atex allergy develops after many previous exposures to latex. Latex allergy symptoms may include hives, itching, stuffy or runny nose. It can cause asthma symptoms of wheezing, chest tightness and difficulty breathing. Symptoms begin within minutes after exposure to latex containing products

1. Latex Allergy
Ahmad Thanin

2. Introduction Latex allergy is a reaction
to certain proteins found
in natural rubber latex; a
product made from the
rubber tree.
Healthcare workers are at
an increased risk of
developing a latex allergy.

3. Latex Allergy Prevention
Latex Definition
• According to the Webster's Dictionary, the term "latex"
refers to natural rubber latex (NRL), the product
manufactured from a milky fluid derived from the rubber
tree, Hevea brasiliensis.
• Several types of synthetic rubber are also referred to as
"latex," but these do not release the proteins that cause
allergic reactions

4. Workers who are
exposed to latex
gloves and other
products that contain
natural rubber latex
may develop allergic
reactions.

5. Latex
Allergies
Allergy to latex was first recognized in the late
1970s.
Since then, it has become a major health
concern as an increased number of people in
the workplace are affected.
Health care workers exposed to latex gloves or
medical products containing latex are especially
at risk.
It is estimated that 8-12% of health care
workers are latex sensitive.

6. Who is at risk ?
• Workers in the health care industry (physicians,
nurses, dentists, technicians, etc.) are at risk for
developing a latex allergy because they use latex
gloves frequently.
• Workers with less frequent glove use
(hairdressers, housekeepers, food service
workers, etc.) and workers in industries that
manufacture latex products are also at-risk for
having a latex allergy.

7. Workers who are exposed to latex gloves and other products that
contain natural rubber latex may develop some of the following
allergic reactions:
• skin rashes (such as hives)
• nasal, eye, or sinus symptoms (sneezing, itchy eyes, or
wheezing from exposure to airborne latex particles)
• asthma
• shock (rarely)

8. Types of Reactions
Irritant contact
dermatitis
Allergic contact
dermatitis (Type
IV delayed
hypersensitivity)
IgE/histamine-
mediated allergy
(Type I immediate
hypersensitivity)

9. Irritant Contact Dermatitis
• When gloves are associated with skin
wounds, the most common reaction is
irritant contact dermatitis.
• Irritant contact dermatitis may be due
to direct irritation from gloves or glove
powder.
• It may also be due to other causes,
such as the following:
• soaps and detergents
• incomplete hand drying
• other chemicals

10. Irritant Contact Dermatitis
Irritant contact dermatitis presents as dried, cracked, split skin.
Although irritant contact dermatitis is not an allergic reaction, the breaking of the
intact skin barrier due to these lesions may afford a pathway for other natural rubber
latex (NRL) proteins to gain access, which can cause a development of sensitivity.
Additionally, irritant contact dermatitis lesions disrupt the barrier function that intact
skin provides to inhibit passage of various chemicals and pathogens.

11. Allergic Contact
Dermatitis
The second type of reaction that may be associated with
glove use is allergic contact dermatitis.
When glove use has been associated with this reaction,
the majority of cases appear to be due to the chemicals
used in processing NRL or other glove materials.
Allergic contact dermatitis has an appearance similar to
the typical poison ivy reaction, with blistering, itching,
crusting, oozing lesions.
Like poison ivy, this dermatitis appears 24-72 hours after
the use of gloves or exposure to other sources of
chemical sensitizers.

12. IgE/histamine-
mediated Allergy
The third and potentially most
serious type of reaction associated
with glove use is Type I or
IgE/histamine-mediated allergy to
allergenic glove protein.
This type of reaction can involve
mild, more-sever, or life-threatening
symptoms.

