Natural Rubber Latex Allergy

Abstract

Natural rubber latex (NRL) is a milky fluid from the Hevea brasiliensis (Hev b) tree, which functions as a protective sealant (Ownby, 2002). Because of its excellent elastic properties, it is widely used in the manufacture of medical devices and in a variety of everyday articles such as gloves, condoms, balloons, baby nipples, syringe plungers, and vial stoppers. As many as 40 000 types of consumer products may contain NRL (Perkin et al., 2000). The use of rubber for surgical gloves was first made in 1984 by Richard Cook and who popularized the use of rubber gloves in surgery was William Hasted (Dyck, 2000). NRL allergy is a common occupational disease. The induction of latex allergy commonly occurs after exposure of skin or mucous membrane to natural rubber latex. It is usually a contact dermatitis or delayed allergy (type IV), and reaction mediated by IgE (type I) or immediate hypersensitivity. Latex allergy symptoms can be mild or severe and manifest as contact urticaria, rhinoconjunctivitis, asthma, and mucosal swelling; systemic reactions consist of generalized urticaria and anaphylactic shock (Hamann et al., 1998; Agarwal & Gawkrodger, 2002; Cao et al., 2010; Cleenewerck, 2010). It affects people who are frequently exposed to products made of natural rubber latex, such as health care workers HCWs (5 to 17%); and groups at high risk included spina bifida cystica patients (to almost 65%), latex industry workers, specific food-allergy patients, and patients with a history of atopy or multiple surgical procedures (Nettis et al., 2002; Turjanmaa et al., 2002; Sullivan, 2005; Sukekava & Sell, 2007; Armentia et al., 2010; Bains et al., 2010; Radauer et al., 2011). Knowledge about latex allergy is important for three reasons: firstly, it is potentially fatal if the patient is not properly managed; secondly, it is common in healthcare workers (HCWs) as an occupational disease; and thirdly, its incidence has been increasing due to increased use of latex gloves as a barrier against viral infections (Agarwal & Gawkrodger, 2002). Also, latex has cross reactivity to banana, avocado, kiwi and other foods. Undiagnosed latex allergy is potentially very serious for patients and is increasingly recognized as a significant contributor to morbidity and mortality during medical and surgical procedures, and anaphylactic shock has been documented (Kosti & Lambrianidis, 2002; Sonofuchi et al., 2010). At present, latex avoidance is the only available treatment and is the key to preventing allergic reactions in latex-sensitized individuals. This chapter will present the etiology, epidemiology, and pathogenesis of natural rubber latex allergy.