In 1987, there was a movement throughout the world to take precautions that would prevent the spread of infectious diseases, especially the AIDS virus. This effort resulted in the application of universal precautions for protecting a person from infectious material using protective barriers. One such barrier was the latex glove. It is estimated that since 1987, the annual United States usage of latex gloves has been 10 billion. This increase in the use of latex has resulted in a dramatic rise in allergy to latex. Health care workers are at particular risk for latex allergy and it is estimated that this allergy affects 2% of all hospital employees. Latex is used in over 40,000 products.

What is latex and where is it found?

Latex is a natural product which comes from the light milky fluid that is extracted from the rubber tree. This milky fluid is often modified during the manufacturing process to form a latex mixture. A person can be allergic to the latex or the mixture or both. Latex-containing products are many and varied (see the list below). One of two procedures is employed during the manufacturing of the latex-containing product. One procedure is "dipping," wherein a form is dipped into a vat of latex and after drying, the latex product is washed and then peeled from the form. If the latex product is not washed well, as is the case with rushed production, more "free" latex is present on the surface. This "free" latex is responsible for a great deal of latex allergy. Dipped latex products include gloves, balloons and condoms. A much less allergic latex product is made by molding the latex. Products such as rubber stoppers and erasers are manufactured using this process. The powder of surgical gloves is a significant problem. Latex will easily stick to powder that is commonly used in surgical gloves.

When the glove is placed on or taken off the hand the glove is frequently "snapped." This snapping places the powder, with latex sticking to it, into the air. Inhaled latex can be a serious allergic problem.

Who is at risk?

Some people are born with a genetic predisposition to be allergic to latex. However, repeated exposure to latex is necessary for an allergy to develop. If a person is repeatedly exposed to latex, especially products that are "dipped," the risk of latex allergy substantially increases. Therefore, persons at risk are health care workers exposed to latex products (such as gloves and catheters), people who require frequent surgery or catheter use, and workers in the manufacturing or distribution of latex products. For unknown reasons, people who have surgeries of the spine or urinary tract have a much higher risk of latex allergy for reasons unknown.

There is also an interesting association of unique food allergy among persons allergic to latex. People allergic to latex are frequently allergic to bananas and sometimes other foods like kiwi, papaya, avocados and apricots. This association with food allergy is real, but the cause of the relationship is uncertain.

How is latex allergy detected?

Allergy to latex comes in two different forms. One form is called a "delayed hypersensitivity" which is usually seen as a skin rash at the site where the latex product contacts the skin. This rash can be quite severe. A more dangerous form of latex allergy is an "immediate reaction" to latex. This is also referred to as anaphylaxis. Anaphylaxis can result in seriously low blood pressure, breathing difficulty, and even death. Some patients can experience irritation of the nasal passages similar to hay fever (allergic rhinitis).

To detect the delayed hypersensitivity reaction, latex, its preservatives and accelerators are placed on the skin using a standard patch test. Caution is used because an immediate reaction is possible with patch testing. To detect an immediate reaction, a blood test and skin test is available. With latex allergy, the blood test is performed first because of the potential severe reaction.

How is latex allergy treated?

Avoidance of the provoking agent (allergen), such as latex, is the most effective way to manage any allergy. Latex free synthetic rubber, such as neoprene, nitrile, SBR, Butyl, and Vitron are polymers that are available as alternatives to natural rubber. There are no naturally occurring proteins in them and they are NOT responsible for latex allergy. Labeling is extremely important, but mandatory labeling is currently not required.

Patients who are known to be allergic should avoid any product that might contain latex until the latex content is determined by contacting the manufacturer. Even products labeled "safe latex" (which indicates lower proportions of natural latex) can cause latex allergy. There is no safe latex for latex allergic sufferers. Federal legislation is pending on truth and labeling for latex products. Powderless gloves are a great help in preventing airborne latex and have been very helpful in reducing surgical exposure of latex for the health care worker and the patient. No current treatment is available to desensitize the person allergic to latex. Treatment of reactions includes antihistamines, adrenaline, and steroids.

Latex-Containing Products (partial list):

Band-Aids, rubber bands, erasers, some shoes and articles of clothing, balloons, surgical gloves, catheters, condoms, some items of sporting equipment , blood pressure cuffs, some watch bands, helmets, tooth brush massagers, bowling balls and ventilator tubing.

Latex Allergy At A Glance

• Latex allergy is dramatically on the rise throughout the world.
• Latex allergy rises with exposure and is suspected to continue to rise until a latex substitute is found.
• Latex allergy can be serious.
• Latex is found in more than 40,000 products and is a common component of surgical gloves.