A TIMELY RESOURCE for ADVANCING the NURSING ENVIRONMENT

Latex Allergy INFORMATION

HISTORY OF LATEX

FEDERAL REGULATIONS

Latex gloves are commonly used in hospitals, and there are over 40,000 other latex medical supplies.

 In the mid 1980's with the start of the AIDS epidemic, the Centers for Disease Control (CDC) and the Occupational and Safety and Health Administration (OSHA) called for the increased use of gloves to prevent exposure.

Latex comes from a natural rubber tree called the Hevea Brasiliensis and is harvested by tapping a white milky substance containing rubber proteins. These proteins cause an allergic reaction in many people.

In 1991 National Institute for Occupational Safety and Health (NIOSH) alerted all hospitals to the increasing danger of latex. In the same year, the Food and Drug Administration (FDA) recommended that all patients be screened for latex allergy and appropriate precautions be taken.

In 1997 the FDA decided to ban the label "hypoallergenic" on gloves because even powder-free gloves have some residual powder from manufacturing processes.

Powder is often used inside the latex gloves as a lubrication to help in donning gloves. Unfortunately, the powder on latex gloves binds and carries latex (rubber) protein.

In 1997 NIOSH recommended that employees use non-latex gloves when latex was not absolutely necessary.

The use of powder-free latex gloves is considered better than regular latex gloves to help rid the environment of latex containing dust.

THE EXTENT OF THE PROBLEM

MORE PROBLEMS WITH LATEX

More and more people are becoming allergic to latex.

Some healthcare workers have had to change work practices dramatically as a result of latex allergies.

 Between 1989 to 1992 the FDA reported 15 patient deaths from the use of latex enema tubes.

Others feel that the general increasing use of all latex products has led to the increased development of allergic reactions.

In surgical patients, the powder has been shown to contribute to intestinal obstruction, female infertility, adhesions, and intraperitoneal granulomas.

The sudden requirement for more gloves in 1987 overwhelmed suppliers, and as a result lower quality gloves flooded the market. Not only were healthcare workers wearing more latex, but it was lower quality and contained more rubber proteins and powder.

With increasing use of powdered latex gloves, some healthcare workers and others progress rapidly from type IV (localized reaction or dermatitis) to a type I reaction (anaphylactic), in which the person cannot breathe.

Currently from 7-17% of all healthcare personnel are allergic with 15-20% of OR personnel are sensitive to latex.

The frequency and extent of exposure plays a direct role.

HIGH RISK POPULATIONS

1.     children with spina bifida

2.     health care professionals

3.     patients who have had multiple surgeries

4.     rubber industry workers

5.     people with a history of several allergies

6.     asthmatics

7.     persons prone to dermatitis

Exposure to latex proteins can occur through:

1.     skin

2.     mucous membranes (ingestion or contact)

3.     parenteral (IV)

4.     airborne (inhalation)

LATEX ALLERGY SYMPTOMS

Usually, type IV reactions include symptoms of contact dermatitis: Localized redness,  itching,   dryness,  crustiness,  sores,  blisters, and skin exfoliation

Usually type I reactions include systemic symptoms: Itching nose,  sneezing,  watery eyes,  runny nose,  wheezing,  difficulty breathing,  asthma,  sudden drop in blood pressure with increased heart rate, and finally anaphylactic shock