Latex Allergy
Latex allergy is an allergy to natural rubber latex (NRL). Latex is milky substance produced by certain plants and trees. NRL is produced by the rubber tree (Havea brasiliensis).
Latex is used in the manufacture of thousands of products such as gloves, condoms, balloons, and rubber bands. The manufacturing process tries to remove the allergy causing proteins and chemicals from rubber latex but some are inevitably left in the finished product. These proteins and chemicals are responsible for the development of allergy to latex products.
Allergic reactions to latex are common in health care workers who use gloves. Also patients who frequently come into contact with gloves or catheters can develop latex allergy.
There are two types of allergic reactions to latex: immediate and delayed. Immediate reaction is the most serious and can be potentially fatal.
Immediate reaction
Immediate reaction starts within minutes of exposure.
A local reaction may cause itching, redness, or urticaria (hives) in one place on the body. A generalized reaction can progress to the signs and symptoms of anaphylaxis including widespread hives, difficulty breathing, and difficulty swallowing. It is impossible to predict who might progress from a local reaction to anaphylaxis. Therefore, once a local allergy to latex develops, it should be taken seriously and every effort made to avoid future exposure to latex.
The immediate reactions are more likely to occur with powdered (rather than non-powdered) glove. The powder, which is corn starch, is non-allergenic, but allergy-promoting proteins seep into the powder and together become airborne, causing generalized symptoms by being absorbed into the body through the nose and lungs.
The anaphylactic reactions from latex almost always occur after exposure to internal body surfaces during surgery or dental or vaginal examinations.
Any person who is exposed to latex frequently is at risk to develop latex allergy. Common examples are healthcare workers, housekeepers, and food handlers.
Diagnosis is based on the history and a blood test.
Treatment is very strict avoidance to latex exposure. The following is a list (not all inclusive) of common items that are a source of latex exposure.
- Wear non-latex gloves and the coworkers should do the same.
- Inform all healthcare workers, including phlebotomists (person who takes blood for blood tests), surgeons, dentists, nurses, and physicians in all clinics, emergency rooms, or hospitals that you have a latex allergy so they can take precautions.
- Wear a bracelet or pendant saying you are allergic to latex.
- Persons who had a systemic reaction from latex should also carry an adrenaline injection (Epipen or Twinject) with them for emergency use in case of an accidental exposure to latex leading to a severe reaction. Adrenaline injection is FIRST AID only. After using the injection one MUST go to the nearest medical facility for further care.
- For minor reaction such as itching or hives in one area of the bodya an antihistamine such as Benadryl or Claritin over-the-counter may suffice.
If you are allergic to one type of latex protein there is a chance you may develop an allergic reaction from exposure to the others. Some foods share common allergy causing proteins, including avocado, potato, banana, tomato, and and kiwi fruit.
Delayed reaction
The delayed reaction (or local contact dermatitis) starts a few hours to 2 days after exposure. Symptoms include intense itching, redness, blistering and weeping skin that extends beyond the area of contact with latex.
The diagnosis is made based on the history and confirmed using patch test (contact with the skin) using chemicals in finished rubber products (e.g., thiuram and mercaptobenzothiazole).
This type of local reaction is a risk factor for the development of a more serious systemic reaction.Therefore, treatment is focused on avoidance - do NOT to use latex gloves or vinyl gloves.
Non-allergic Reaction
Irritant contact reaction or irritant dermatitis is the most common reaction. It is a skin reaction but is not caused by an allergic reaction of the body's immune system. It is present only in areas of contact with latex and causes dry, itchy, red, and cracked skin. There are no blisters or weeping of the skin. Frequent washing of the hands and not drying the hands between frequent changing of gloves may increase the risk of this condition.
The treatment is to avoid powder gloves, dry hands thoroughly after washing, wear cotton glove liners under the latex gloves, and apply non-petroleum based barrier creams and moisturizers.
American Latex Allergy Association
www.latexallergyresources.org/
American Academy of Asthma, Allergy and Immunology
www.aaaai.org
