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Latex AllergyWhat Is It?

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Latex Allergy What Is It?

Medical content reviewed by the Faculty of the Harvard Medical School

http://www.intelihealth.com/IH/ihtIH/WSIHW000/9339/10248.html

Symptoms

Diagnosis

Prevention

Treatment

When To Call a Professional

Prognosis

Additional Info

What Is It?

A latex allergy is a hypersensitivity to latex, which is a natural

substance made of the milky sap of the rubber tree. Latex allergies

arise when the immune system, which normally guards the body against

bacteria, viruses and toxins, also reacts to latex. In any type of

allergy, when the immune system reacts against an otherwise harmless

substance, the substance is called an allergen. In the case of latex

allergies, there are two possible allergens. The first is a chemical

additive used in the manufacturing process. This allergen commonly

causes allergy among people who wear latex gloves to do their daily

work. The second allergen is a protein in the latex itself.

When the immune system detects the allergen, a type of antibody

named immunoglobulin E (IgE) is produced, triggering the release of

chemicals within the body. One chemical is histamine. Histamine is

partly responsible for the redness, itching and swelling that can

occur in the skin during an allergic reaction, and it produces

symptoms of hives; rashes; a runny nose; and watery, swollen eyes.

Histamine can also lead to breathing difficulties and a severe

allergic reaction called anaphylaxis that can include a sudden drop

in blood pressure, an increase in pulse, and tissue swelling.

Latex is a flexible, elastic and relatively inexpensive material

used in a number of healthcare and consumer products. Because it

forms an effective barrier against infectious organisms, latex is

used to make hospital and medical items, such as surgical and

examination gloves and some parts of anesthetic tubing, ventilation

bags, respiratory tubing and intravenous (IV) lines. In addition, it

is used in making countless consumer products, including balloons,

condoms, diaphragms, rubber gloves, tennis shoe soles, nipples for

baby bottles and pacifiers, toys, rubber hoses, and tires. Seven

million metric tons of latex are used in manufacturing each year.

There are two forms of latex allergies. The first involves an

immunological reaction, not to the latex itself, but to the chemical

additives used in the manufacturing process. This type of allergy

usually is seen in people who wear latex gloves regularly as part of

their work. The second type of reaction, recognized only since the

late 1970s, involves a reaction to the plant proteins in the latex

itself.

As the use of latex products increases, so does the incidence of

latex allergies. With the AIDS epidemic and increased precautions,

latex examination gloves are used routinely when handling body

fluids. Today, anyone who might come into contact with a person's

body fluids wears protective gloves. As a result, health care

workers are at increased risk of developing a hypersensitivity to

latex products.

In addition to workers whose occupations expose them to latex,

people who undergo repeated surgical procedures can develop latex

allergies. For example, children born with the birth defect called

spina bifida are usually exposed repeatedly to latex products

because they need a series of medical and surgical procedures. About

50% of children with spina bifida develop a latex allergy.

People can become sensitized to latex as a result of direct contact

with natural rubber products. Inhaling latex particles is a common

way for health care workers to become sensitized to latex. Many

medical gloves are coated with cornstarch to make them easier to

pull on and off. Cornstarch absorbs the latex proteins and then

carries them into the air where they can be inhaled.

Symptoms

As with any type of allergy, the first exposure to latex allergens

usually does not cause any reaction. However, this first exposure

can sensitize the immune system to the allergen, which can cause

symptoms after later exposures.

When the sensitivity is to a chemical additive used in manufacturing

rubber latex, the reaction typically occurs one to two days after

exposure and usually involves a form of contact dermatitis, a rash

that resembles poison ivy. The skin is usually red, cracked and

blistered. When the sensitivity is to the latex protein, more

serious symptoms can occur within minutes of exposure. Symptoms

include hives, runny nose (allergic rhinitis) and allergic asthma.

In rare instances, this type of allergy can cause anaphylaxis, a

severe allergic reaction that can include a sudden drop in blood

pressure, an increase in pulse, difficulty breathing and tissue

swelling. Without prompt and proper treatment, anaphylaxis can lead

to unconsciousness and, rarely, death.

