Allergy to proteins in natural rubber latex became a significant concern by the late 1980s. Fortunately however, the epidemic was not of concern by 1990s. Latex allergy appears to have originated from an increased use of latex gloves at health care facilities, and changes in processes used to manufacture latex products.
What is latex?
Latex is a milky fluid produced by rubber trees (Hevea brasiliensis). Using different methods, latex can be processed into a variety of products, such as gloves and balloons. During manufacturing, chemicals are added to increase the speed of curing and to protect the rubber from oxygen in the air. Products made from blends of natural rubber latex and other compounds are very common. In those with latex allergy, allergic reactions are most often triggered by dipped latex products. Products that commonly cause reactions can include gloves, balloons and condoms. Almost all latex paints are not a problem since they do not contain natural rubber latex.
Types of allergic reactions
There are two types of allergic reactions to latex. The first is delayed-type contact dermatitis rash that appears 12-36 hours after contact with a latex product. This most commonly appears on the hands of people who wear latex gloves, but it may occur on other parts of the body following contact with rubber products. This form of latex allergy is usually the result of sensitization to chemicals that are added during rubber processing. This form of allergy is not life-threatening. Immediate, or IgE antibody-mediated allergic reactions, are potentially the most serious form of allergic reactions to latex. Like other common forms of allergy, these reactions occur in people who have previously been exposed to latex and have become sensitized (latex-specific IgE antibody positive). With re-exposure, symptoms such as itching, redness, swelling, sneezing, and wheezing may occur. Rarely, but life-threatening symptoms as in with anaphylaxis may occur, and is characterized by symptoms such as shock, severe trouble breathing or loss of blood pressure. The severity of the immediate reaction depends upon the person's degree of sensitivity and the amount of latex allergen to which the person is exposed. The use of non-powdered latex gloves, or synthetic (vinyl, nitrile) gloves reduces the risk of these reactions.
Individuals with spina bifida (a congenital problem in the development of the back) and those with congenital urinary tract problems who need multiple surgeries seem to have a risk of nearly 50%. Health care workers and others whose jobs require wearing latex gloves or working around them have a risk of about 18%. Others who may be at increased risk are those who have had many medical or surgical procedures, resulting in repeated exposure to latex gloves. Rubber industry workers also are at increased risk. Even in normal adults, the risk of sensitization to latex may be as high as 6%. People with latex allergy may also experience an allergic reaction to some foods that contain some of the same allergenic proteins as those in latex. This reaction called cross-reactivity can be triggered by bananas, avocados, kiwi fruit, and chestnuts.
Evaluation and treatment
The first step in treating latex allergy is awareness of the problem. Visit your allergist/immunologist if you think you may have symptoms of latex allergy. After taking a detailed history and examining you, your doctor will decide whether additional diagnostic tests for latex allergy are needed. If you are allergic to latex, you should avoid contact with natural rubber latex products as much as possible. Inform your family, health care professionals, employer and school personnel about your allergy. Discuss with your physician whether you should wear a special bracelet or necklace that notifies others of your allergy. Your doctor will also determine whether you should carry injectable adrenalin (epinephrine) to provide immediate, emergency treatment in case you experience a severe allergic reaction. You may try substituting synthetic (vinyl or nitrile) gloves for latex gloves. However, they are more expensive. Manufacturers are currently working to produce latex products that contain less latex allergen. As these products become more available, the risk of reactions should decrease.