Stop Latex Now!

Our facility needs to become latex-free!  How many times have you heard someone make this statement?  Latex-free has become the new trend in the healthcare industry and every day, more and more hospitals are jumping on the bandwagon for one reason to prevent latex allergies.

The healthcare industry is pushing for a latex-free environment to minimize workers from developing latex related allergies including irritant contact dermatitis and allergic contact dermatitis.  Symptoms range from skin redness to respiratory symptoms and in rare cases shock.  As individuals are exposed to latex frequently, they can develop sensitivity and eventually become allergic. 

Who should be concerned?
Anyone who has frequent exposure to latex is at risk for developing latex allergy.  This means healthcare workers (nurses, physicians, dentists, and laboratory technicians) who wear latex exam gloves are highly affected.  About 5-10% of health care providers have developed latex allergy.

Background of Latex Exam Gloves
Latex is made from the sap of rubber trees called Hevea Brasiliensis (Brazilian Rubber).  Latex rubber has a milky white appearance and is made of various lipids, phospholipids and proteins.  This protein causes allergic reactions to some people who are sensitive to latex.

The use of latex as the preferred material for medical gloves ramped up due to the scare of contracting AIDS or HIV.  At the time, latex became the barrier of choice for the medical industry and there was a rush to manufacturer latex gloves as demand soared.  As a result, in the late 1980s and early 1990s, there were sudden increases in reported cases of latex reactions.

The hazards of latex protein were not secret.  In fact, the removal of the hazardous protein is one of the steps for manufacturers when creating latex gloves.  This process is called leaching which removes water-soluble chemicals and latex protein from the gloves.  Unfortunately, this process does not remove all the protein found in latex gloves.

Latex-free Alternatives
Due to concerns of latex allergies, latex-free glove production has increased.  Today, vinyl and nitrile material has become the material of choice for latex-free alternatives.  Combined with improved technologies, latex-free gloves have become just as effective, if not more, as latex gloves as a barrier of protection.

Types of Reactions:

Testing for type 1 natural rubber latex allergy is through blood testing, such as RAST (radioallergosorbent test) identifies what types of IgE proteins trigger allergic reactions. While the standard for allergen testing is the skin prick test, there is no approved skin testing reagent for latex in the United States at this time. Some other countries do have approved skin testing reagents for natural rubber latex. Some people who are allergic to latex are also allergic to clothes, shoes and other things that contain natural rubber latex - for example elastic bands, rubber gloves, condoms, pacifiers and baby-bottle nipples, balloons, cars and clothing containing natural rubber based elastic. Synthetic elastic such as elastane or neoprene do not contain the proteins that trigger type 1 reactions. Type 1 natural rubber latex allergy is caused from IgE (immune) mediated reactions to proteins found in the hevea brasiliensis tree, a type of rubber tree. Synthetic latex products do not contain the proteins from the hevea brasiliensis tree and will not cause this type of reaction.

Type 4 reactions are caused by the chemicals used to process the rubber. Patch testing needs to be done to verify which type of chemical triggers the reaction. Once the chemical is identified, then the person can choose products that are not processed with that chemical. Both natural rubber and synthetic rubber products may cause type 4 reactions.

• Children with myelomeningocele (also known as Spina bifida). Between 40% to 100% will have a reaction.
• Industrial rubber workers, exposed for long periods to high amounts of latex. About 10% have an allergic reaction.
• Healthcare workers. Given the ubiquitous use of latex products in health care settings, management of latex allergy presents significant health organizational problems. Latex allergies are becoming more common among doctors, as they have regular and prolonged exposure to latex, mostly examination gloves. Between about 4% to 15% of healthcare workers have a reaction, although this is usually Irritant Contact Dermatitis, rather than an allergy.
• People who have had multiple surgical procedures, especially in childhood.

Estimates of latex sensitivity in the general population range from 0.8% to 6.5%, although not all will ever develop a noticeable allergic reaction.

A latex allergy can also cause further reactions, to food items from the latex plant groups - banana, avocado, chestnut, strawberry, and kiwifruit. The Asthma and Allergy Foundation of America estimates that nearly 6 percent of the pediatric and adult population has some type of food allergy and up to 4 percent have an allergy to latex.[1] It can also cause reactions from foods touched by latex products in the most severe cases. There are some known cases of latex allergies being provoked from genetically modified foods such as tomatoes with latex proteins.

It is also worth noting that some highly latex allergic individuals have had allergic reactions to foods that were handled or prepared by people wearing latex gloves.

There are several theories that explain the recent increase in prevalence of latex allergy. The most plausible is the introduction of universal precautions in an effort to prevent the spread of hepatitis B and HIV infections (Centers for Disease Control, 1987). With universal precautions, a single standard of blood and bloody body fluid precautions must be used with all patients at all times, as it is assumed that these fluids are potentially infectious. One of the main ways of complying with universal precautions is through the use of gloves. This has created a growth industry for latex glove production and has resulted in greater exposure of predisposed health care workers and patients to latex products.

Increase demand for latex gloves created changes in glove processing and manufacturing, including shorter wash and shelf times, which have increased the amount of latex protein antigens in gloves and other products. Despite improvements to the manufacturing process to reduce the protein allergens, high levels of extractable latex antigens are still being found in latex gloves. Recent research has indicated that not all manufacturers have lowered the allergen level (Jones et al., 1994). Low-protein latex gloves are now being evaluated for allergenicity (Yunginger et al., 1994).

Another reason for the increased prevalence relates to the greater familiarity with latex allergy and the corresponding increased recognition and reporting of it (Kelly et al., 1994).