Latex Allergy in Health Care Personnel - Statistical Data Included

AORN Journal, July, 2000 by M. H. Baena De Moraes Lopes, R. Aparecida Mendes Lopes

There are reports of a possible association between latex allergy and allergy to banana, nuts, and avocados.(16) Atopic individuals (ie, those with a hereditary tendency to immediate allergic reactions) also are more prone to latex allergy.(17)

All high-risk individuals should undergo tests for latex allergy. The current quantitative and qualitative evaluation methods do not easily and clearly identify the proteins (ie. antigens) responsible for the allergic reaction or their concentrations. The available standardized tests used to analyze total proteins to which the individual is exposed have been well accepted.(18)

PREVALENCE

Individuals who belong to risk groups have a high prevalence of latex allergy, which appears to be directly related to the frequency of latex exposure (Table 2).

  Table 2

  LATEX ALLERGY PREVALENCE(1)

Risk groups                               Prevalence
General population                             0.37%
Patients with spina bifida                18% to 68%
Occupational exposure                    2.9% to 17%
Occupational exposure
(individuals with atopic dermatitis            36.4%
Atopic patients                                 6.8%
Patients who have undergone
various surgical procedures                     6.5%

NOTE

(1.) D M Korniewicz, K J Kelly, "Barrier protection and latex allergy associated with surgical gloves," AORN Journal 61 (June 1995) 1037-1044.

Studies of the incidence of latex allergy among health care workers have shown that they are an important risk group. Most studies estimate latex sensitivity in health care workers without symptoms to be 2% to 17%, and when they have symptoms, up to 69% show evidence of sensitivity.(19) One group of researchers found a latex sensitization prevalence of 12.5% among anesthesiologists.(20) The prevalence among OR nurses was 10.7%, and was prevalent 4.4 times more often in atopic nurses.(21) Among RNs, the prevalence was 8.9%.(22) A study of 1,351 hospital workers showed a prevalence of 12.1%; the prevalence was highest in laboratory workers (16.9%) and nurses and physicians (13.3%).(23)

SIGNS AND SYMPTOMS

The signs and symptoms of type I and type IV reactions are shown in Table 3. Life-threatening reactions generally occur after mucous or parenteral exposure, and cutaneous exposure causes local reactions.(24)

  Table 3

  TYPE I AND TYPE IV REACTIONS(1)

Type I reactions                      Type IV reactions
Edema and itching around eyes         Erythema
Rhinitis                              Pruritis
Itching nose                          Vesiculitis
Sneezing                              Papules
Urticaria                             Exfoliation
Wheezing, sibilismus
Shortness of breath
Asthma
Bronchospasms blocking airways
Sudden attack. Blood pressure drops
inexplicably and heart rate increases,
which may lead to a circulatory collapse
and anaphylactic shock.

NOTE (1.) J G Reis, "Latex sensitivity," AORN Journal 59 (March 1994) 615-621; E C Barton, "Latex allergy: Recognition and management of a modern problem," The Nurse Practitioner--The American Journal of Primary Health Core 18 (November 1993) 54-58.