced, the rash may become chronic. Inhalers and other medications may be prescribed for those with asthma or other systemic latex allergies.

But the primary treatment is avoidance of latex. Healthcare workers with latex dermatitis may wear unpowdered latex gloves or, more likely, plastic, vinyl or other non-latex gloves. Using "hypoallergenic" latex gloves does not reduce the risk of latex allergy (but may reduce reactions to chemical additives). When patients with latex allergies enter a healthcare setting, they should caution their healthcare providers. Many hospitals have formed latex committees to establish policies for treating patients with latex allergies. For patients with systemic latex allergies, they may wish to wear a medical alert bracelet and even carry self-injectable epinephrine in case of an emergency asthma attack.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.