Latex-Safe
Information
Disclaimer:
In the medical industry, some products contain Natural Rubber Latex (NRL),
which has been associated with sensitization or allergic reactions. The
contents of this section are for informational purposes only. It is not
to replace medical direction or advise. If you have any questions or medical
concerns, please consult an allergist or immunologist.
To the best of School Health Corporation's knowledge, the information provided
by manufacturers about Natural Rubber Latex content is considered to be
true. See section, Manufacturer's Statement,
for further information.
What Does It All Mean?
 |
1. |
Chemical
Contact Dermatitis-a delayed cell-mediated Type IV localized allergy
that is caused by chemicals used to manufacture rubber products. |
| 2. |
Latex
Protein Immediate Hypersensitivity (termed latex-allergy)-Latex Allergy
is a Type 1 IgE-mediated hypersensitivity reaction that involves systemic
antibody formation to proteins in products made from natural rubber
latex. Natural rubber latex is harvested from the rubber tree, Hevea
brasiliensis, and used to manufacture rubber products. Natural rubber
latex contains up to 240 potentially allergenic protein fragments,
and different persons may be sensitized to different combinations
of latex allergens. Synthetic latexes are not involved in latex allergy. |
|
Incidence:
Studies have shown the incidence of latex allergy to be as high as
67% in patients with spina bifida, (1) 6.5% in patients who have undergone
multiple surgeries, (2) 8% to 17% in health care workers, (3-5) and
between 1% and 6% in the general population. (4,6,7) These figures
would indicate, based on assumptions, that there are presently more
than 5.5 million health care workers in the United States (1) and
272 million Americans in the current US population. An estimated 440,000
to 935,000 health care workers, or 2.7 million to 16 million Americans,
may suffer from some type of allergic reaction to latex.
Medical Glove Allergenicity
Latex Medical Gloves are the most prominent source of latex allergen
exposure by cutaneous contact, inhalation, wound inoculation and ingestion.
(8,9) Allergens levels vary considerably in gloves from different
manufacturers, and from lot to lot, with higher levels occurring in
powdered gloves and examination gloves than in powder-free gloves
and surgical gloves. (8,10) Latex gloves that are inadequately processed
during manufacture contain loosely-bound protein that readily rubs
off or leaches into sweat, then accumulates on glove wearer's hands
and easily transfers by touch to other persons and objects (e.g. medical
records, telephones, doorknobs, food, etc.).
Powder-Free
Adverse reactions to natural rubber latex gloves have emerged
as an important occupational health concern for workers who
are required to wear gloves as a barrier against infectious
agents. (11) The most severe reaction associated with latex
gloves, Type 1 immediate hypersensitivity, a rare but potentially
life threatening allergic reaction to latex proteins, may
be elicited not only by dermal contact with gloves but also
by exposure to latex proteins contained in airborne glove
powder. (11,12) Powder can become airborne during unpackaging,
putting on and taking off of gloves. (11) Airborne particles
of powder and protein may remain suspended for up to 5 hours,
contaminating the air, ventilation system, skin, hair, clothing,
wounds and objects which can result in occupational asthma.
(14,15)
Cornstarch
powder has long been used on latex gloves as a lubricant to facilitate
putting the gloves on. Cornstarch or other powder is also used by
some (but not all) manufacturers to ease removal of gloves from molds.
For powder free gloves, the powder is removed afterwards by washing.
The United States Food and Drug Administration (FDA) has recommended
that powder free gloves contain no more than 2mg residual powder and
powdered gloves no more than 120 mg powder. (13) The FDA guidelines
only apply to gloves for medical use.
