Issues in Latex Allergy

    Friday, 03 April 2015 07:00  Blog

iStock 000036825214 SmallA growing number of latex allergies are being recognized and diagnosed. It is believed that about 3 million people in the United States are allergic to latex. Those allergic to latex react to a milky fluid found in latex that is produced by rubber trees. As with other allergies, the immune system perceives the allergen (i.e. the milky fluid found in latex) as harmful. Many latex allergies are mild and may simply cause some slight irritation to the skin, termed irritant dermatitis. However, the allergy can also be much more serious, leading to hives, asthma, rhino-conjunctivitis, and of particularly concern, anaphylaxis. Because anaphylaxis is potentially fatal, increasing our understanding of latex allergy and how it may lead to this serious condition is important. Further, it is critical that people recognize risk factors for latex allergy so that they can minimize the likelihood of developing this allergy and manage the allergy safely when it does occur.

Risk Factor 1: Exposure to Latex

Like many other allergies, the risk for developing a latex allergy increases with exposure to latex. Between 7 and 10% of workers who where latex gloves regularly become allergic to latex. For instance, one study determined that over 12% of all anesthesiologists suffer from latex allergy, and many studies have reported the relatively high numbers of nurses with latex allergy. Though latex free gloves tend to be more expensive than latex gloves, several hospital programs have been developed to implement latex-free only gloves for use within the hospital. Supporters of these initiatives argue that the liability and spending that is saved by preventing employees from developing bothersome and potentially dangerous allergies is worth the added financial cost. A Japanese analysis, for example, concluded that using latex-free gloves could actually end up saving 3.5 million yen each year.

The FDA, however, says that latex free labels are misleading because there is no test that can accurately and definitively assure that no latex is present in products. However, they also acknowledge that complete elimination of latex is probably not required to prevent allergic reactions to latex. Accordingly, programs that switch to “latex free” gloves have indeed significantly reduced latex allergies among healthcare workers.

Risk Factor 2: Family History of Allergy

Those with a family history of allergy seem to be more likely to suffer from latex allergies. About 33% of all people who receive positive skin test results for latex allergy do not demonstrate any allergy symptoms. For those who do suffer from allergic symptoms when exposed to latex, using powder free latex gloves can reduce symptoms, particularly if those symptoms are respiratory because reducing powder minimizes the airborne exposure to latex.

Risk Factor 3: Allergy to Fruits and Vegetables

Those allergic to fruits and vegetables may be more prone to latex allergies. Recently, some researchers have begun to focus on the potential cross-reactivity between latex allergies and food allergies. Indeed, a number of people who are allergic to latex turn out to also be allergic to specific foods Some of the most highly implicated foods for those allergic to latex are avocado, potato, and banana. Tomato, chestnut, bell peppers, papaya, and kiwi are also often problematic for those with allergies to latex. Some clinicians use the term “latex-fruit syndrome” because of the relatively high incidence of comorbid allergy to both latex and fruit. The reason this cross-reactivity occurs is that the protein in latex that leads to an allergic reaction is structurally similar to proteins found in many foods, particularly fruits and vegetables.

Other Groups Shown to be Vulnerable to Latex Allergy

The elderly population also appears to be vulnerable to latex allergy, though whether this vulnerability is simply due to an increased likelihood that elderly individuals have been exposed to latex more than younger individuals is not clear. Another group that often suffers from latex allergies is children with spina bifida. Between one quarter and two thirds of children with spina bifida test positive for latex allergy. Many studies conducted in Northern America, Europe, and Asia find about half of those with spina bifida also suffer from latex allergy.

Avoiding Latex

Much of the literature focuses on latex in gloves, which has been shown to significantly impact the healthcare community. However, latex has been identified in a number of products, ranging from balloons to yoga mats to eyelash glue. There have also been reports of vaccines and flu shots causing latex allergy reactions. Though many people misinterpreted these observations as indicating a problem with the medicine that was injected into patients, it is generally agreed that the most likely cause for these reactions is the latex found in syringes. Further support for this notion comes from the fact that the reactions tended to be local, causing irritation in the area of the skin where the injection was made. If, on the other hand, the medicine itself contained latex, a more widespread reaction would be expected with the injection of that medicine into a patient’s circulation.

Restaurants are another place where people report latex allergies. Because workers often wear latex gloves while handling food in restaurants, those who later consume that food can react to the latex that remains on the food. As a result, many restaurants have switched to vinyl gloves, though it has been reported that vinyl suffers its own dangers. In 1999, Rhode Island became the first restaurant to ban the use of latex gloves in restaurants. In the next few years, both Arizona and Oregon followed.

Diagnosis and Treatment of Latex Allergy

Latex allergies can be identified with both serum testing and skin prick testing. The American Latex Allergy Association says that the early symptoms of latex allergy include: hives, welts, a runny nose, swelling, headache, sneezing, itching, watery or reddening eyes, sore throat, chest tightness, wheezing, shortness of breath, or abdominal cramps.

There is not yet a universally adopted highly effective treatment for latex. The best option for preventing latex allergy is currently avoidance. However, other treatments have been shown to be useful in certain cases. For instance, last year, researchers successfully desensitized a nurse to latex using sublingual immunotherapy, which involves placing a small amount of latex under the tongue. This type of therapy works by getting the immune system used to the allergen in small doses so that it no longer reacts to the allergen as if it is a dangerous foreign invader.

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