Risk For Latex Sensitization Research Articles

Comparing the Level of Dexterity offered by Latex and Nitrile SafeSkin Gloves

An increase in the occurrence of latex allergy has been concurrent with the increasing use of latex gloves by laboratory and healthcare workers. In recent years nitrile gloves have been used to replace latex gloves to prevent latex allergy. Nitrile gloves offer a comparable level of protection against chemical and biological agents and are more puncture resistant. However, if manual dexterity is compromised by nitrile gloves to a greater degree than latex then this may increase the risk of sharps injuries. The Purdue pegboard test, which measures both gross and fine finger dexterity, was used to test the dexterity levels of two glove types used at HPA CEPR; Kimberly-Clark SafeSkin nitrile and latex laboratory gloves. There was a statistically significant 8.6% increase in fine finger dexterity provided by latex compared with nitrile SafeSkin laboratory gloves but no difference in gross dexterity between the glove types. There was no significant relationship between glove dexterity and age or gender. The selection of glove size was influenced by the digit length of participants. Moreover, those with longer, thinner fingers appeared to have an advantage when using nitrile SafeSkin gloves. The level of dexterity provided by latex and nitrile SafeSkin gloves for tasks on a gross dexterity level are comparable and health workers will benefit from the non-allergenic properties of nitrile. For tasks requiring fine finger dexterity nitrile SafeSkin gloves may impede dexterity. Despite this, the degree of restriction appears to have a negligible impact on safety in this study when compared with the risk of latex sensitization and subsequent allergy. In addition to glove material, working practices must also take into account glove size, fit, grip and thickness, as these factors can all influence dexterity.

Prävalenz IgE-vermittelter Naturlatexallergien bei Mitarbeitern der Klinika in Rostock, Deutschland, und im Fremantle Hospital Perth, Australien

Introduction: Studies about the prevalence of latex allergies in health care workers (HCW) have been made worldwide and differ in the single studies between 2 and 17%. The aim of our study was to investigate and compare the natural rubber latex allergies in health care workers in Rostock and Fremantle. Material/method: In our study we examined 557 people, 276 employees of the University Hospital Rostock and of the hospital Klinikum Slid in Rostock as well as 281 colleagues of the Fremantle Hospital Perth, educational hospital of the University of Western Australia. We developed questionnaire, included a present history, family history, allergy and latex anamnesis. For the prick test we used commercial test solutions made by ALK-Scherax. The in vitro diagnostic contained the determining ofthe latex-specific IgE by the Allergopharma specific IgE ELISA (RV). Results: The 2 groups of test persons from Rostock and Fremantle hospital did not differ in regard to age and sex. In the Fremantle group we found a significantly higher number of atopic persons (R = 25.4%; F = 50.9%). The probands from Rostock were found to have served for a longer period in their jobs (R = 15 ′ 10.7 years; F = 12.4 ′ 10 years). The use of unpowdered and latex-free gloves were more common in Rostock. On average, the wearing time and the number of the daily used gloves were significantly higher in Rostock than in Fremantle. The 2 groups from Rostock and Fremantle did not show any significant differences in the SPT (R = 4.0%; F = 3.9%), in the EAST classes ≥ 2 (R = 2.5%; F = 3.9%), in latex sensitization (R = 4.7%; F = 5.3%) and in natural rubber allergy (R = 3.3%; F = 3.6%). In our study we could prove that probands with atopic disease, as well from Rostock as from Fremantle, are significantly more frequent latex-sensitive than test persons without an atopic disease (p < 0.001). The risk of latex sensitization is within the persons with atopic disease 8 times higher than within those, who don't have any atopic disease. Conclusion: The results of our study, with an allergy rate of 3.3% in Rostock and 3.6% in Fremantle, show a low prevalence of latex allergy in comparison to other in literature published investigations. The risk of latex sensitization was significantly higher under the atopics.

