How can latex allergy be prevented?
First, notice if you have any of the above symptoms. Healthcare workers are so good at taking care of others that we tend to overlook ourselves. If you do have symptoms, (especially at work but not at home), keep a journal to find a
pattern. Ask your doctor or allergist to be tested for latex allergy and remind them that you are at high risk because of your occupation, and even more so if you have other allergies. There is also a hereditary component to latex allergy, so find out if anyone in your family has symptoms. Finally, avoid latex gloves as much as possible.
Legislation
Latex allergy is recognized as a serious occupational health risk by the FDA (Federal Drug Administration, OSHA (Occupational Safety and Health Administration), NIOSH (National Institute for Occupational Safety and Health), and the CDC (Centers for Disease Control). The FDA now requires manufacturers of medical supplies to put warning labels on products that contain latex, and is regulating the use of the misleading term "hypoallergenic." The FDA and the American Society for Testing and Materials are recommending that manufacturers limit the amount of latex protein in gloves and that this limit be printed on the glove label. In 2002, the CDC released new hand hygiene guidelines for healthcare facilities that recommend reduced-protein, powder-free latex gloves when there is a risk of blood exposure. In addition, most nursing, medical, and dental associations now have position statements on latex allergy that recommend decreasing the use of powdered latex gloves and providing alternative products that are latex free.
A number of states passed legislation that either limits, or completely bans, the use of powdered latex gloves in healthcare facilities and food establishments. The following are some examples.
ARIZONA
The Arizona Department of Health Services has updated the requirements for food safety in restaurants and other food service establishments for the first time in 25 years. One of the new rules is that food service workers must wear non-latex gloves when preparing food. This went into effect on October 3, 2001.
MAINE
A bill has been enacted in Maine which prohibits health care facilities from using powdered latex gloves. This means the gloves cannot be provided by the organization, or even allowed in the building. Healthcare facilities affected include: hospitals, psychiatric hospitals, nursing facilities, kidney disease treatment centers (including free-standing hemodialysis centers), rehabilitation facilities, ambulatory surgical facilities, independent radiologic service centers, independent cardiac catheterization centers, cancer treatment centers, and private physician and dentist offices, whether in individual or group practice. Any facility found noncompliant can be fined up to $500. (Note: This bill still allows powder-free latex gloves to be used, but it's a step in the right direction. The Maine Nurses Association is encouraging legislation that would ban all latex gloves.)
MASSACHUSETTS
The General Laws of Massachusetts have been amended by the State Senate and House of Representatives to prohibit latex gloves in any food establishment. This includes businesses that manufacture and store food, as well as those that sell it. Any business found noncompliant can be fined up to $100 for each violation.
NEW YORK
The public health law has been amended by the State Senate and House of Representatives to require any food service establishment that uses latex gloves to provide written notice to patrons that states: "Latex gloves are used by staff in the preparation and conveyance of food in this establishment. If you are allergic to latex products, please take appropriate action." (Note: Unfortunately this bill does not ban the use of latex gloves in food preparation, but again, it's a step in the right direction. Latex allergy is being recognized at the state level.)
OREGON
The Oregon Legislative Assembly has passed a bill that "requires health care facilities to use non-latex products, to provide workers with information and diagnostic services for ailments related to the use of latex, and prohibits use of powdered latex products in health care facilities." This includes not only all healthcare and dental facilities, but also home health agencies. Any facility found noncompliant can be fined up to $100 for the first violation and not more than $500 for each subsequent violation. (Each day of continuing violation is considered a subsequent violation.) In addition, a notice of these requirements must be posted in a conspicuous place, or the facility can be fined up to $100 for each day of violation.
RHODE ISLAND
Rhode Island has passed a Latex Glove Safety Act that prohibits the use of disposable natural rubber latex gloves in food establishments. In addition, any other business regulated by the state that uses latex gloves must post a sign in a conspicuous place, in both English and any other language spoken by customers, that states:
(a) that latex gloves are used in the business;
(b) that latex exposure may result in development of an allergy;
(c) that allergic reactions to latex can manifest by skin rash, hives, nasal and eye irritation, asthma, and shock;
(d) that anyone experiencing symptoms of an allergic reaction to latex should contact their healthcare provider.
In addition, healthcare workers must be provided with initial and periodic education about latex allergy and must be represented on latex allergy or safety committees. Any facility or business found noncompliant is subject to a fine of $500 and license revocation.
Progress is being made, but the fact remains that latex is the best barrier against blood-borne diseases, and it's a superior material in terms of strength, flexibility, and durability. Surgeons and dentists especially favor latex gloves over synthetic because of these factors. Even healthcare facilities that aren't affected by state legislation are taking steps to decrease powdered latex glove use and are providing latex-free alternatives. This has proven to be effective, as the incidence of latex allergy among healthcare workers has decreased. It will take healthcare organizations some time to work through this issue, since the ramifications related to blood contact are so great. However, workers who have no risk for blood contact should not hesitate to switch to synthetic gloves. The cost of synthetic gloves has been shown to be comparable to that of latex gloves, and the health benefits are worth the change.
Julie's story continued…
Julie asked her doctor about her symptoms and he referred her to an allergist. The allergist suspected latex allergy based on her history and did a scratch test. Within minutes of the latex solution application, her arm became swollen, red, and itchy. Spirometry indicated that Julie has asthma, and since it had not been previously documented in her medical record, the allergist diagnosed latex allergy-induced asthma. Julie can no longer work in the ICU, so the employee health nurse is helping her find another job within the hospital that will be safe for her.
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