Hypoallergenic
The "hypoallergenic" label generally means that gloves are
low in chemical contact sensitizers, but "hypoallergenic"
does not refer to latex allergens. (16)
School Nurse Responsibilities in
Creating a Latex Safe Environment
|
|
1. |
Educate
School Personnel: Educate personnel regarding students
and other school personnel with latex allergies and the need to minimize
the risk of sensitizing children or personnel who are at risk for
developing latex allergy. Also, attempt to balance two needs: maximum
inclusion of the child in school life and activities with safety from
exposure to a potentially life threatening allergy. Identify latex
sensitized students and personnel. |
| a. |
Establish
an inventory of non-latex alternatives for latex medical devices |
| b. |
Educate
personnel regarding latex allergy and related issues |
| c. |
Implement
latex allergy guidelines pertaining to students and school
personnel |
| d. |
Provide
task appropriate, powder and latex free gloves
|
| 2. |
Identify
Potential Exposure: Access high-risk areas for
latex sensitive students |
| a. |
Classrooms
for erasers and rubber bands, art supplies, science and lab
equipment |
| b. |
Cafeteria
for food preparation with latex gloves. School personnel should understand
the cross contamination between latex and certain foods such as bananas,
kiwi and avocado |
| c. |
Gym
and playground for rubber mats and flooring, balls and racquet
handles |
| d. |
Housekeeping
supplies, latex gloves for cleaning classrooms, hallways etc.
may leave allergic powder on surface or in the air |
| e. |
Nurse's
office deserves a real close look. Even if a child has a separate
supply of non-latex gloves and other first aid items, protein-laden
powder from latex gloves used with other children can easily
contaminate surfaces and remain airborne long enough to trigger
a respiratory reaction
|
| 3. |
Develop
Emergency Protocol: Protocols should include specific plans
for recognizing and treating a reaction in each child, when to call
for help and facilitating ambulance and emergency room preparedness
and latex safety. Easily accessible latex free first aid supplies
are an important part of any emergency plan.
|
|
A few things to keep in mind: |
| 1. |
Oil-based
solutions (hand moisturizers containing jojoba, aloe vera,
palm oil, coconut oil, lanolin, mineral, petrolatum products)
break down the molecular structure of latex and some synthetic
glove materials within a few minutes. |
| 2. |
Soaps,
detergents, alcohol and various chemicals also degrade latex. |
| 3. |
Water
and glycerin-based hand care products are compatible with
latex.
|
| |
Allergenic
Cross-Reactivity of Latex and Foods
For more information on cross-reactivity between latex and
food, click
on this link to go to the Tripod.com website to see an
article published with permission by Greer Laboratories.
Latex
Allergic People Cross React to Many Plants
"The
latex and food allergy connection" by Judy E. Perkin.
Journal of the American Dietetic Association. Nov, 2000.
|
| References |
| 1. |
Kelly
KJ, Krup VP, Reijula KE, Fink JN.
"The diagnosis of natural rubber latex allergy."
J. Allergy Clinical Immunology
1994;93:813-816 |
| 2. |
Moneret-Vautrin
DA, Beaudouin E, Widmer S, et al.
"Prospective study of risk factors in natural latex sensitivity."
J. Allergy Clinical Immunology
1993;77:905-908 |
| 3. |
Watts
DN, Jacobs RR, Forrester B, et al.
"An evaluation of the prevalence of latex sensitivity among atopic
and non-atopic intensive care workers."
Am J Ind Med
1998;34:359-363
Medline |
| 4. |
Arellano
R, Bradley J, Sussman G.
"Prevalence of latex sensitization among hospital physicians
occupationally exposed to latex gloves."
Anesthesiology
1992;77:905-908. |
| 5. |
Liss
GM, Sussman GL, Deal K, et al
"Latex Allergy: epidemiological study of 1351 hospital workers."
Occup Environ Med.
1997;54:335-342
Medline |
| 6. |
Ownby
DR, Ownby HE, McCollough J, et al.
"The prevalence of anti-latex lge antibodies in 1000 volunteer
blood donors."
J. Allergy Clinical Immunology
1996;97:1188-1192
Medline |
| 7. |
Sussman
GL, Beezhold DH.
