A review of latex sensitivity related to the use of latex gloves in hospitals

AORN Journal,  July, 2004  by Rosimeire Aparecida Mendes Lopes,  Maria Cecilia Cardoso Benatti,  Ricardo de Lima Zollner

• E-mail
• Print
• Link

DIAGNOSIS

Diagnosis of latex allergy is based on a detailed clinical history of consistent IgE-mediated reactions to latex, as well as the presence of certain risk conditions, such as atopy, multiple surgeries, history of allergy to certain fruits and nuts, and occupational exposure to latex. A clinical diagnosis can be verified by laboratory tests, including a skin prick test that detects specific IgE to latex or a serologic test that detects and quantifies specific IgE in the serum. (13,14) The most common auxiliary diagnostic tests used are in vivo tests, such as a skin prick test using a solution of rubber antigens, which is considered the most reliable diagnostic method, or an in vitro test using the enzyme-linked immunoabsorbent assay. (11)

EPIDEMIOLOGY

European studies on prevalence of positivity to a skin prick test using latex as an antigen vary between 0.9% and 10%. In a British hospital, the prevalence of type I allergy to latex extracted from gloves was 0.90/0 determined by a skin prick test. (15) In a Swiss hospital, researchers found type I allergic sensitivity to latex in 10% of participants in an exposed group (ie, surgeons, anesthesia care providers, nurses) and in 6% of a unexposed group (ie, hospital administrative personnel). (16)

Canadian and American studies present high prevalence rates of type I allergic sensitivity to latex, ranging from 6.2% to 30%. Researchers found type I allergic hypersensitivity to latex in 30% of 342 health care workers in an American hospital, and their symptoms suggested that the allergic reactions were related to the use of latex gloves. (17)

In Canada, a group of researchers used serological analysis and obtained a 12.5% prevalence of type I hypersensitivity to latex among anesthesiologists and nurses; 2.4% of these individuals had clinical symptoms, and 10.1% had no symptoms. (18) Using a skin prick test, another group of researchers obtained a 14% prevalence of type I hypersensitivity to latex among workers in an intensive care unit. (19) In a study conducted on the presence of IgE antilatex in 531 health care workers, researchers found a 6.2% prevalence of latex sensitization. (20)

In Argentina, a study involving patients in a teaching hospital found the prevalence of latex allergy among children who had undergone multiple surgeries was 32.1% (nine of 28), and the prevalence for outpatients was 18.6% (23 of 123). The prevalence among health care workers in this same study was 17.3% (17 of 98). (21)

In the first controlled Brazilian epidemiological study on latex allergy, researchers studied 50 professionals working in the surgical sector of a metropolitan hospital in Rio de Janeiro and, using a puncture test, found a prevalence of 6% allergic sensitization. (22) Another cross-sectional, descriptive survey focused on 96 Brazilian health care workers in the neonatal intensive care trait at the Women's Integral Health Center (ie, Centro de Atencao Integral a Saude da Mulher), State University of Campinas, Sao Paulo, Brazil. The prevalence of latex allergy obtained by a skin prick test with an antigen extract from latex gloves and latex-specific igE measure was 8%. In eight cases, the skin prick tests were positive, although only one serological test was in agreement with the skin test. (23)