Latex sensitivity awareness in preoperative assessment

The role of the preoperative assessment practitioner (POAP) has evolved hugely to allow them to become more autonomous in decision-making, particularly in the design of local protocols and guidelines for preoperative assessment. Good practice guidelines are imperative to ensure that all requirements for the patient have been identified before the day of surgery, which minimises the risk of late cancellations.

Type IV Hypersensitivity from Rubber Chemicals: A 15-Year Experience in Taiwan

BACKGROUND

Allergic contact dermatitis from rubber chemicals is frequent but has not been reported form Asia.

OBJECTIVE

To study the pattern of type IV allergy to rubber chemicals in a Chinese-based population.

METHODS

A retrospective study was conducted by reviewing the patch test results of 2,235 (604 men, 1,631 women) patients from January 1986 to December 2000.

RESULTS

Ninety-nine patients (4.4%) had one or more positive reactions, 42 (6.9%) men and 57 (3.5%) women. The incidence did not increase throughout the study period. Among thiuram, mercapto, carba and black-rubber mix, thiuram is the most potent sensitizer, mostly for the hand and mercapto mix for the foot. Thiuram allergy is considered occupation related, while mercapto allergy, mostly from rubber slippers, is not typically related to an occupation. A negative correlation between thiuram and carba was found despite the frequent association between these two mixes. A high risk of rubber sensitization was noted in construction, health service, transportation, agriculture and hairdressing workers. A high frequency of concomitant sensitivity to cobalt was found.

CONCLUSION

This is the first statistically analyzed study of rubber chemical allergy in Asia, which supports major trends concerning rubber chemical allergy from European studies. However, wearing rubber slippers in Taiwan contributes to the high percentage of foot dermatitis. Carba should still be retained in the European standard series because of the coexistence of thiuram and carba in rubber products. The concomitant sensitization to cobalt in rubber-allergic patients needs further evaluations.

[Reactivity and antigenic cross-reactivity of latex in children with allergic disorders]

OBJECTIVE

To explore the relationship between latex allergen and clinical presentation as well as allergenic cross-reactivity between latex and other allergens, to know the incidence of latex allergy in Chinese children and elucidate the allergenic cross-reactivity of latex with other allergens.

METHODS

Totally 265 children with allergic disorders were assayed with 13 international standard allergen agents by means of SPT.

RESULTS

In 79 children with latex allergenic SPT position, 53 were boys and 26 were girls with an average age of 5.6 years, and 14 cases had episodes occurred in winter, 14 cases in spring, 24 cases in summer, and 27 cases in autumn. Of them, 66 cases presented as asthma, 5 cases atopic skin disorders, 1 case anaphylactoid purpura, 1 case hives and 6 cases only had mild cough. Statistical analysis showed that the positive percentage of the latex SPT had no obvious relation with sex and age, but was higher in summers and autumns than in winters and springs (P < 0.01). Children with allergic symptoms had higher positive rate in latex allergenic SPT than those without them, that is, the positive percentage of the latex SPT significantly increased among children presenting with some allergic symptoms, such as asthma, hives and atopic skin disorders (P < 0.01). All the children with latex allergenic SPT position had cross-reactivity with acarid allergen, 62.0% approximately 43.0% with animal protein allergens including milk, cats, shrimp, dogs, eggs in the order of decreasing cross-reaction rate, and 10.1% - 3.8% with mold and plant farina allergens. But the cross-reactivity between latex and mold or tree farina I were not statistically significant.

CONCLUSION

Thirty percent of the children with allergic disorders were latex allergenic SPT positive. Latex allergenic SPT positive results were significantly correlative to allergic clinical presentation and season, while were not relative to sex and age. The cross-reactivity of latex with acarid was most common, followed by animal protein allergens, while the cross-reactivity with mold and plant farina allergen was rare.

Latex protein allergy and your choice of gloves: a balanced consideration

Natural rubber gloves have been acknowledged as the best protective devices available for protecting health care personnel and their patients against viral transmission and infectious fluids. Yet, with the adoption of standard safety precautions and the increase in the use of gloves, an increasing number of people are being affected with latex allergy. Negative publicity related to latex allergy has resulted in health care personnel deciding against using the highly protective natural rubber gloves. The relationship between natural rubber gloves and latex protein allergy needs to be better understood in order for health care professionals to make an informed choice in their selection of gloves.

