The Medical Minute: Increased use of latex leads to more latex allergies

August 25, 2004

By John Messmer
Penn State Milton S. Hershey Medical Center
Penn State College of Medicine

Latex is everywhere. Natural rubber latex comes from the treated sap of the rubber tree, Hevea brasiliensis, and has been used in clothing, toys, household products and medical and dental applications for 100 years. Because of its ability to cushion, stretch and protect, it has become ubiquitous.

In 1987, the Centers for Disease Control and Prevention and the Occupational Safety and Health Administration introduced universal precautions due to the prevalence of blood-borne viral illnesses, such as hepatitis B and HIV. Because latex provides a reliable barrier to viruses, the annual use of latex gloves increased from 12 billion pairs before 1987 to more than 200 billion pairs. This increased latex exposure by medical and dental professionals and the general public allows sensitivity to develop in many people.

Our immune systems are designed to protect us from foreign substances that may be harmful, but sometimes our immune systems react inappropriately to chemicals or microorganisms that should be innocuous. It is estimated that about one in 10 people is allergic to latex in varying degrees with reactions typically developing after repeated exposures. Asthmatics and people with skin inflammations, such as eczema, are predisposed because of already-sensitive immune systems. Besides reacting to the latex proteins, people can be sensitive to chemicals used to process the latex.

Latex gloves commonly have been covered with cornstarch to make them easier to put on. The starch attracts latex proteins and when the gloves are stretched or snapped, starch particles with latex proteins become airborne and can be inhaled. This is believed to be a frequent way of developing latex allergy. Application of gloves on dry, cracked or irritated skin allows latex proteins into the body, where the immune system also can be sensitized. Children with certain birth defects, such as urinary and brain or spinal cord deformities, are at increased risk of latex sensitization because they receive multiple exposures from surgical procedures and caretakers early in life.

Latex allergy can manifest as red, weepy rashes or blisters as in poison ivy from direct contact with the rubber or as itching and hives. Asthma-like wheezing, abdominal cramps and nausea can occur and even life-threatening obstruction of the airway from an anaphylactic reaction is possible. Some people get itchy, watery eyes and runny noses similar to hay fever as their reaction. The degree of reaction and amount of exposure necessary to cause a reaction varies from person to person.

In addition to latex gloves, people may contact latex in the rubber dams used by dentists while repairing teeth; in adhesive bandages and tape; urinary catheters; electrode pads; and from needles as they pass through rubber stoppers used to seal vials of medication and vaccines. Very sensitive individuals may react to blood pressure cuffs, stethoscopes, face masks and tourniquets used in drawing blood.

Latex also is found around the home in balloons, rubber bands, condoms and diaphragms, erasers, toys, pacifiers and nipples, elastic in clothing, buttons, handles and carpet pads. Adding to the problem, latex-allergic people may cross-react to some foods including banana, avocado, passion fruit, papaya, chestnut, kiwi fruit, melon, apple, tomato, potato and celery.

Testing for latex allergy can be done, but a history of rashes, itching, hives or wheezing in association with exposure to rubber is the hallmark of diagnosis. Once diagnosed, avoidance is the foundation of treatment. With the prevalence of latex allergy, alternate products have been developed.

Latex glove manufacturers are treating their gloves to reduce the amount of free protein released to help reduce the chance of sensitization developing. Vinyl is not considered to be as protective from viruses, but is a satisfactory substitute for many applications and many medical organizations have vinyl gloves available or have switched to them entirely. Polyurethane is believed to provide a barrier to viruses and has been used in male (Avanti) and female (Reality) versions of condoms. Other synthetic rubber materials include neoprene, butadiene and styrene, all of which are safe in latex-sensitive people.

If you are latex allergic you may tolerate limited exposures, but consider replacing or eliminating non-synthetic rubber carpet pads; foam pillows; rubber non-skid mats; rubber handles on tools, toothbrushes, and so on; sports equipment; toys; pencils and pens; rubber glue and adhesives on stickers and stamps; adhesive tape and bandages; and natural-rubber containing footwear. Wash new clothing before wearing to remove residual latex proteins. In restaurants, ask if the food handlers wear latex gloves. Advise doctors, nurses, dentists and technicians so they may avoid using latex gloves and medical instruments. If you are receiving an injection, explain that latex particles can contaminate the liquid. Where possible, removing the rubber stopper or opening a new multidose vial and changing needles between drawing up the shot and administering it may reduce the exposure to latex.

Don't worry about latex paint - there's no latex in it. Most pool liners are vinyl. However, rubber ducks are latex. For more information on latex allergy go to http://www.cdc.gov/niosh/topics/latex/ or http://www.hmc.psu.edu/healthinfo/jkl/latexallergy.htm

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Last Updated March 19, 2009