Occupational asthma caused by natural rubber latex: Outcome according to cessation or reduction of exposure

Abstract

Background: The long-term effects of reducing exposure to latex in subjects with latex-induced asthma remain unknown. Objective: The purpose of this study was to compare the health and socioeconomic outcomes of subjects with latex-induced asthma before and after reduction or cessation of exposure to latex. Methods: Thirty-six subjects with latex-induced asthma as ascertained by specific inhalation challenges were investigated after a median follow-up of 56 months (range, 12 to 92 months). Initial and follow-up visits included use of a detailed questionnaire and measurement of the concentration of histamine causing a 20% fall in FEV1 (PC20). At follow-up, information on employment, financial status, and quality of life was collected. Results: At follow-up, 16 subjects were no longer exposed to latex, whereas 20 subjects had reduced exposure. In the subjects who avoided exposure, asthma severity decreased from a median score of 8.5 to 3.5 (P = .001) and the median histamine PC20 value increased from 0.4 mg/mL to 2.3 mg/mL (P = .002). In the subjects who reduced their exposure, asthma-severity score improved from 6.5 to 2.5 (P < .001) and PC20 values rose from 0.5 mg/mL to 2.4 mg/mL (P < .001). Cessation of exposure to latex was associated with asthma-related work disability (69%) and loss of income (62%) more frequently than was reduction of exposure (35% and 30%, respectively). Conclusion: Reduction of exposure to latex should be considered a reasonably safe alternative that is associated with fewer socioeconomic consequences than removal from exposure. (J Allergy Clin Immunol 2002;109:125-30.)