"Allergy to Latex Rubber"
Annals of Internal Medicine
1995;122:43-46
Medline |
| 8. |
Yunginger,
JW (1995) "Variances in antigenicity of latex products. Immunology
and Allergy Clinics of North America", 15 (1), 61-70. |
| 9. |
Yunginger,
J, Jones, R, Fransway, A et al. (1994) "Extractable latex allergens
and proteins in disposable medical gloves and other rubber products.
Journal of Allergy and Clinical Immunology", 93:83-42. |
| 10. |
Jones,
RT, Scheppmann, DL, Heilman, DK and Ynuginger, JW (1994). "Prospective
study of extractable latex allergen contents of disposable medical
gloves." Annals of Allergy. 73(4), 321-325. |
| 11. |
Lynch
MC, Neiders ME. "Risks of occupational exposure to latex gloves."
NY State Dental Journal 1998; 64:35-9. |
| 12. |
Gliniecki
CM. "Management of latex reactions in the occupational setting."
AM Assoc. Occup. Health Nurses Journal 1998: 46:82-93 |
| 13. |
Food
and Drug Administration. Medical Glove Guidance |
| 14. |
Kelly,
KJ |
| 15. |
American
Academy of Allergy, Asthma, and Immunology and American College of
Allergy, Asthma and Immunology. "Joint Statement Concerning the
Use of Powdered and Non-Powdered Natural Rubber latex-Gloves."
Arlington Hts., IL: ACAAI, July 21, 1997. |
| 16. |
Truscott,
W. (1995). "The industry perspective on latex. Immunology and
Allergy Clinics of North America", 15 (1) 89-121. |
|
Frequently
Asked Questions
| Q: |
Who
is at risk of developing latex allergy? |
| A: |
1. |
Health
care workers are at risk because they use latex gloves frequently.
Workers with less glove use (such as hairdressers, housekeepers
and workers in industries that manufacture latex products)
are also at risk.
|
| 2. |
Children
at risk:
 Spina
Bifida patients
Children
who have been in intensive care for long periods.
Children
who have had a lot of surgeries.
Children
who have had invasive medical procedures with latex items.
|
| 3. |
People who
have allergies to certain foods; see section on Allergenic
Cross-Reactivity of Latex and Foods.
|
| Q: |
What
are the symptoms of latex allergy? |
| A: |
The
symptoms are: skin rash, hives, flushing, itching, nasal,
eye or sinus symptoms, asthma and sometimes anaphylactic shock.
|
| Q: |
Do
I have to worry about other medical products besides gloves? |
| A: |
Latex
is found in many items in health care settings and the home. Included
could be such items as: elastic and adhesive bandages, rubber bite
blocks, BP cuffs, condoms, diaphragms, balloons, cloth adhesive tape,
teething rings, pacifiers, manual ventilation bags, tourniquets, medication
ports on I.V. lines, ECG electrodes, pencil erasers and rubber bands.
|
| Q: |
Will hypoallergenic gloves protect me from latex allergy? |
| A: |
Hypoallergenic
gloves are not latex-free, although they contain fewer additives and
reduce the risk of allergic contact dermatitis. Wearing a cotton glove
liner does not help either; latex can leach from the gloves onto perspiring
hands.
|
| Q: |
Are
your School Health Brand Adhesive bandages latex-safe? |
| A: |
The
School Health Adhesive Bandage is latex-free, BUT the adhesive on
the bandage package does contain natural rubber latex. A better choice
for a 100% latex free bandage and packaging would be the 100% Latex-Free
Bandages offered by School Health. Click
here for ordering information.
|
|
Manufacturer's Information
To the best of School Health Corporation's knowledge, the information provided
by manufacturers about Natural Rubber Latex content is considered to be
true. School Health Corporation cannot be responsible for products containing
NRL that may be still in an inventory or distribution system by a particular
manufacturer. We have provided the list of our manufacturer's websites so
you may obtain specific information related to a product of interest.
Resource
Links
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