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Diagnosis and Treatment |

Allergy to Latex Rubber

Gordon L. Sussman, MD, FRCP; and Donald H. Beezhold, PhD
[+] Article and Author Information

From the Guthrie Foundation for Medical Research, Sayre, Pennsylvania. Requests for Reprints: Gordon L. Sussman, MD, FRCP, 202 St. Clair Avenue West, Toronto, Ontario, M4V 1R2 Canada.


Copyright ©2004 by the American College of Physicians


Ann Intern Med. 1995;122(1):43-46. doi:10.7326/0003-4819-122-1-199501010-00007
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Objective: To summarize the clinical symptoms of latex rubber allergy and provide guidelines for the management of this allergy.

Data Sources: The English-language literature was searched from 1979 through 1994 manually and using MEDLINE. Conference proceedings and reference lists of relevant articles were reviewed.

Data Extraction: Studies clinically relevant to latex allergy were selected.

Results: The most common clinical presentation of latex allergy is a nonimmunologic, irritant dermatitis of the hand. Contact dermatitis (type IV delayed hypersensitivity reactions to rubber additives) is the most common immunologic manifestation of latex rubber allergy. Type I allergic responses are less common and include contact urticaria, rhinoconjunctivitis, asthma, and anaphylaxis. Seven percent to 10% of health care workers regularly exposed to latex and 28% to 67% of children with spina bifida have a positive skin test result to latex proteins indicating increased blood levels of IgE antibody. About one third of patients with positive skin test results, however, do not yet have symptoms of latex allergy. Systemic (life-threatening) anaphylactic shock can occur intraoperatively in highly sensitive patients because of mucosal absorption of latex protein allergens from the surgeon's gloves. The present treatment for latex allergy is careful avoidance of latex materials. In addition, the use of powder-free latex gloves can eliminate airborne latex exposure and can allow health care workers with inhalant allergic reactions to return to work.

Conclusion: Latex allergy currently affects thousands of people. These persons have IgE-mediated cutaneous, respiratory, and systemic allergic reactions. A reduction of the total protein level on latex rubber devices may prevent further sensitization and eliminate latex allergic reactions.

Figures

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Figure 1.
Overview of the identification and management of persons with latex allergy.

Patients are divided into those with positive or negative histories and those with positive or negative results from skin testing, and a management outcome for these patients is given. Patients with negative histories do not receive skin testing unless they are categorized as high risk. RAST = radioallergosorbent testing; SPT = skin-prick testing.

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