14. Mild Symptoms: Localized reactions occur at
the site of exposure.
Itching
Skin Redness
Hives or Rash

15. More-Severe Symptoms: Systemic symptoms that may
indicate a serious latex allergy include the following:
Sneezing or Coughing
Runny Nose
Itchy, Watery Eyes
Scratchy Throat
Difficulty Breathing or Wheezing

16. Life-Threatening Symptoms:
• The most serious allergic reaction to latex is anaphylaxis.
• An anaphylaxis reaction develops immediately after latex exposure in
highly sensitive people.
• It rarely happens the first time someone is exposed.

17. Signs and
symptoms of
anaphylaxis
include:
Difficulty breathing or
Wheezing
Hives or Swelling
Nausea and Vomiting
Drop in blood
pressure or
Rapid/weak pulse
Confusion, Dizziness,
or Loss of
consciousness
If any of these
symptoms develop
following an
exposure to latex,
medical treatment
must be initiated
immediately.

18. Diagnosing Latex Allergy
A latex allergy should be suspected in anyone who develops
symptoms after latex exposure.
Any exposed worker who experiences the known symptoms
should be evaluated by a physician as soon as possible.
• Further exposure could result in a serious allergic reaction.
Taking a complete medical history is the first step in
diagnosing a latex allergy.
• Blood tests approved by the Food and Drug Administration (FDA) are
available to detect latex antibodies.

19. Diagnosing Latex Allergy
Testing is also available to diagnose allergic contact dermatitis.
• In this FDA-approved test, a special patch containing latex additives is applied to the skin
and checked over several days.
• A positive reaction is shown by itching, redness, swelling, or blistering where the patch
covered the skin.
In some cases, tests may fail to confirm a worker who has a true allergy
to latex.
• In other instances, tests may suggest latex allergy in a worker with no clinical symptoms.
• Therefore, test results must be evaluated by a knowledgeable physician.

20. Latex Allergy Protection
Use non-latex gloves for activities that are not likely to involve contact with
infectious materials.
When handling infectious material, such as blood, use powder-free gloves with
a reduced protein content.
When wearing latex gloves, do NOT use oil-based hand creams or lotions, as
they can cause the glove to deteriorate.
Frequently clean work areas contaminated with latex dust, such as carpets and
ventilation ducts.
Learn to recognize the symptoms of a latex allergy.
Take advantage of all latex allergy education and training provided by your
employer.

21. Developing Symptoms
If you develop symptoms of a latex allergy, avoid direct contact
with latex gloves and other latex-containing products until you
can see a physician experienced in treating latex allergies.
If you have a latex allergy, your health care professional or
physician may discuss the following precautions:
• Avoiding contact with latex gloves and products.
• Avoiding areas where you might inhale the powder from latex gloves worn
by other workers.
• Telling your employer and health care providers (physicians, nurses, dentists,
etc.) that you have a latex allergy.
• Wearing a medical alert bracelet.

22. Remember
• Latex allergy in the workplace can result in
potentially serious health problems for workers,
who are often unaware of the risk of latex
exposure.

23. Barrier Protection
• It is extremely important
that barrier protection be
used when hands would
otherwise contact infectious
materials or hazardous
chemicals, such as latex.

24. OSHA's
OSHA's Bloodborne Pathogens Standard (29 CFR 1910.1030) requires that
gloves be worn when it is reasonably anticipated that hand contact may
occur with blood, other potentially infectious materials, mucous membranes,
non-intact skin, or contaminated items or surfaces, as well as when
performing vascular access procedures [except as specified in paragraph
(d)(3)(ix)(D)].
When gloves are being worn to protect against bloodborne pathogens, the
standard requires that employers provide readily accessible alternatives,
such as glove liners, for employees who are allergic to the gloves normally
provided.

25. Reducing Exposure and Risk
Reducing Exposure
• Reducing exposure has been the primary prevention method to protect workers with latex
allergies.
• Gloves made of NRL as well as alternative materials have been cleared by the FDA for
marketing as medical gloves.
Reducing Risk
• A prudent risk reduction strategy involves an initial survey and assessment, with a
coordinated effort to identify and catalogue all NRL products used in the workplace.
• An ongoing program involves close coordination between both resources and
management staff.
• This will help monitor NRL content of incoming products so management can be prepared
to choose appropriate alternatives to protect at-risk employees.

