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Natural Rubber Latex Allergy
A Guideline for Allergic Patients
This Guideline has been produced by the Canadian
Society of Allergy and Clinical Immunology(CSACI). CSACI wishes to
acknowledge the assistance of the Task Force on Latex Allergies of the
Medical Devices Bureau of Health Canada.
Principal authors of this booklet are:
Dr. G. Sussman, MD (University of Toronto)
Dr. M.A. Drouin, MD (University of Ottawa)
Dr. F.E. Hargreave, MD (McMaster University)
Mr. A. Douglas (Health Canada)
Dr. K. Turjanmaa, MD (University of Tampere, Finland)
The authors wish to thank the many participants of the
Task Force on Latex Allergies who have offered their suggestions in the
preparation of this document.
1994
What is natural rubber latex?
Natural latex rubber is a particular kind of
rubber that has been manufactured from the sap of the rubber tree.
Rubber tree sap, or natural rubber latex, is a cloudy white liquid (a
chemical "Latex") containing a large amount of natural rubber
that can be used to manufacture various consumer products. Table
A gives a list of common natural rubber latex products.
Natural rubber latex products cannot be identified
visually. Any rubber-like object could be made of natural rubber
latex, or it could be made of synthetic material (including synthetic
rubber). Even things which are not stretchy may have natural rubber
latex on them as a paint-like coating.
"Latex" does not necessarily mean natural
rubber latex. Latex paints and latex caulking are synthetic
materials that do not usually contain natural rubber latex.
What is "latex allergy"?
A "latex allergy" is an allergy to
products made from natural rubber latex. It is an allergy to
proteins originating from the rubber tree and still present in products
made from natural rubber latex.
Products made from natural rubber latex usually contain
a number of chemicals. Some people are not allergic to natural
rubber latex itself, but chemicals found in manufactured natural latex
rubber latex products. Your allergist will identify which materials
affect you. If you react to chemicals, you may have a "rubber
allergy" and may be referred to a dermatologist for further tests.
Who suffers from latex allergy?
In the last 5 years latex allergy has become
more common and its consequences better recognized. The major use
and exposure to natural rubber latex is from gloves used in medical and
dental practices.
People most at risk of having or developing a latex
allergy are those who have other allergies (such as hay fever) and
regularly use natural rubber latex products. High risk persons who
have been identified include people who used natural rubber latex gloves
in their everyday occupation. This includes physicians, nurses,
dentists, dental hygenists and dental assistants. Children with
certain medical conditions (such as spina difida) that result in frequent
exposure to natural rubber latex products are also commonly latex
allergic.
What are the symptoms of latex allergy?
Latex allergy often begins with a rash on the
hands when using natural rubber latex gloves. Other allergic
symptoms include hay fever type reactions such as itchy swollen eyes,
runny nose, and sneezing. Some patients may develop asthma symptoms
such as chest tightness, wheezing, coughing and shortness of breath.
However, people that have skin problems on their hands
from glove use are not necessarily latex allergic.
How are latex and rubber allergies identified?
Patients at risk or with symptoms of possible
latex allergy should be tested by an allergy specialist. The latex
skin prick test is a very sensitive and safe mean of identification of
potentially allergic patients. Other skin tests can identify whether
you are allergic to natural rubber latex or the chemicals added to rubber
products.
Can my latex allergy get worse?
There is evidence that the more you are exposed
to latex, the more allergic you may become. If you have only a minor
latex allergy, you should minimize your exposure to latex so that you do
not risk becoming more sensitive.
If you suffer from hay fever symptoms when exposed to
latex, continued exposure to latex can cause you to develop asthma.
Can a latex allergy be life-threatening?
While it is uncommon, some latex allergic
individuals can suffer a potentially life-threatening allergic reaction
when they come in contact with natural rubber latex.
This serious reaction is called anaphylactic
shock. It occurs within minutes of exposure, and is characterized by
generalized hives, breathing difficulties and low blood pressure.
Anaphylactic shock may be fatal and must be promptly treated by adrenalin
injection.
Anaphylactic shock is most likely to occur during direct
tissue contact with natural rubber latex products. Direct contact
occurs when the skin barrier which protects you has been broken, or the
contact is across a mucous membrane. Mucous membrane contact can
occur in the mouth (e.g. blowing up a balloon, dental surgery, anesthetic
administration), vagina (condom use, vaginal examination), rectum and
colon (examination or enema administration), or urethra
(catheterization). Direct tissue contact occurs during surgery
because surgeons normally wear natural rubber latex gloves when operating
on a patient.
Can latex allergy be treated?
No treatments are yet available to cure natural
rubber latex allergy. So far the best "treatment" is to
avoid exposure to latex. Medications are available to temporarily
alleviate symptoms.
What precautions should allergic patients take?
Latex allergic patients take certain precautions
to prevent future allergic reactions:
Patients who are only mildly sensitive to latex
products should observe the following precautions:
- Avoid contact with natural rubber latex products such
as those listed in Table A Non-latex
substitutes are available for most commonly used natural products.
- Before visiting doctors or dentists for any
examination or procedure, warn them of your allergy to latex.
Ask to be scheduled as the first patient in the day in order to
minimize your exposure to airborne latex particles. Allergy
causing latex dust is put into the air when staff put on and take off
powdered natural rubber latex gloves. Dust from non-latex gloves
will not cause an allergic reaction, since it is the latex (not the
powder) which is allergenic.
- If you work in high latex exposure areas and have
skin irritation, hay fever or asthma symptoms, you must advise the
employee health department and consult a physician about your
treatment. You may only be able to work in that environment if
your symptoms are minimal or if your co-workers change to non-latex or
powderless natural rubber latex gloves.
- You should consult with your physician about medicine
you can take to reduce allergy symptoms.
- You should be aware that some latex allergic people
also have certain food allergies. Foods so far associated with
latex include bananas, avocados, and chestnuts. If any of these
foods give you symptoms such as itching around the mouth, local
swelling, hives or shortness of breath, you should avoid them.
Patients who are very sensitive to latex - for
example, react even when briefly in contact with a balloon or glove -
should take the following additional precautions:
- Obtain and wear a Medic Alert bracelet printed with
"severe allergy to natural rubber latex".
- When traveling to areas where medical supplies are
limited, carry with you a variety of sizes of non-latex sterile
gloves, in case you should need emergency medical or dental
work. Non-latex sterile gloves are a specialty item that should
be obtained in advance of traveling to these regions. Consult
your doctor or hospital.
- Be familiar with the proper use of the
self-administration of epinephrine (adrenalin). The indications
and proper use of this should be explained by your physician.
- Prior to surgery you should consult your physician
about the need for a latex-free operating environment.
What is being done to help people with latex allergy?
Health Canada is working with medical doctors
and manufacturers to try to overcome problems caused by latex
allergies. For information about the federal program contact:
Medical Devices Bureau
Health Protection Branch
Health Canada
775 Brookfield Rd
Ottawa ON K1A 1C1
Tel: (613) 954-0738
Fax: (613) 993-0281 |
