Readers respond to latex article they consider biased: latex allergy - Letters To The Editor - Letter to the Editor

AORN Journal,  March, 2004  by Susan Q. Wilburn,  Butch De Castro,  Catherine J. Galligan,  Sandy Leblanc,  Esah S. Yip,  Nancy irard

• E-mail
• Print
• Link

We read the article "Accommodating Latex Allergy Concerns in Surgical Settings" by Esah S. Yip, DSc, (vol 78, October 2003) with great concern and alarm. The article clearly serves as an advertisement for natural rubber latex gloves by the Malaysian Rubber Export Promotion Council, of which Dr Yip is noted as the director. The arguments presented are biased and inappropriately lead readers to a false sense of security regarding the use of and safety offered by natural rubber latex gloves despite being low-powder or powder-free and low in latex protein content.

A disservice is done to nurses and all health care workers when the safety of low-protein natural rubber latex gloves is touted inaccurately. Health care employers, administrators, managers, and purchasing departments may think that using low-protein gloves sufficiently accommodates latex-sensitive workers. Additionally, nurses and other health care workers easily can get the wrong impression that they can work safely in an environment with low-protein gloves without cause for concern. The fact is that no safe level of latex protein exposure exists for patients and health care workers with a type I immunoglobulin allergy to natural rubber latex. This is not mentioned in the article.

Further, throughout the article, the summary of research used to support the author's claims is misleading in that conclusions specifically supporting the use of natural rubber latex gloves are picked out and presented without effectively recognizing the limitations of generalizability of findings. Although we do agree with the statement that "it is vital that the most important criteria for wearing gloves--to protect all health care personnel and their patients against viral transmission and infectious diseases--is not overlooked," the author's review of barrier protective qualifies for types of gloves other than natural rubber latex (eg, polyvinyl chloride, nitrile, neoprene) does not provide a complete picture. The discussion excludes research that demonstrates natural rubber latex as an inferior barrier, particularly for handling chemical disinfectants and hazardous medication, such as chemotherapeutic agents.

Although the author accurately quotes the American Nurses Association's position recommending low-protein, powder-free gloves to prevent sensitization among health care workers and patients, it should be made clear that this does not mean that latex, even at low quantities, is safe. We believe that a better approach to the prevention of latex allergy should include universal precautions against exposure to natural rubber latex proteins and the use of nonlatex synthetic examination gloves in all settings. Many nurses and other health care workers suffer tremendously from latex-sensitivity and allergy. Nonlatex product alternatives, including gloves and supplies, must be considered on an organization-wide basis to successfully provide both nurses and patients a safe environment of care.

SUSAN Q. WILBURN,

RN, MPH

SENIOR SPECIAlIST

OCCUPATIONAL SAFETY AND HEALTH

AMERICAN NURSES ASSOCIATION

BUTCH DE CASTRO,

RN, MSN, MPH, PHD

SENIOR SPECIALIST

OCCUPATIONAL SAFETY AND HEALTH

AMERICAN NURSES ASSOCIATION

The October 2003 issue of the AORN Journal includes the article "Accommodating Latex Allergy Concerns in Surgical Settings" by Esah S. Yip, DSc. According to the note following the article, Dr Yip is the director of the Malaysian Rubber Export Promotional Council's (MREPC's) Washington, DC, office.

I believe it is inappropriate for AORN to publish an article encouraging the use of latex surgical gloves authored by an individual who has a vested interest in promoting latex gloves. Dr Yip's employer cites its mission as facilitating and enhancing the exports of Malaysian rubber and rubber-based products. (1) Malaysia is one of the five largest producers of natural latex rubber in the world, and the Malaysian economy relies heavily on the export of latex gloves. According to the Malaysian Rubber Glove Manufacturer's Association, Malaysia is the world's top producer of latex gloves, and glove exports are expected to reach more than $1.1 billion. (2) Almost two-thirds of the total workforce in Malaysia's rubber products industry are employed in the latex glove industry, with the bulk of the gloves exported to the United States. (3)

As director of the Washington office of MREPC, Dr Yip's foremost interest is protecting the Malaysian latex rubber industry. AORN would perform a greater service to its readership by presenting educational materials from unbiased sources with no financial benefit to be gained. I encourage AORN to inform its readers of the author's conflict of interest related to latex gloves and to seek more neutral perspectives on the topics.

CATHERINE J. GALLIGAN

MS

SUSTAINABLE HOSPITALS PROJECT

CLEARINGHOUSE MANAGER

LOWELL CENTER FOR SUSTAINABLE

PRODUCTION

UNIVERSITY OF MASSACHUSETTS

LOWELL, MASS

Notes

(1.) "MREPC's role," Malaysian Rubber Export Promotion Council, http://www.mrepc.com /webmrepc/about/role.php?pid=about (accessed 6 Feb 2004).