An evidence-based approach to medication preparation for the surgical patient at risk for latex allergy: is it time to stop being stopper poppers?

Heitz, James W.; Bader, Stephen O.

doi:10.1016/j.jclinane.2009.12.006

Cited by 15 publications

(7 citation statements)

References 45 publications

(64 reference statements)

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“…It has been reported that latex allergies can be caused by food contaminated by workers wearing latex gloves 3) and medicines/vaccines contaminated by latex-containing vial or medical devices [28][29][30] . Natural rubber is a widely used material approved by FDA for food additive, packaging, and medical devices ( Table 4).…”

Section: Latex Contamination In Foods and Medicinesmentioning

confidence: 99%

Current prevalence rate of latex allergy: Why it remains a problem?

McIntosh

Liu

2016

Journal of Occupational Health

109

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Objectives: This article aims to review the current prevalence rate of latex allergy among healthcare workers, susceptible patients, and the general public, and to investigate why latex is still a ubiquitous occupational health hazard. Methods: Scientific publications on PubMed, particularly those published within the last five years, and current regulations from agencies such as Food and Drug Administration (FDA) were reviewed. Consumer and commercial products that may contain latex were also surveyed. Results: Approximately 12 million tons of natural rubber latex is produced annually and is widely used to manufacture millions of consumer and commercial products. Only limited number of latex-derived products have been approved and regulated by government agencies, such as FDA, whereas the majority of finished products do not label whether they contain latex. Owing to millions of unidentifiable products containing latex and many routes for exposure to latex, preventing contact with latex allergens and reducing the prevalence of latex allergy are more difficult than expected. Reported data suggest that the average prevalence of latex allergy worldwide remains 9.7%, 7.2%, and 4.3% among healthcare workers, susceptible patients, and general population, respectively. Conclusions: Latex-derived products are ubiquitous, and latex allergy remains a highly prevalent health risk in many occupations and to the general population. Developing alternative materials and increasing the ability to identify and label latex-derived products will be practicable approaches to effectively control the health risks associated with latex.

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Section: Latex Contamination In Foods and Medicinesmentioning

confidence: 99%

Current prevalence rate of latex allergy: Why it remains a problem?

McIntosh

Liu

2016

Journal of Occupational Health

109

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“…Latex avoidance is required in proven or highly suspected latex allergy. A list of latexcontaining products and a supply of latex-free products should be available, 19,20 whilst a collaboration between physicians and pharmacists may be contributive to identify hidden latex-containing devices. 21 Finally, relevant staff (OR, recovery room, in-patient unit) must be alerted to the latex allergy status.…”

Section: Latex Allergymentioning

confidence: 99%

Anaesthetic management of patients with pre-existing allergic conditions: a narrative review

Dewachter

Kopač

Laguna

et al. 2019

British Journal of Anaesthesia

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This narrative review seeks to distinguish the clinical patterns of pre-existing allergic conditions from other confounding non-allergic clinical entities, and to identify the potential related risks and facilitate their perioperative management. Follow-up investigation should be performed after a perioperative immediate hypersensitivity to establish a diagnosis and provide advice for subsequent anaesthetics, the main risk factor for perioperative immunoglobulin E (IgE)-mediated anaphylaxis being a previous uninvestigated perioperative immediate hypersensitivity reaction. The concept of crossreactivity between drugs used in the perioperative setting and food is often quoted, but usually not supported by evidence. There is no reason to avoid propofol in egg, soy, or peanut allergy. The allergenic determinants have been characterised for fish, shellfish, and povidone iodine, but remain unknown for iodinated contrast agents. Iodinated drugs may be used in seafood allergy. Evidence supporting the risk for protamine allergy in fish allergy and in neutral protamine Hagedorn insulin use is lacking. Conversely, cross-reactivity to gelatin-based colloid may occur in a-gal syndrome.Atopy and allergic asthma along with other non-allergic conditions, such as NSAID-exacerbated respiratory disease, chronic urticaria, mastocytosis, and hereditary or acquired angioedema, are not risk factors for IgE-mediated drug allergy, but there is a perioperative risk associated with the potential for exacerbation of the various conditions.

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“…For patients, avoidance of exposure to the allergen is essential to minimizing perioperative complications (Heitz & Bader, 2010). In 1998, the Food and Drug Administration (FDA) started to require the labeling of medical devices made from rubber latex; since that time substantial progress had been made in identifying latex-free alternatives.…”

Section: Management and Treatmentmentioning

confidence: 99%