The implications of latex allergy in healthcare settings

Abstract

Latex allergy is on the increase. This paper focuses on how sensitization can occur and the use of latex gloves. Implications for the healthcare setting are addressed and recommendations made focusing on glove usage.

Latex allergy: diagnosis and management

“…However, conclusions based solely on the results of serologic tests may be misleading (7,59). Health care providers wear latex gloves frequently and for an extended period (5,23,24), and there is evidence that with sufficient exposure, employment in the health care field can lead to an increased risk of IgE sensitization to NRL (55).…”

“…Latex allergic patients may be sensitized to at least one latex protein from Hev b 1 to Hev b 13 (70). Most of these proteins are water‐soluble with allergenic fractions having molecular weights ranging from 5 to 115 kDa (5,8,70,71). Among these proteins, the most important ones are Hev b 1 and Hev b 3 for children with spina bifida and Hev b 2, Hev b 5, Hev b 6, and Hev b 7 for healthcare workers (4,25,30,33,38,49,68,71–73).…”

“…NRL is the milky fluid of agricultural origin obtained from the sap of the Hevea brasiliensis tree, which grows in Africa and peninsular Malaysia (1,3,5,8–10). NRL is composed of spherical polyisoprene droplets coated with a layer of water‐soluble proteins (11).…”

“…The disproportionate increase in type I allergies to NRL within the past two decades (1,3,24,25) may be the result of several of the following factors: 1) increased frequency and duration of exposure to NRL‐containing devices as a result of the CDC universal precautions and OSHA regulations for glove usage for healthcare workers; 2) changes in the manufacturing process of latex gloves with inexperienced manufacturers of NRL gloves producing poorly compounded and inadequately leached/washed products with higher NRL allergen content; 3) a bias of ascertainment or increased recognition of natural rubber latex by clinicians in association with improved diagnostic techniques; 4) increased awareness of NRL allergy by latex‐exposed workers; and 5) possibly a true increase in latex allergy incidence parallel to increased atopy and sensitivity to various allergens in western populations (1,3–6,14,23,26–32).…”

Making patients safer: nurses’ responses to patient safety alerts

“…Whilst the incidence of latex allergy in the population is unknown, the evidence is that it is the growing (Meric et al. 1998, Bowyer 1999, Lieberman 2002) NHS organizations, castigated before the study for not having done enough to alert staff (NPSA 2004), appeared to have taken slow and relatively ineffective action to address this shortcoming. The timescale required for policy development was unacceptably long, especially in cases where the original alert had not been distributed pending managerial action.…”