Diagnosis

Your doctor may suspect that your symptoms are related to a latex

sensitivity if you have a history of exposure followed rapidly by

the appearance of symptoms. If you have other allergies and allergic

conditions, you may be more susceptible to latex allergy. Examples

of allergic conditions are asthma, hay fever and eczema (atopic

dermatitis). There also seems to be a link between latex allergies

and allergies to certain foods: avocados, bananas, kiwi, pineapples,

tomatoes and chestnuts.

Along with your exposure history, a blood test called RAST can help

to determine your sensitivity to latex. The RAST measures the amount

of latex-associated IgE antibodies in your blood. Skin testing for

latex allergy also can be done. In some cases, challenge tests with

latex products are used to confirm the diagnosis. In a challenge

test, you stay away from the suspected allergen for a period, then

are exposed to the substance to see if you develop symptoms.

Prevention

The best way to prevent any type of allergy is to avoid exposure.

With latex allergies, that means using gloves not made of latex for

dishwashing or other chores, refraining from blowing up balloons,

avoiding rubber bands and using condoms made of materials other than

latex. You also should tell your health care providers so that they

can avoid exposing you to products that contain latex. But if you

work in the health care field, avoiding latex can be trickier. Many

medical products contain latex. Although you may not be able to

avoid latex completely, you may be able to limit the use of latex

products and find products that are less irritating.

The amount of latex allergens shed by different types of gloves, for

example, varies tremendously. Some contain less of the chemical

additives that have been shown to cause skin sensitivity. A number

of successful lawsuits involving latex reactions have prompted many

manufacturers to change the way they make latex products. Because

latex gloves that are powdered with cornstarch appear to cause the

most problems, using gloves that are not powdered may help to

prevent reactions.

Treatment

The most important treatment for occupational latex allergies is to

avoid repeat exposures, because repeated exposures can increase

sensitivity. People with latex allergy may need to be reassigned to

different work duties or may need to change occupations.

Once you have a reaction to latex, treatment depends on the type and

severity of your reaction. An antihistamine can block the actions of

histamine, so an antihistamine can decrease itching and swelling.

Corticosteroid drugs, which are powerful anti-inflammatory agents,

are used for more severe symptoms. These are available as tablets,

nasal or bronchial sprays or topical creams. Although corticosteroid

medications can be very effective against allergic reactions, they

can produce serious side effects when used in high dosages or over

long periods. Your doctor will weigh the benefits against the risks

of side effects, using corticosteroids in the lowest dose that works

for you if you need them.

Anaphylaxis, the most serious allergic reaction, can cause blood

vessels to dilate and air passages of the lungs to narrow, leading

to wheezing, breathing difficulties and a drop in blood pressure. In

the most severe cases, loss of consciousness and death can occur.

Anaphylaxis requires an emergency injection of epinephrine

(adrenaline) and treatment with intravenous fluids.

If you have a latex allergy, consider carrying an emergency

epinephrine kit.

When To Call a Professional

If you suspect a latex allergy, you need a medical evaluation.

If you experience difficulty breathing, a rapid pulse, facial

swelling or dizziness, contact your doctor or go to an emergency

room at once. These symptoms could signal anaphylaxis, which

requires emergency treatment.

Prognosis

With prompt, appropriate treatment, most people recover completely

from an allergic reaction to latex. In rare cases, an allergic

reaction to latex can be severe, leading to anaphylaxis and death.

If latex is strictly avoided, the allergy reaction will not occur.

Additional Info

American Academy of Allergy, Asthma & Immunology (AAAAI)

555 East Wells St.

Suite 1100

Milwaukee, WI 53202-3823

Phone: 414-272-6071

Toll-Free: 1-800-822-2762

E-Mail: info@...

http://www.aaaai.org/

National Institute for Occupational Safety and Health

4676 Columbia Parkway

Mail Stop C-18

Cincinnati, OH 45226

Toll-Free: 1-800-356-4674

Fax: 513-533-8573

http://www.cdc.gov/niosh/

Last updated March 22, 2007

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