Latex Allergy

Erin M. Warshaw, MD

Disclosures
In This Article

Prevalence of Type I Allergy to Latex

Studies evaluating the prevalence of latex sensitivity must be considered in the context of study population, definition of sensitization, and selection criteria for inclusion. Individuals without symptoms are less likely to answer questionnaires and undergo testing. Prevalence of latex sensitivity in the general population is probably less than 2%.[20] Studies analyzing serum samples from blood donors indicate higher rates of sensitization (6%–12%),[21] probably because health care workers, thought to be at risk for latex allergy, are more likely to donate blood. Importantly, not all individuals who show evidence of sensitivity by testing have or will have clinical symptoms.

The prevalence of latex allergy is reportedly higher in several major risk groups including: 1) individuals routinely exposed to natural rubber latex products (e.g., health care workers, hairdressers, janitorial staff, and rubber manufacturer workers); 2) atopics (individuals with a personal or family history of atopic dermatitis, asthma, or allergic rhinitis); 3) individuals with a history of multiple surgical procedures (especially individuals with spina bifida and congenital urologic abnormalities); 4) females; and 5) individuals with pre-existing hand dermatitis.

Individuals who are occupationally exposed to natural rubber latex products, such as health care workers and rubber manufacturing employees, have sensitization rates of approximately 15%.[22–24] Although it is often claimed that healthcare workers are at increased risk of latex sensitization, there is no convincing epidemiological evidence for this claim. A recent study[25] using data from 5512 adults from the Third National Health and Nutrition Examination Survey found that latex sensitization was not statistically associated with occupations involving latex glove use. Atopics were found to be at much greater risk than nonatopics for latex allergy (prevalence odds ratio, 28; 95% confidence interval, 3.6– 216).

Sensitization rates in individuals with spina bifida have been reported as high as 69%.[26] Studies of individuals with a history of multiple surgical procedures, including individuals with spina bifida, show evidence of an exposure-response relationship. Exposure-related factors, such as the number of operations or the use of specific devices such as catheters and shunts have been associated with an increased risk of latex sensitization and allergy.[27] Direct internal or mucosal contact with natural rubber latex medical devices appears to be an important route of sensitization in these populations.

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