What is Latex?

In the 1990s, latex allergy reached epidemic levels among healthcare workers.

Julie is a nurse in a busy ICU. Over the past year, she has noticed an itchy rash on her hands after working, along with occasional wheezing and shortness of breath. She had attributed the difficulty breathing to being out of shape, but after just being on vacation for two weeks, she is surprised to find all of her symptoms gone. Is Julie allergic to work?

Julie does have an allergy, not to her job, but as a result of it. Her work environment has put her at risk for developing a latex allergy; it looks like she has succumbed, along with many others.

What is Latex?

Natural rubber latex comes from the milky sap produced by a variety of plants; however, the latex used in manufacturing comes primarily from the rubber tree Hevea brasiliensis. Natural rubber latex should be differentiated from synthetic (man-made) rubber, as well as from the technical term "latex," which refers to a combination of different kinds of particles but which does not necessarily indicate the presence of natural rubber latex. (An example of this is latex paint.) Allergic reactions are only caused by natural rubber latex from rubber tree sap.

Who is at Risk?

In the 1990s, latex allergy reached epidemic levels among healthcare workers. It was estimated that 8-12% of healthcare workers developed a latex sensitivity due to frequent exposure to powdered latex gloves (SGNA, 2007). The increased incidence is dramatically shown by the growing number of Medic Alert bracelets listing latex allergy. In 1986, there were just 12, but by 2005, there were over 16,000. (ENA position statement, 2005). Much progress has been made in latex allergy research and awareness, and the number of healthcare workers who are newly diagnosed has now greatly diminished due to decreased use of powdered latex gloves in healthcare facilities. However, because the development of latex allergy is directly related to frequent exposure, any healthcare workers who are still regularly exposed to powdered latex gloves remain at high risk for developing the allergy.

Healthcare workers who are regularly exposed to powdered latex gloves remain at high risk for developing latex allergy.

This is also true for other workers who are frequently exposed to powdered latex gloves on the job or at home. These include firefighters, police, food service workers, environmental services workers, beauticians, auto mechanics, greenhouse workers, day care workers, painters, and people working in latex manufacturing. Latex gloves are sold in most stores and many people wear them for routine household chores such as cleaning and washing dishes. The continued use of latex gloves in everyday life combined with an unawareness of the allergy has now made the general population the group at highest risk. There is even a report of a horse farmer who developed a latex allergy.

Certain patient populations are also highly prone to developing latex allergy. Children born with spina bifida often have frequent surgeries and urogenital procedures, which used to mean frequent contact with latex gloves and catheters. In fact, the first fatalities related to latex allergy resulted from the use of latex catheters used for barium enemas. In industrialized countries, the prevalence of latex allergy in children with spina bifida is about 50% (Rolland & O'Hehir, 2008); therefore, these children are now simply treated as though they are allergic to latex from birth and strict latex precautions are used. Patients with preexisting asthma, or a history of atopy are also likely to develop latex allergies. Atopy is defined as a genetic predisposition to allergic conditions, such as asthma, eczema, or hay fever. The presence of coexisting allergies is strongly correlated with the development of latex allergy.

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