Hev b 7 is a Hevea brasiliensis protein associated with latex allergy in children with spina bifida

BACKGROUND

In addition to their disease-associated handicaps, patients with spina bifida (SB) are at high risk of developing latex allergy. Individuals with SB represent a special group of latex-allergic patients, inasmuch as their IgE-binding patterns differ from those of other populations of latex-allergic individuals. Two allergens strongly associated with latex allergy in patients with SB--Hev b 1 and Hev b 3--have already been identified.

OBJECTIVE

We intended to identify a predominant IgE-binding band--in addition to Hev b 1 and 3--at 43 kDa in a study population of 38 latex-allergic (IgE antibodies to latex and symptoms on provocation with latex gloves) and 15 latex-sensitized (IgE antibodies to latex but no symptoms on provocation) children with SB (mean age, 12.3 years) and to determine its frequency of recognition.

METHODS

Sera of latex-sensitized or latex-allergic patients with SB were tested on latex C extract containing natural Hev b 1, Hev b 3, and Hev b 7 and with the recombinant 43-kDa Hev b 7 in immunoblot and inhibition studies.

RESULTS

Natural Hev b 1 was recognized by 82% and natural Hev b 3 by 79% of the latex-allergic children with SB. In addition to some other proteins, 15 (39.5%) of 38 latex-allergic and 2 (13%) of 5 latex-sensitized children with SB revealed IgE binding to a 43-kDa band in the latex protein extract. We identified this 43-kDa IgE-binding band as natural Hev b 7 by immunoblotting and inhibition experiments using recombinant Hev b 7.

CONCLUSION

From these data, we conclude that Hev b 7, the patatin-like Hevea latex protein, is the third SB-associated latex allergen. Future immunotherapy for latex-allergic individuals with SB will have to include Hev b 7 in addition to Hev b 1 and Hev b 3.

Latex sensitivity and allergy: raising awareness in Australia

Natural rubber latex allergy is a public health issue that is yet to be addressed in many Australian hospitals. It is suggested that there is a widespread lack of awareness amongst hospital staff of the implications of this relatively new health problem. Natural rubber latex allergy is a cumulative, serious and incurable occupational health problem and a disabling disease. It can result in chronic illness, disability, loss of career and even death, for nurses and other health professionals. The serious risk that natural rubber latex allergy presents to staff health and patient safety, requires that hospital-wide strategies be developed to address the prevention and management of this condition as a matter of urgency. An overview of the problem of natural rubber latex allergy is presented, and strategies for addressing it suggested. The need for further research into the scope of the problem in the Australian context is emphasised.

Workers' compensation claims from latex glove use: a longitudinal analysis of Minnesota data from 1988 to 1997

Allergic reaction experienced by health care workers from latex glove use has increasingly become the focus of researchers evaluating occupational sources of injury in health care settings. Many studies have attempted to estimate the prevalence of latex sensitization among health care workers by using various methods, but the findings have been inconsistent and do not predict reactivity. This study used workers' compensation data from Minnesota from 1988 to 1997 to assess allergic reactivity rates, injury severity, and costs associated with latex allergic reactions. The average reactivity rate was 7.1 claims per 100,000 health care workers, and total cost associated with the claims averaged $0.295 per health care employee. Using empirical cost data from another study, it was found that it is not cost-beneficial for health care institutions to globally adopt latex glove-free policies solely on the basis of workers' compensation costs.

Perioperative care of patients with latex allergy

Initially identified in the pediatric population, latex allergy and sensitivity now are seen at increasingly higher rates in all age groups, and are especially prevalent in health care workers. Knowledge about the sources of latex in the environment, the signs and symptoms seen in latex sensitivity and allergic reaction, risk factors for sensitivity, and how to assess patients and those working in the health care profession for possible latex sensitivity is important for perioperative nurses.

Latex allergy in health care personnel

This article presents a summary of literature published in recent years about latex allergy. The first article on allergic reactions associated with latex was published in Britain in 1979. Since then, the number of reported cases has increased. A wide variety of allergic reactions that range from contact dermatitis to anaphylactic shock are described in literature. Conclusions support that health care team members must be well informed about the implications of latex allergy to better help allergic individuals.

Latex allergy: creating a safe environment

Latex allergy is a serious problem for health care providers and the general public. Understanding the problem and following several simple suggestions can safeguard patients and workers in health care settings.

What you need to know about latex allergy

Learn the pathophysiology and types of latex allergy, including diagnostic criteria.