According to the Webster’s Dictionary, the term "latex" refers to natural rubber latex, the product manufactured from a milky fluid derived from the rubber tree, Hevea brasiliensis. Several types of synthetic rubber are also referred to as “latex,” but these do not release the proteins that cause allergic reactions.
Workers in the health care industry (physicians, nurses, dentists, technicians, etc.) are at risk for developing a latex allergy because they use latex gloves frequently. Workers with less frequent glove use (hairdressers, housekeepers, food service workers, etc.) and workers in industries that manufacture latex products are also at-risk for having a latex allergy.
Workers who are exposed to latex gloves and other products that contain natural rubber latex may develop some of the following allergic reactions:
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Use of natural rubber products may result in reactions that fall into the following three categories:
When gloves are associated with skin wounds, the most common reaction is irritant contact dermatitis. Irritant contact dermatitis may be due to direct irritation from gloves or glove powder. It may also be due to other causes, such as the following:
Irritant contact dermatitis presents as dried, cracked, split skin. Although irritant contact dermatitis is not an allergic reaction, the breaking of the intact skin barrier due to these lesions may afford a pathway for other natural rubber latex (NRL) proteins to gain access, which can cause a development of sensitivity. Additionally, irritant contact dermatitis lesions disrupt the barrier function that intact skin provides to inhibit passage of various chemicals and pathogens.
The second type of reaction that may be associated with glove use is allergic contact dermatitis. When glove use has been associated with this reaction, the majority of cases appear to be due to the chemicals used in processing NRL or other glove materials. Allergic contact dermatitis has an appearance similar to the typical poison ivy reaction, with blistering, itching, crusting, oozing lesions.
Also, like poison ivy, this dermatitis appears 24-72 hours after the use of gloves or exposure to other sources of chemical sensitizers.
The third and potentially most serious type of reaction sometimes associated with glove use is a true IgE/histamine-mediated allergy (also called immediate or type I hypersensitivity) to allergenic glove protein. This type of reaction can involve local or systemic symptoms.
Localized reactions occur at the site of exposure. For example, hives that appear in the area where contact occurred, is a localized reaction.
Mild localized symptoms including the following:
Systemic (more severe) symptoms that may indicate a serious latex allergy include the following:
The most serious allergic reaction to latex is anaphylaxis. An anaphylaxis reaction develops immediately after latex exposure in highly sensitive people. It rarely happens the first time someone is exposed.
Signs and symptoms of anaphylaxis include:
If any of these symptoms develop following an exposure to latex, medical treatment must be initiated immediately.
A latex allergy should be suspected in anyone who develops symptoms after latex exposure. Any exposed worker who experiences the known symptoms should be evaluated by a physician as soon as possible. Further exposure could result in a serious allergic reaction.
Taking a complete medical history is the first step in diagnosing a latex allergy. Blood tests approved by the Food and Drug Administration (FDA) are available to detect latex antibodies.
Testing is also available to diagnose allergic contact dermatitis. In this FDA-approved test, a special patch containing latex additives is applied to the skin and checked over several days. A positive reaction is shown by itching, redness, swelling, or blistering where the patch covered the skin.
In some cases, tests may fail to confirm a worker who has a true allergy to latex. In other instances, tests may suggest latex allergy in a worker with no clinical symptoms. Therefore, test results must be evaluated by a knowledgeable physician.
Workers who have ongoing exposure to latex should take the following steps to protect themselves:
If you develop symptoms of a latex allergy, avoid direct contact with latex gloves and other latex-containing products until you can see a physician experienced in treating latex allergies.
If you have a latex allergy, consult your physician regarding the following precautions:
The following case reports briefly describe the experiences of three workers who developed a latex allergy after occupational exposures. These cases are not representative of all reactions to latex but are examples of the most serious types of reactions. They illustrate the experience in some individuals.
Source: National Institute for Occupational Safety and Health
Latex allergy in the workplace can result in potentially serious health problems for workers, who are often unaware of the risk of latex exposure.
It is extremely important that barrier protection be used when hands would otherwise contact infectious materials or hazardous chemicals, such as latex.
OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) requires that gloves be worn when it is reasonably anticipated that hand contact may occur with blood, other potentially infectious materials, mucous membranes, non-intact skin, or contaminated items or surfaces, as well as when performing vascular access procedures [except as specified in paragraph (d)(3)(ix)(D)].
When gloves are being worn to protect against bloodborne pathogens, the standard requires that employers provide readily accessible alternatives, such as glove liners, for employees who are allergic to the gloves normally provided.
NRL is a glove material that has been used in the health care environment for barrier protection for several years. In response to reported NRL allergy in some patients and health care employees, measures have been recommended to reduce the risk of reactions to allergenic NRL proteins in employees. Reducing exposure has been the primary prevention method to protect workers with latex allergies. Gloves made of NRL as well as alternative materials have been cleared by the FDA for marketing as medical gloves. They can be used effectively for barrier protection against bloodborne pathogens.
Employers should follow the hierarchy of controls to help prevent latex allergies in the healthcare setting.
Elimination & Substitution: Eliminating exposure to latex is the most effective method of control. Unnecessary latex-containing materials should be eliminated. When materials, such as gloves and bandages, are required, a non-latex version should be substituted to replace the latex-containing version.
Administrative controls: Healthcare facilities should implement administrative controls, which include policies and procedures, to reduce the risk of allergic NRL reactions. For example, creating so-called "safe zones" to protect those employees who are already sensitized to NRL allergenic proteins might be necessary. "Safe zones" are areas where non-NRL products are used and NRL allergenic proteins have been removed from the environment.
A prudent risk reduction strategy involves an initial survey and assessment, with a coordinated effort to identify and catalogue all NRL products used in the workplace. An ongoing program involves close coordination between both resources and management staff. This will help monitor NRL content of incoming products so management can be prepared to choose appropriate alternatives to protect at-risk employees.
Latex allergy can be prevented only if employers adopt policies to protect workers from undue latex exposures. NIOSH recommends employers take the following steps to protect workers from latex exposure and allergy in the workplace:
Workers should take the following steps to protect themselves from latex exposure and allergy in the workplace:
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