Last updated on 4/19/24 | First published on 4/19/24 | Literature review current through Oct. 2024
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INTRODUCTION
Overview
This topic is part of a document published by the U.S. National Institute for Occupational Safety and Health (NIOSH), which is in the public domain and may be freely copied or reprinted.[1]
A NIOSH Alert, Preventing Allergic Reactions to Natural Rubber Latex in the Workplace,[2] outlines many of the safety and health issues related to occupational exposure to products that contain natural rubber latex (NRL). This chapter includes information from the Alert as well as from other material useful to healthcare workers. Unless otherwise cited, the material in this chapter is from the Alert.
In this chapter, latex means NRL and includes products made from dry, natural rubber. Allergic reactions to latex range from mild to severe, including skin rashes; hives; nasal, eye, or sinus symptoms; asthma; and (rarely) shock. Most persons who are sensitive to latex are not born with the allergy. They develop it after repeated exposures to products that contain latex. Limiting exposure to latex is important for both home healthcare workers and the patients in their care to prevent allergic reactions to latex.
LATEX EXPOSURE
What are some sources of exposure to latex?
Although many different products may expose workers in different professions to latex, workers in the healthcare industry are frequently affected because of their repeated exposure: commonly wearing latex gloves
[3] and using latex-containing medical equipment. Gloves made from latex are still used because of their low cost, tactile qualities, durability, and resistance to leakage.
[4][5][6] Some latex gloves contain a powder that is used as a lubricant, and the proteins responsible for latex allergy attach to this powder. When powdered gloves are worn, more protein reaches the skin, and when these gloves are changed, the particles of powder are released into the air and are inhaled. Therefore, the use of powder-free gloves may decrease both skin and respiratory exposure to latex.
[7] Also, using non powdered latex gloves with reduced protein lowers allergen exposure and has been shown to decrease the prevalence of latex reactions in hospital settings.
[7][8]
What are the effects of latex exposure?
Three types of reactions can occur in persons using latex products:
- Irritant contact dermatitis
- Allergic contact dermatitis (delayed hypersensitivity)
- Latex allergy (immediate hypersensitivity)
What is irritant contact dermatitis?
Irritant contact dermatitis is the most common adverse reaction associated with using latex gloves. Dry, itchy, irritated areas of the skin—most frequently the hands—are the symptoms.
[9] Irritant contact dermatitis is not an allergy but a reaction to repeated exposure to an irritating substance. This skin condition can be caused by putting on and taking off latex gloves or gloves of other materials. It can also be caused by repeated hand washing and drying, incomplete hand drying, using cleaners and sanitizers, and repeated contact with powders added to some latex gloves. A skin rash may also be a first sign of latex allergy and of more significant reactions that may occur with continued exposure to latex.
What is allergic contact dermatitis?
Allergic contact dermatitis is caused by contact with chemicals added during harvesting, processing, or manufacturing latex products. This is a skin reaction that resembles the rash that occurs after contact with poison ivy. This rash, when caused by latex gloves, generally begins 24–96 hours after contact and may develop to oozing blisters or spread from the initial area of contact.
[9][2]What is latex allergy?
Latex allergy is potentially a more serious reaction than irritant contact or allergic contact dermatitis. The reaction may occur at low
exposures if the person is highly sensitized. Although reactions usually occur within minutes of exposure, the symptoms may be delayed for a few hours. Mild reactions consist of redness of the skin, hives, or itching. More serious reactions might include runny nose, sneezing, itchy eyes, scratchy throat, and asthma (difficulty breathing, wheezing, and cough). Rarely, shock may occur, but a life-threatening reaction is seldom the first sign of latex allergy.[2]
A latex-exposed worker who develops any of the more serious allergic reactions given above, including unexplained shock, should be taken to a doctor right away. The doctor should ask the worker’s medical history and may give a physical exam and medical testing. FDA-approved skin and blood tests are available. Occasionally, tests do not confirm a suspected latex allergy in someone who has a true latex allergy or may indicate allergy in someone without a compatible medical history. Therefore, clinical judgment from the doctor is important.
What are some products that contain latex ?
The preceding two tables list products that may contain latex. The tables are not complete lists; other products may contain latex.
[4][2] The American Latex Allergy Association maintains lists of latex-free medical, dental, and consumer products that may be considered for substitution.
The FDA requires all natural rubber products that come in contact with humans be labeled to say that the products contain natural rubber
latex and may cause allergic reactions, [10] therefore any glove that contains latex will state so on the box.PREVENTION
How can I prevent exposure to latex?
The following recommendations can reduce or prevent exposure to latex.
[11][6][2]
Recommendations for Employers
- Provide workers with nonlatex gloves when there is little contact with infectious materials.
- If the potential exists for contact with infectious materials, select gloves that pass the ASTM F1671 penetration test for resistance to bloodborne pathogens.[12] Various manufacturers of vinyl, nitrile, polymer, and latex gloves have appropriate gloves for infectious materials.
- If latex gloves are selected, provide reduced-protein, powder-free gloves.
- Provide training to supervisors and staff on latex allergy.
- Promptly arrange a medical evaluation for workers with early symptoms.
- Evaluate current prevention strategies whenever a worker is diagnosed with latex allergy.
- Frequently clean areas possibly contaminated with latex dust (upholstery, carpets, ventilation ducts, and plenums) in a manner that minimizes dust dispersal, such as use of a vacuum with a high-efficiency particulate air filter.
Recommendations for Workers
- Use nonlatex gloves for activities that are likely not to involve contact with infectious materials.
- Ask your employer for gloves that do not contain latex but still offer protection against infectious materials.
- If your employer supplies latex gloves, ask for reduced-protein, powder-free ones. These gloves may reduce the risk of latex allergy.
- Avoid oil-based creams or lotions when using latex gloves. Oil-based creams or lotions may cause the gloves to break down and deteriorate.
- Wash hands with a mild soap and dry hands completely after using gloves.
- Participate in training provided by your employer. Learn ways to prevent latex allergy.
- Recognize symptoms of latex allergy (rash; hives; flushing; itching; nasal, eye, and sinus irritation; asthma; and shock).
- If you develop symptoms of latex allergy, avoid direct contact with latex gloves and other latex-containing products until you can see a doctor. Until your appointment, also avoid areas where you may contact powder from latex gloves.
- If you are diagnosed with latex allergy, do the following:
- Avoid touching, using, or being near latex-containing products.
- Avoid areas where latex is likely to be inhaled (for example, where powdered latex gloves are being used).
- Inform your employer and your personal healthcare professionals that you have latex allergy.
- Wear a medical alert bracelet.
- Follow your doctor’s recommendations about latex allergy.
- Before receiving any shots (such as the flu shot), be sure the person giving it uses a latex-free vial stopper.[13]
- Before receiving a medical procedure or surgery, consult the specialist who will perform the procedure about any modifications that may be needed in the materials that will be used.
RESOURCES
- American Latex Allergy Association 3791 Sherman Road Slinger, WI 53086 1–888–972–5378 [www.latexallergyresources.org/].
- Canadian Society of Allergy and Clinical Immunology. Natural rubber latex allergy: a guideline for allergic patients [http://www. allergyfoundation.ca/website/latex_allergy_ guidelines.htm].
- NIOSH. Latex allergy: a prevention guide [www.cdc.gov/niosh/98-113.html].
- NIOSH. Occupational latex allergies topic page [http://www.cdc.gov/niosh/topics/latex/].
- Sustainable Hospitals. Alternative products and procedures [www.sustainablehospitals. org/HTMLSrc/Alternative.html].
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