Latex Allergy

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Why is this a new problem?

Latex has been described as the allergen of the '90s. This is a relatively new problem that can trace its origins to the demand of universal precautions brought on by the appearance of AIDS. To meet the demands of universal precautions, there were significant changes in the manufacturing of latex products, specifically latex gloves which have contributed to the appearance of latex as a significant allergen.

There also exists a significant amount of disbelief and poor acceptance regarding latex allergy. This can cause increased risk and continued exposure.

Latex reactions can be irritation of the skin as in a contact dermatitis. Latex has also been a cause of hives and swelling, inflammation of the nose, and asthma. There have also been cases of anaphylaxis due to latex.

What is latex?

Latex refers to a milky sap of any plant. In the world of allergy is refers to that milky sap from the rubber tree. Hence we should properly refer to this as natural rubber latex sensitivity.
Latex paint does not contain natural rubber. Here the term refers to a physical property of the paint. Once upon a time, natural rubber latex was used in chewing gum.

What are the risk factors? There are a number of populations at risk for developing latex sensitivity. Children who have spina bifida, health care providers, and those who have had extensive urologic surgical procedures have an increase frequency of reactions to latex. Approximately 70% of children with spina bifida and more than 20% of health care workers have latex sensitivity. There have also been increases in the general population- in groups who were thought not to be at increased risk of sensitization. 5% of the general population has sensitivity to latex.

In these groups the risk factor is exposure to the natural rubber latex.

In children with spina bifida, there are a number of factors that increase the risk of an anaphylactic reaction. Those factors are:

Asthma
Contact sensitivity
Food allergy
Reaction to adhesive tape
Daily rectal dis-impaction > 9 surgeries
Increased latex-specific IgE
Elevated IgE

How is the diagnosis of latex allergy made?

The diagnosis is made by history and physical examination. Currently, there is no skin test material available to test for latex allergy. A blood study is available.

How can latex allergy be prevented?

As with everything in allergy, the most effective form of therapy is avoidance. It may be difficult to find a latex free environment, however it is possible to strive for a latex safe environment. Recommendations for avoidance are as follows:

No direct contact with latex implants or toys
No opening of "powdered" latex products in the same room
No powdered latex gloves
Wash hands after using natural rubber latex products
Read labels

What are the issues for children and pediatricians?

There are a number of foods that cross-react with natural rubber latex. The lists of these foods has become extensive when any degree of cross-reactivity is detected. The foods with the highest levels of cross-reactivity are:

Banana
Avocado
Kiwi
Chestnut

Pacifiers and toys such as Kush balls and balloons are made with natural rubber latex. Look for latex free alternatives.

What does the future look like?

There have been extensive efforts to provide a latex safe environment for the children at risk. Proper and understandable labeling has been an issue. In the future skin test material may be commercially available and there may be treatment protocols too. For now, know what products are safe and know what to avoid. An allergist can help with the diagnosis, avoidance, and management of severe reactions.

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