Healthcare workers with occupationally-acquired type 1 allergic reactions to natural rubber latex are compelled to leave clinical work
because of severe allergic reactions (1,2,3). Although sensitized
workers avoid contact with latex gloves and other rubber accessories,
they cannot escape latex that is ubiquitous in the workplace. For
example, airborne latex particles settle on hospital surfaces and
clothing and enter ventilating systems (4,5). And sensitized employees
know from experience that latex remains on telephones and other
objects that were handled by persons who either wore latex gloves or
neglected handwashing after removing gloves. Additionally, house-
keeping personnel who wear latex exarnination gloves to clean sinks,
furniture and equipment inadvertently contaminate the workplace.
Healthcare settings so suffused with latex can be life-threatening to
latex-sensitized employees.
Little information has been published about the occupational problems
of latex-sensitized healthcare workers. However, growing clinical
experience and anecdotal information suggests that many employees
have problematic encounters with their employers when latex allergy
interferes with job performance (4, 5). This article reports a pilot study
that explored latex-sensitized employees' experiences with hospital
administrators. A telephone survey was conducted with seven latex-allergic healthcare workers living in six states. The participants were
recruited by word-of-mouth referral through a national latex allergy
network. All participants were women, aged 29 to 63 years, who were
compelled to leave their hospital positions as licensed practical nurses,
patient care attendants, registered nurses, respiratory therapists and surgical technicians. They worked in chronic care, acute care, intensive
care and operating room settings.
All seven women described multiple episodes of anaphylaxis occurring
at work. Six of the women explained that they can no longer enter
physicians' offices, hospitals, emergency rooms or emergency vehicles
because of anaphylaxis. They described their lives as "living in a
bubble" and "being homebound" because they react to latex in
grocery stores, department stores, public buildings and when eating
in restaurants.
In response to the question, "What was your experience with your hospital administration when you were having trouble with latex allergy at
work?" each woman described herself as a good employee who valued
her work, income and benefits. And each participant described variations of becoming entangled in a prolonged scenario consisting of
allergic reactions: taking sick days and leaves of absence; attempting to
return to work; negotiating placements in other positions; sorting
through regulations of short-term/long-term disability; receiving
threats from disability insurance companies; finding a lawyer free of
conflicting interests; filing workers' compensation claims and appeals;
applying for Social Security Disability; and losing health insurance,
income, career and health.
One woman stated that her hospital responded supportively by conducting latex allergy in-service education and developing policies for
employee health and patient care. But her claim has not been settled.
Five other women initially considered their managers to be responsive
to their latex allergy problem; but communication deteriorated drastically as time passed and managers relinquished responsibility to human
services, employee health or safety representatives. The seventh
woman was urged to resign without being informed of her rights as an
employee with an occupational injury, but she refused to do so.
One participant summarized her experience by saying, "It was all negative. They made you feel like they were trying, but they weren't. They
would rather get rid of an employee than make changes. They tried to
place me in the worst jobs with the lowest wages and the worst hours.
But I never gave up. I got a lawyer."
Another woman said, "My doctor was on the hospital board of directors and wouldn't fight for me. One day he turned to his nurse and said,
'She's crazy. We'll have to com~nit her.' They let me continue working
until I could hardly live. No one told me I had a life-threatening problem. They should have told me. I shouldn't have had to find out on my
own. I went to my union because the hospital was not trying to help
me, and the insurance company was threatening me, abusing me when
I was so ill. I'm still waiting for compensation."
A third woman recalled, "In the beginning, the hospital administration
said, 'We'll take responsibility. There is an answer.' They had no idea
of latex allergy. They thought it would be easily taken care of and I'd
be back at work. I wanted to work. I was a great employee. They wanted me back. I was on compensation for nine months and the insurance
company called and said, 'What exactly are you going to do? We've
been very patient with you.' I told them to tell me where to be and I'd be
there in an hour. That was the last rude comment. My allergy is so bad
that I have to sit outside the emergency room when I have a reaction."
Another woman said, "I don't think much of them. The chief counsel
of the hospital was very condescending. It's very frustrating. They had
access to articles. They had information they failed to share. I should
not be in this condition. It all comes down to dollars and cents. Most of
the employees with latex allergy are in the 20 to 30 year age range and
they don't know they've got it. We're stuck with no treatment and it
gets worse. I have a limited life, no income, no profession, no
livelihood. And, we have a legal system that doesn't do well with
new things. You have to deal with everything and you're sick. Luckily,
I'm very strong. I pray a lot."
This woman also explained that she contacted former co-workers who
were experiencing early symptoms of latex allergy, "...but nobody
wants to talk about it. Everybody wants to make light of it. The
hospital gets off scot-free and can't be sued. We're battling the legal
and medical systems."
The women spoke of the urgency to protect additional healthcare
workers from being sensitized. They observed that most hospital
administrations and employee health services are unprepared to deal
with latex allergy. Yet for these women, prevention of this catastrophic
occupational injury and the safety of latex-sensitized patients is a paramount ethical and legal concern, as well as a matter of survival. The
women who participated in this survey hope that their experiences will
contribute to preventing latex hypersensitization among fellow healthcare workers and to developing safe care for latex-allergic patients.
REFERENCES
- Staff. ( 1993, April). Nurses are forced to give up jobs due to latex allergies. Hospital Employee Healm, pp. 50-52.
- Staff. (1994, February). Latex allergy sufferers fight uphill battle to collect workers' compensation. Hospital Employee Health, pp. 13-18.
- Stehling, D. (1992, September). Latex allergies: When rubber rubs the wrong
way. FDA Consumer: The Magazine of the U.S. Food and Drug Administration,
pp. 17-21.
- Baur, X. (1990). Airborne antigens from latex gloves. Lancet. 335, 912.
- Baur, X., Ammon, J., Chen, Z., Beckmann, U., & Czuppon, A.B. (1993).
Lancet. 342, 1148-1149.
