The American Academy of Allergy & Immunology (AAAI) national
conference held in Chicago, March 12-17, recognized the emerging
subject of latex allergy as a new and growing allergic disorder. More
than 30 scientific papers, poster sessions and a Grand Seminar were
directed at briefing the 5,000 AAAI members attending on the subject
of testing, diagnosis, research direction and treatment of latex allergy.
Scientists from Europe and the U.S. presented work directed at the two
primary candidates for latex allergy - spina bifida patients and health
care workers.
The need for epidemiology studies on sensitization rates was clearly
felt when physicians estimated that 250,000 to I million U.S. health
care workers are sensitized to latex allergens. Mayo Clinic has identified 65 employees with latex allergy and feel there are probably 150 to
200 additional symptomatic workers to be evaluated with potential estimates of over 1,000 sensitized workers, the vast majority of whom are
unidentified. Current sensitization prevalence rates of 3% to 10% are
possible in workers who regularly use latex gloves. In spina bifida,
chronically catheterized and multi-operated on patients, the range escalates to an estimated 28% to 67%.
The routes and products of sensitization vary according to many of the
papers presented. Allergens have been identified in latex pacifiers, balloons, condoms, rubber toys and balls as well as medical products.
Controversy over methods of testing patients was seen in the reluctance
of some allergists to skin prick test patients due to their experiences of
severe systemic adverse reactions which occurred in patients while testing.
Several scientists confirmed that natural rubber latex and banana have
cross reading allergens. Whether banana and other fruit allergens could
be the primary sensitizing agent in children with latex allergy is unclear.
Other work describes efforts to characterize the specific proteins in
latex which may be the antigen causing systemic reactions and anaphylaxis. Only a few of these proteins have the potential to be allergenic
and attempts to correlate total protein content in latex products to allergenicity of the material have failed.
Isolation of the specific allergen(s) would allow for several breakthroughs including development of a reliable test to predict who is latex
allergic and may be at some risk for systemic reaction. Identification of
specific allergens can also direct manufacturers to remove them during
the manufacturing process, thereby creating a safer work environment.
