Latex gloves have become the material of choice for universal precautions. They form an
effective barrier in protecting people against infections from hepatitis and HIV. As healthcare workers increase their use of latex gloves, hey place themselves at greater risk for developing or immediate hypersensitivity o latex. Currently, between 10-17% of the
healthcare work force may be sensitized to natural rubber latex protein retained on the
finished products.
Reactions to finished latex products may be a ype IV delayed hypersensitivity (contact
dermatitis) or a Type I IgE mediated hypersensitivity (immediate). What starts as a contact
dermatitis may break down the skin barrier leaving the person at risk for infection or direct
antigen inoculation inducing an IgE mediated response. The healthcare worker with
immediate hypersensitivity also is at risk for developing respiratory symptoms due to
aerosolization of the latex protein by the love powder.
It is imperative that efforts be made to decrease exposure to latex for confirmed latex allergic
people and those at risk for developing a latex allergy. These include spina bifida
genitourinary tract abnormality patients; healthcare/rubber industry workers; contact
dermatitis to rubber; atopic individuals; patients with multiple surgeries; idiopathic
anaphylaxis, especially in surgery; certain fruit allergies, e.g., bananas.
Once the diagnosis of latex allergy is made, the treatment regime is not a simple one. Latex
allergy impacts on the work and daily health of the healthcare provider and may result in
drastic life style changes.
At first, the healthcare worker may require use of non-latex gloves. If this is not successful,
removal from work for 2-3 weeks may be necessary to alleviate symptoms. When symptoms
persist the person may be moved to another clinical area, then a non clinical area and
finally out of the healthcare facility. The final stop may be loss of job and career.
It is at this point that the larger reality becomes apparent. Questions surface, such as: "What
happens if I get sick and need health care? What if my children and/or spouse need
hospitalization? Where do I go for dental treatment? Will the emergency medical system that I
encounter have a latex free emergency kit?"
Soon a financial reality emerges as the person is off work with mounting medical bills. Not
all healthcare facilities are sympathetic due to the financial implications of workers'
compensation. The facility may see latex allergy not as an injury, but as an allergy with sensitization
taking place in an environment other than work. A legal battle ensues and the once loyal
employer becomes a rival.
Other problems may surface simultaneously. The person may become sensitized to certain
foods (kiwi, water chestnuts, potato, banana and other tropical fruits).
Trips to the grocery store, hardware store or commercial office buildings may cause reactions. At times, the person may only feel safe at
home in an environment they can control.
Family life changes. The spouse or children may now need to do the
shopping, cleaning and accompany others to the doctor, functions that
the person with latex allergy used to accomplish. The marriage may be
strained as forms of birth control and intimacy need to change. Children can perceive the parents' anxiety and develop apprehensions
concerning the future. Alone, isolated and feeling guilty, the allergic
person may overcompensate.
It was with these factors in mind that a network for latex allergy
patients was sponsored by the Medical College of Wisconsin. The initial purpose was to create a forum for support. Once confronted with
other healthcare workers with the allergy, the strengths of each individual surfaced. The group identified its purpose as creating community
awareness of latex allergy and titled the group, the Allergy to Latex
Education and Resource Team (ALERT).
The following goals were established:
- Provide education to the public regarding latex allergy (manufacturers, government, food and clothing industry, FDA, law enforcement).
- Promote research regarding the prevention, diagnosis and treatment of latex allergy.
- Promote information and sharing of knowledge, ideas and
research among members.
- Serve as a body to which healthcare workers may convey concerns, obtain information and explore issues related to natural rubber latex allergy.
- Provide resources to healthcare facilities in establishing protocols
for patients and workers with natural rubber latex allergy.
- Facilitate legislative change through lobbying activity at state and
federal levels.
A program committee was designated to arrange meetings, which
consist of 1/2 hour of business, 1 hour educational programming, and
1/2 hour of networking. During the first year, the group was addressed
by allergists, a dentist, a psychologist and paramedics.
The membership committee receives release forms from patients
wishing to join the group. These are forwarded to the board for
approval. They also facilitate the collection of dues, update network
lists and mailings. To date we have 63 members from the Canada
and Canada.
The educational committee has developed a program on natural rubber
latex allergy for healthcare facilities and healthcare workers. This slide
presentation can travel to various sites. A bibliography of latex related
articles is maintained, and a bimonWy newsletter is published. The
newsletter has an editorial board and features various columns. The
newsletter logo also is being developed which can be used as a symbol
of warning for those allergic to latex.
In the future, we hope to obtain a grant to facilitate our efforts. The
need for family support is becoming more evident, and we are looking
for a psychological consultant.
The group is collaborating with a manufacturer to sponsor a meeting in
the central Canada so latex allergic patients may meet to broaden
knowledge regarding latex allergy, discuss the latest in research and
develop relationships with other individuals with latex allergies.
The efforts of this group have given many people with latex allergy a
vehicle to channel their frustrations, anger and need to control. Specialeffort is made to ensure that information disseminated is scientifically
based to maintain credibility for those living with an allergy that some
try to discredit.