Latex allergy in children with oesophageal atresia

Latex allergy is frequently found in children and patients with spina bifida and urogenital abnormalities and have been considered at risk for latex sensitization. The aim of the study was to evaluate the incidence of latex sensitization in patients with oesophageal atresia and undergoing three or more surgical procedures and to identify possible risk factors in the process of latex sensitization. A total of 20 patients were analysed: 19 boys and one girl. The oesophageal atresias were as follows: type I in three children, type II in two and type III in 15 children. Surgical and anaesthetic procedures, intensive care management, age, type of oesophageal atresia, associated congenital malformations, Waterston and Montreal prognostic classifications were considered as risk factors that may be implicated in the process of sensitization. Five patients (25%) were considered sensitized to latex (group 1) and 15 (75%) nonsensitized (group 2). Among the five sensitized patients, three reported clinical reactions to latex, while the other two presented only specific IgE sensitization. The number of operations, the total hours of surgery, the number of drainages, the total days of drainage, the total days of central venous catheter were significantly greater in group 1 than in group 2. Both of the highest risk oesophageal atresia classes (Waterston C and Montreal II) were related to latex allergy. Oesophageal atresia, especially in cases of prolonged management, must be considered as a risk for the development of latex allergy.

Latex hypersensitivity in spinal cord injured adult patients.

Latex hypersensitivity is a major cause of anaphylaxis during anaesthesia. Patients with spina bifida, health care or rubber industry workers have been considered at risk for latex sensitization. By analogy, the existence of other at-risk subsets of patients with latex exposure due to frequent surgical procedures has been suggested. The aim of this study was to evaluate the prevalence of latex sensitization in a cohort of adult patients with spinal cord injury and repeated latex exposure. Forty-two adult patients with spinal cord injury were studied and retrospectively compared to a group of 30 children with spina bifida evaluated using a similar protocol. Patients were administered a questionnaire concerning history of latex hypersensitivity, atopy, and surgical procedures. Latex sensitivity was investigated by skin prick-tests and latex-specific IgE assay. The search for atopy was based on in vivo and in vitro tests against a panel of environmental allergens. No chronic spinal cord injured patient had a history of latex allergy. When compared with spina bifida, the number of surgical procedures was not statistically different. Although not significantly different, the prevalence of atopy was higher in spina bifida patients. The high level of latex sensitization in spina bifida patients contrasted sharply with the absence of sensitization observed on both skin and in vitro tests in patients with spinal cord injury (P<0.0001). This study confirms that adult patients with chronic neurologic defects resulting from spinal cord injury exhibit a low risk of latex sensitization. These results suggest that considering adult patients with repeated surgical procedures as a group at risk for latex sensitization because of a high degree of latex exposure should be re-examined.

Neonatal sensitization to latex

Babies born in delivery rooms of hospitals are exposed to latex through skin and mucous membrane contact with prepowdered latex gloves worn by midwives and doctors, and through the inhalation of latex-bound starch powder in the air of the delivery room. This paper examines the hypothesis that they are at risk for latex sensitization, and that part of the sharp increase of childhood asthma, eczema and anaphylaxis in the past 30–40 years may be linked. These possibilities seem hitherto unsuspected. In over 700 papers on latex allergy no mention of neonatal exposure to latex has been found. Even obstetric papers discussing the risks for an atopic mother (atopy – a tendency to develop allergies) do not seem to anticipate any risk for the baby, who might also be atopic. Latex allergy is primarily regarded as an occupational hazard. This paper suggests that it is a hazard for every baby handled by latex gloves at birth.

Latex sensitization in general pediatric surgical patients: A call for increased screening of patients

Background/Purpose: Latex sensitization is a well-documented occurrence in children with myelodysplastic and urologic anomalies. The incidence of latex allergy in general pediatric surgical patients, however, has not been previously addressed. The purpose of this study was to examine the risk of perioperative latex reactions in a general pediatric surgical practice over a 1-year period. Methods: This study examined the occurrence of latex sensitization using two methods. First, the preoperative anesthesia records of patients that have undergone surgery from October 1995 through September 1996 at Mott Children's Hospital were reviewed retrospectively. Second, all patients who had intraoperative anaphylaxis attributable to latex sensitization, including those from three additional hospitals, were evaluated. Results: During a 12-month period, 1,523 pediatric general surgical operations were performed at the C.S. Mott Children's Hospital. Of these, only 11 operations on five patients were performed under latex precautions. All of these patients had a preoperative diagnosis of latex sensitivity. During the same period, intraoperative anaphylactic reactions caused by latex allergy occurred in two of the general surgical patients (0.13%) at the C.S. Mott Hospital. Four additional cases are also reported from other study hospitals. None of these patients were suspected, based on current screening methods, of having a latex allergy before their surgery. Conclusions: Latex allergy is a potentially life-threatening condition in the pediatric general surgical population. Further study is needed to develop criteria to preoperatively identify patients at risk for latex sensitization.