Latex medical glove
|Classification and external resources|
Latex allergy is a medical term encompassing a range of allergic reactions to the proteins present in natural rubber latex. Latex allergy generally develops after repeated exposure to products containing natural rubber latex. When latex-containing medical devices or supplies come in contact with mucous membranes, the membranes may absorb latex proteins. The immune system of some susceptible individuals produces antibodies that react immunologically with these antigenic proteins. As many items contain or are made from natural rubber, including shoe soles, elastic bands, rubber gloves, condoms, baby-bottle nipples, and balloons, there are many possible routes of exposure that may trigger a reaction. People with latex allergies may also have allergic reactions to some fruits, such as bananas.
Natural rubber latex is known to cause Type I and Type IV allergic reactions, as well as irritant contact dermatitis.
The most serious and rare form of latex allergy, Type I hypersensitivity can cause an immediate and potentially life-threatening reaction, not unlike the severe reaction some people have to bee stings. Such reactions account for a significant proportion of perioperative anaphylactic reaction, especially in children with myelomeningocele. Type I natural rubber latex allergy is an IgE (immune) mediated reaction to proteins found in the Hevea brasiliensis tree, a type of rubber tree.
Anaphylactic shock can be provoked in allergic persons by the previous use of latex in an area: latex is typically powdered to prevent sticking, latex proteins become attached to the particles of powder, and the powder becomes airborne when the latex item is used, triggering potentially life-threatening Type I reactions when the latex-contaminated powder is inhaled by susceptible persons. In radiological units latex allergy may mimic contrast medium allergy
Type IV (allergic contact dermatitis)
Type IV allergy, also known as allergic contact dermatitis, involves a delayed skin rash that is similar to poison ivy with blistering and oozing of the skin (see urushiol-induced contact dermatitis). It can be diagnosed through a positive skin-prick test, although a negative test does not rule out a latex allergy.
Irritant contact dermatitis
Natural rubber latex can also cause irritant contact dermatitis, a less severe form of reaction that does not involve the immune system. Contact dermatitis causes dry, itchy, irritated areas on the skin, most often on the hands. Latex-glove induced dermatitis increases the chance of hospital-acquired infections, including blood-borne infections, being transmitted.
Some people who have latex allergy may also have an allergic response to any of a number of plant products, usually fruits. This is known as the latex-fruit syndrome. Fruits (and seeds) involved in this syndrome include banana, pineapple, avocado, chestnut, kiwi fruit, mango, passionfruit, fig, strawberry and soy. Some but not all of these fruits contain a form of latex. Hevein-like protein domains are a possible cause for allergen cross-reactivity between latex and banana or fruits in general (latex-fruit syndrome).
- Children with spina bifida. Up to 68% will have a reaction.
- Industrial rubber workers, exposed for long periods to high amounts of latex. About 10% have an allergic reaction.
- Health care providers. Given the ubiquitous use of latex products in health care settings, management of latex allergy presents significant health organizational problems. Those healthcare workers—such as physicians, nurses, aides, dentists, dental hygienists, operating room employees, occupational therapists, laboratory technicians, and hospital housekeeping personnel—who frequently use latex gloves and other latex-containing medical supplies are at risk for developing latex allergy. Between about 4% to 17% of healthcare workers have a reaction, which usually presents as Irritant Contact Dermatitis and can develop through allergic sensitivity to a status of full anaphylactic shock, with the affected workers losing their vocation. In the surgical setting, the risk of a potentially life-threatening allergic reaction by a patient has been deemed by Johns Hopkins Hospital to be sufficiently high to replace all latex surgical gloves with synthetic alternatives.
Estimates of latex sensitivity in the general population range from 0.8% to 8.2%.
- Synthetic rubbers such as elastane, neoprene, nitrile and artificially synthesized polyisoprene latex do not contain the proteins from the Hevea brasiliensis tree.
- Products made from guayule natural rubber emulsions also do not contain the proteins from the Hevea rubber tree, and do not cause allergy in persons sensitized to Hevea proteins.
- Chemical treatment to reduce the amount of antigenic proteins in Hevea latex has yielded alternative materials, such as Vytex, which reduce exposure to latex allergens while otherwise retaining the properties of natural rubber.
- In 1994, the first polyurethane condoms were produced, designed for people with latex allergies.
For some people, the sensitivity is so extreme that replacement of latex products with products made from alternative materials may still result in a reaction if the products are manufactured in the same facility as the latex-containing products, due to trace quantities of natural rubber latex on the non-latex products.
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- The American Latex Allergy Association
- UK Latex Allergy Support Group
- Asthma and Allergy Foundation of America
- Basic Pathology - Robbins et al - 9th edition