Natural rubber latex products are manufactured from a milky fluid derived from the rubber tree, hevea brasiliensis. Several types of synthetic material are also known as "latex" but these do not release the proteins that cause allergic reactions. The term latex will refer to the natural rubber product in the remainder of this product.
There are 3 types of reactions common to latex glove use:
| Irritant Contact Dermatitis
||Most common reaction. Similar reactions caused by frequent hand washing, incomplete drying, and contact with glove powders.
||Dry, itchy, irritated areas on the skin
| Allergic Contact Dermatitis
||Also called chemical sensitivity dermatitis. Result of chemicals added to gloves during harvesting, processing or manufacturer. (e.g., residues of thiurams, carbamates and phenylenediamines) Methythymol blue (MTB) dye may also contribute).
||Skin rash within 24-48 hours post contact. May progress to oozing skin blisters much like poison ivy. May be spread away from the initial area of latex contact by skin contact
| Latex Allergy (immediate hypersensitivity)
||Reactions may occur within 10 minutes of exposure or may begin hours later. Symptoms and severity may vary.
- skin redness, rash, hives or itching.
More severe - respiratory symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma (difficult breathing, coughing spells, and wheezing).
Severe - shock (rare, seldom the first sign of latex allergy)
Latex allergy is a reaction to certain proteins in latex rubber. The amount of latex exposure needed to produce sensitization or an allergic reaction is unknown. Increasing the exposure to latex proteins increases the risk of developing allergic symptoms. In sensitized persons, symptoms usually begin within minutes of exposure; but they can occur hours later and can be quite varied.
|Routes of Exposure
||How Exposure Occurs
||Glove or other protective device used next to bare skin
||Latex proteins inhaled through the lubricating powder used in some gloves becoming airborne as the gloves are removed.
|Mucus Membrane Contact
||Through the nasal cavity, mouth, etc. Use of invasive or contact with medical devices during dental or medical procedures.
The risk of developing latex allergy is directly related to the frequency and length of exposure. Simply, the more time you spend in contact with latex the more likely you are to become sensitized or allergic. Once sensitized any product containing latex may trigger an allergic reaction. Individuals with multiple allergies or existing allergies to foods such as avocados, potatoes, bananas, tomatoes, chestnuts, kiwi fruit and papaya are at greater risk of developing initial latex allergy. Once sensitized, even a small dose or contact with latex material may result in allergic reaction.
A partial list of products that may contain latex (Synthetic or latex free equivalents may be available)
||Blood Pressure Cuffs, Stethoscopes, Disposable Gloves, Endotracheal Tubes, Tourniquets, Tubing, Syringes, Electrode Pads, Nasal cannulas
|Personal Protective Equipment
||Gloves, Goggles, Rubber Aprons, Surgical Masks, Respirator Masks
||Anesthesia Masks, Catheters, Wound Drains, Injection Ports, Rubber Top, Vials, Dental Dams
||Rubber Bands, Erasers, Rubber Thumbs
||Balloons, Waist Bands in Clothing, Shoe Soles, Dishwashing Gloves, Condoms, Diaphragms, Motorcycle, and Bicycle Hand Grips, Cricket Handles, Automobile Tires, Pacifiers Baby, Bottle Nipples, Water Bottles, Swimming Goggles
Limit your exposure to natural rubber latex where possible. Wash and dry skin that has come in contact with latex products (e.g. after removing gloves). Frequently wet wipe areas in your work place where latex lubricating powders may settle. Notify your supervisor and others who may use latex products near you of any existing latex sensitization you may have. If you have a mild reaction to a product that contains latex, contact EH&S Workers' Compensation Manager to arrange for an allergy screening.
The only known effective treatment for a worker who has been sensitized to latex is avoidance. Use non-latex gloves (synthetic rubber, nitrile, vinyl or neoprene) for activities where exam type gloves are recommended. Synthetic gloves are not as comfortable as natural rubber latex. They are less elastic, more difficult to put on and remove and do not breath well. The FDA imposes the same quality control standards on gloves regardless of manufacture material. Synthetic rubber is not known to cause allergic reactions. Remember, latex and other exam type gloves offer little chemical resistance. Check glove labels carefully to be sure you know what product you are choosing. "Hypoallergenic" latex gloves packaged prior to September 30, 1998 do not reduce the risk of latex allergy, they are simply rinsed in ammonia to reduce the residues of rubber accelerators used in manufacture. they may be useful in reducing the allergic contact dermatitis reactions to chemical additives in the latex. As of September 30, 1998, FDA regulation 21 CFR Part 801 requires "medical devices containing rubber produced by the Natural Rubber Latex process that contacts humans shall bear labeling with the following statement in bold print: "Caution: This Product Contains Natural Rubber Latex Which May Cause Allergic Reactions." Gloves packaged for "non-medical" purposes are not regulated by FDA and may not carry the cautionary label (e.g. utility gloves, food service gloves, any glove that does not claim medical use in its distribution or advertisement).
There are 2 methods of latex glove production equally likely to produce an allergic reaction:
1. Natural Rubber Latex
2. Dry Rubber
Sensitized individuals can use only synthetic rubber that includes no natural rubber latex or dry rubber in the formulation. Use appropriate work practices to reduce the chance of reactions to latex. When wearing latex gloves, do not use oil-based hand creams or lotions (can cause glove to deteriorate). After removing latex gloves, wash hands with a mild soap and dry thoroughly. Practice good housekeeping: Frequently clean areas and equipment contaminated with latex-containing dust. Learn to recognize the symptoms of latex allergy as previously listed. If you experience symptoms that you suspect may be related to latex glove use, contact your supervisor and EH&S immediately. Those sensitized to latex should avoid contact with latex products and areas where they may inhale the powder from other employees wearing latex gloves. If your allergy is confirmed notify your supervisor, other occupants of immediate work area, personal health care provider and wear a medical alert bracelet.
Resources and References:
1. Latex Allergy: A Prevention Guide, NIOSH, publication number 98-113 http://www.cdc.gov/niosh/98-113.html
2. Preventing Allergic Reactions to Natural Rubber Latex in the Workplace, NIOSH publication number 97- 135 http://www.cdc.gov/niosh/98-113.html
3. 21 CFR Part 801, Food and Drug Administration, Natural Rubber-Containing Medical Devices; User Labeling Final Rule, September 30, 1998 http://www.fda.gov/
4. American Latex Allergy Association http://latexallergyresources.org/
5. Certified Latex-Free Hospital Product Database http://www.latexfree.com/