Asthma caused by latex


Occupations
  • Toy manufacture
  • Hospital staff
  • Manufacture of surgical gloves
  • Medical personnel
  • Nurse
  • Surgeon
  • Textile industry
  • Toy manufacture
Agents
Latex
 
Incidence
Incidence: the proportion of hospital personnel reported as being sensitized to latex (PT+) varies from 2.9% to 5.5% depending upon the authors and attains 8% in subjects who are regularly exposed to this product. The influence of atopy has yet to be established. IgE-dependent mechanism.
 
Occupational urticaria (surgeons and nurses) and anaphylactic reactions to latex during surgical operations have been described . On the other hand, an antigenic cross reactivity has been demonstrated between latex, banana, chestnuts and kiwis (and perhaps also with melon). There is a partial cross-reactivity with ficus benjamina.
 
In South Africa, a programme on the incidence of occupational asthma demonstrated that latex is the principle causative agent of such asthma.
 
Conditions
Exposure during the manufacture or use of latex surgical gloves made with latex from Hevea Braziliensis. In hospitals, this risk is greatest for surgical staff, since latex particles remain airborne. A similar pathology exists amongst cleaning staff wearing gloves. Together with glutaraldehyde, latex is responsible for the majority of work-related asthma amongst medical staff as shown by epidemiological studies. New cases have been reported in the textile industry in seamstresses sewing the elastic of clothing.
 
Measurement of latex airborne particles have been made in dental surgeries. The level of allergens in the waiting room varies between 6 and 25 ng per cubic meter of air and in the treatments room the levels are between 25 and 90 ng per cubic meter of air during working periods. With the use of non-powdered gloves, the levels become undetectable (less than 5 ng per cubic meter of air). The risk of sensitisation to latex manifests itself during the first 3 years of exposure as a function of the workplace and the levels of allergen present in the atmosphere. Whilst there is exposure cutaneous sensitisation and rhinitis, the risk of occupational asthma becomes greater and greater. Preventative measures, such as the use of non-powdered gloves, and the use of latex gloves only when necessary, is the best avoidance measure possible in hospital settings.
 
Symptoms
Asthma in the work place frequently associated with pruritus and ENT symptoms. Two cases of recurrent anaphylaxis to hidden latex at work have been reported, with ingestion of a food item acting as a trigger.
 
Diagnostic methods
Skin prick test: not commercially available.
 
Immunological assay: RAST:CAP RASR with latex.
 
Bronchial provocation test using the raw materials (in hospital).
 
Peak flow measurements in the work place.
 
The combination of skin tests and clinical history is less precise in the diagnosis of occupational asthma than bronchial provocation tests.

References

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As in all diagnostic testing, the diagnosis is made by the physican based on both test results and the patient history.