It is important to understand the sensitization process in order to answer this question.
Sensitization is the development of immunological memory by exposure to a given antigen, usually a protein. It is not known what level of protein is required to sensitize an individual; the amount most likely varies from individual to individual reflecting differences in human immune responses. Animal studies demonstrate that absorption of protein through the skin predilects an IgE response and that repeat exposures require smaller and smaller antigen levels to induce sensitization1. It has been recognized that the inhalation of latex protein absorbed to the corn starch powder used in donning gloves is one possible route of sensitization. While individuals may be exposed to similar amounts of latex antigen, differences in immune responses which favor sensitization at doses ranging from "minute" to "large" are also important.
In studies of allergy due to such environmental antigens as house dust mite2, it is clear that threshold levels of sensitization and symptom induction can be determined2. Individuals exposed to levels of allergen above the threshold have a high incidence of allergic respiratory disease. Thus it would be expected that exposure to high allergen latex gloves would reach the "threshold" and sensitize sooner than would gloves with low levels of antigen.
Researchers agree that the lower the protein value in latex gloves, the lower the potential for that product to cause an allergic reaction. Researchers do not know what level of protein is safe and/or what level of protein can be tolerated on a glove without causing sensitization1.
It has been shown that both powdered and powder-free latex gloves vary extensively in the amount of detectable allergen present. Studies from the Mayo Clinic indicated that there may be 3000-fold difference between "low" allergen and "high" allergen gloves3.
Individuals working in environments where they use high-allergen gloves have more symptoms than those in environments where measurable latex protein antigen levels have been reduced by the use of nonpowdered or latex-free gloves4,5,6.
Low-allergen, powder-free latex gloves reduce (the risk of) inhalation of latex allergen and thus should significantly reduce the rate of sensitization of exposed healthcare workers and the progression of allergic disease in those already sensitized4.
Based on researchers' current understanding of latex allergy, protein test methods, and the routes of exposure and sensitization, they strongly recommend that OR personnel use only low-protein, powder-free gloves1.
In summary, it is likely that high allergen and low allergen gloves do not sensitize health care workers at equal rates. Exposure to high allergen gloves would sensitize at a faster rate.
REFERENCES
- D H Beezhold, G L Sussman, Determining the Allergenic Potential of Latex Gloves, Surgical Services Management, Feb 1997, V3N2.
- R Sporik, S. Holgate, T. Platts-Mills, et al., Exposure to house dust mite allergen (Der pl) and the development of asthma in childhood. N. Engl. J Med 1990; 323:502.
- J W Yunginger, R T Jones, A F Fransway, et al., Extractable latex allergens and proteins in disposable medical gloves and other rubber products. J Allergy Clin Immunol 1994; 93:836.
- K J Kelly, G Sussman, J N Fink, Rostrum - Stop the sensitization. J Allergy Clin Immunol 1996;98:857-858
- M C Swanson, M E Bubak, L W Hunt, et al. Quantification of occupational latex aeroallergens in a medical center. J Allergy Clin Immunol, 1994:94:445-551.
- S M Tarlo, G Sussman, A Contals, M C Swanson, Control of airborne latex by use of powder-free latex gloves. J Allergy Clin Immunol 1994;93:985-9.