26. Controlling Exposure and Risk
• Employers should follow the well-known hierarchy of controls to help
prevent or mitigate exposure and the risk of latex allergies in the
healthcare setting.
• The strategies in the hierarchy for latex protection include
elimination, substitution, administrative controls, and PPE.

27. The strategies in the hierarchy for latex
protection
Elimination.
Substitution.
Administrative
controls
PPE.

30. Elimination &
Substitution
Eliminating exposure to latex is the most
effective method of control.
Unnecessary latex-containing materials should
be eliminated.
When materials, such as gloves and bandages,
are required, a non-latex version should be
substituted to replace the latex-containing
version.

31. Administrative controls
Healthcare facilities should implement
administrative controls, which include
policies and procedures, to reduce the
risk of allergic NRL reactions.

32. For example:
Creating so-called "safe zones" to protect those employees who are already sensitized to NRL allergenic
proteins might be necessary.
•"Safe zones" are areas where non-NRL products are used and NRL allergenic proteins have been removed from the environment.
Ensuring workers use good housekeeping practices to remove latex-containing dust from the workplace.
Policies are developed to:
•identify areas contaminated with latex dust for frequent cleaning (upholstery, carpets, and ventilation ducts); and
•make sure workers change ventilation filters and vacuum bags frequently in latex-contaminated areas.
Providing workers with education programs that include instruction and hands-on training about latex
safety.
Periodically screening high-risk workers for latex allergy symptoms. Detecting symptoms early and
removing symptomatic workers from latex exposure are essential for preventing long-term health effects.

33. Personal Protective Equipment (PPE)
• NIOSH recommends employers take the following steps
to protect workers from latex exposure and allergy in
the workplace:
• Provide workers with non-latex gloves to use when
there is little potential for contact with infectious
materials (for example, in the food service
industry).
• Appropriate barrier protection is necessary when
handling infectious materials.
• If latex gloves are chosen, provide reduced protein,
powder-free gloves to protect workers from
infectious materials.

34. Remember
• No matter which control methods are used, it's
important to evaluate current prevention strategies
whenever a worker is diagnosed with latex allergy
and provide the necessary controls to mitigate
future risk.

35. Employer
Responsibilities
Latex allergy can be prevented only if
employers adopt policies to protect workers
from undue latex exposures.
Detecting symptoms early and removing
symptomatic workers from latex exposure are
essential for preventing long-term health
effects.
NIOSH recommends employers take the
following steps to protect workers from latex
exposure and allergy in the workplace:

36. NIOSH
recommends
Ensure workers use good housekeeping practices to
remove latex-containing dust from the workplace:
• Identify areas contaminated with latex dust for frequent cleaning.
• Make sure that workers change ventilation filters and vacuum
bags frequently in latex-contaminated areas.
Provide workers with education programs and
training materials about latex allergy.
Periodically screen high-risk workers for latex allergy
symptoms.
Evaluate current prevention strategies whenever a
worker is diagnosed with latex allergy.

37. Employee
Responsibilities
Use non-latex gloves for activities that are not likely to involve contact with
infectious materials.
If you choose latex gloves, use only powder-free gloves with reduced protein
content. "Hypoallergenic" latex gloves do not reduce the risk of latex allergy.
However, they may reduce reactions to chemical additives in the latex (allergic
contact dermatitis).
When wearing latex gloves, do not use oil-based hand creams or lotions (which
can cause glove deterioration) unless they have been shown to reduce latex
related problems and maintain glove barrier protection.
After removing latex gloves, wash hands with a mild soap and dry thoroughly.
Use good housekeeping practices to remove latex-containing dust from the
workplace.
Frequently clean areas contaminated with latex dust (upholstery, carpets, and
ventilation ducts).