Latex Allergy : Who's at Risk?

by Food and Drug Administration (FDA)

(Page 3 of 3)

To protect themselves, Slater recommends that people allergic to latex: — carry non-latex gloves (a medium size is their best bet) at all times for health professionals to use during both routine examinations and emergency procedures — wear a Medic Alert bracelet — carry an emergency epinephrine kit in case they are accidently exposed to latex and go into anaphylactic shock (epinephrine immediately counteracts the shock) — alert all health professionals they deal with about their latex sensitivity.

For Adriana Reynolds, worry over when and if her son could have another reaction is compounded by the lack of knowledge about latex allergies.

"It's all very new," she says. "You tell people that your son has a rubber allergy and they say 'rubber?' I've had to meet with the people at Paul's school several times to convince them that this is serious. I had to buy vinyl gloves for the school nurse [Paul has to be catheterized during the day] and remind them about things like rubber balls in physical education."

For Lockwood, the worst part of her allergy is the loss of her career as a surgical technician. Since she first started reacting to latex more than a year ago, her sensitivity has become so acute that even if she were to wear vinyl gloves during surgery, airborne latex from the rest of the surgical team's gloves would cause her problems.

"There's no way I can work in surgery anymore," she says. "I can't deal with that loss yet. I want my career back."

Why Stick with Latex?

What is it about latex gloves? Why not just switch everyone to something else?

"We can't switch everybody out of latex," says B. Lauren Charous, M.D., chairman of the American College of Allergy and Immunology's task force on latex hypersensitivity. "There's no real reason to. We're still dealing with a very small percentage of health-care workers."

There are, however, real reasons to keep donning latex gloves. The main one is "latex is the barrier of choice [to protect against HIV]," says Orhan Suleiman, Ph.D., chairman of FDA's latex sensitivity task group.

"It's primarily a question of durability," says Thomas Arrowsmith-Lowe, D.D.S., deputy director for health affairs in FDA's Center for Devices and Radiological Health. "Within 15 minutes after putting on a vinyl glove, it starts to lose its barrier effectiveness. Latex maintains the barrier longer."

Of almost equal importance is latex's ability to stretch and conform to the shape of the hand. "You can stretch it to four or five times its original length and it will not tear," says Barry Page of the Health Industry Manufacturers Association. "There aren't many materials that will do that."

In addition, because latex gloves can be stretched so thin, they don't interfere with the sensitivity and fine manual dexterity required in many medical procedures.

"Latex gloves are better fitting and it's easier to feel veins and start IVs," says Vicki Freund, a paramedic/firefighter with the Montgomery County, Md., fire department. "So, I end up wearing those."

She also ends up with hives on the backs of her hands. "They itch like crazy." Sometimes her eyes swell up and itch and her nose starts running, too.

For now, because her reactions are relatively minor, Freund just lives with the problem.

But there are efforts to find an alternative for people like her. Several companies have developed latex-free gloves that the companies claim can stretch like latex and don't impair the wearer's sense of touch. As with all new products that make medical claims, these new gloves have to be reviewed by FDA before they can be sold.

Allergist Charous encourages people with mild reactions to try several different brands of gloves. He adds that "people who have only a history of mild latex glove eczema are not at risk [of a serious reaction] in any immediate sense. I want to emphasize that."

Who's at Risk?

Common to all allergic reactions to natural substances is the body's need to recognize the substance. The more often the body comes in contact with the substance, the greater the opportunity to recognize and react.

For the general public, the risk of an allergic reaction to latex is less than 1 percent. But because of constant exposure to latex, two groups are at greater risk — health-care workers and children with spina bifida and other conditions involving multiple surgical procedures. Because latex-containing medical devices abound in surgical suites, dental offices, and other health-care settings, contact with latex is an occupational hazard for health-care workers. It is also part of daily health maintenance routines (for example, catheterization) and the many surgeries high-risk children undergo.

According to Jay E. Slater, M.D., attending physician in allergy and immunology at Children's National Medical Center in Washington, D.C., the risk is so high for children with spina bifida, "we should treat them as latex-allergic regardless, whether we know that they are or not."

He cites his own research as the basis for his statement. When he tested the blood of 64 spina bifida patients, he found 25 of the children had antibodies to latex.

"Among those who had the antibody, approximately half had a history of latex-associated reactions," he says. He adds that more and more of these kids will have reactions as time goes on.

About the Author

www.fda.gov
FDA is A United States government body that oversees medical devices, including contact lenses, intraocular lenses, excimer lasers and eyedrops. In the US, these products must be approved by the FDA before they can be marketed.