Search for other papers by Jon Musmand in
Current site
Google Scholar
PubMed
Search for other papers by Christopher R. Brigham in
Current site
Google Scholar
PubMed
Abstract
Natural rubber latex (NRL) allergy is discussed in the AMA Guides to the Evaluation of Permanent Impairment (AMA Guides), Fifth Edition, in Section 8.5, Natural Rubber Latex Allergy, and refers to an IgE-mediated immediate hypersensitivity reaction to one or more protein allergens in latex devices, especially gloves. Among health care workers, NRL allergy is the most common cause of occupationally induced rhinoconjunctivitis and asthma, and clinical manifestations range from dermatitis and contact urticaria, allergic rhinoconjunctivitis, and asthma, to anaphylaxis. Evaluating physicians must be cognizant that a suggestive clinical history is necessary but not sufficient to diagnose NRL allergy, and FDA-approved NRL-specific IgE serum tests may have sensitivity as low as 75% and up to 27% false-positive results. No FDA-approved skin test reagent is available for testing. In evaluating impairment due to NRL allergy, evaluators should determine if the individual's problem can be resolved by avoidance of wearing latex gloves. Most patients who have asthma or air passage disruption impairment due to NRL have problems with bronchospasm only when they are exposed, and these patients may not necessarily have any ratable impairment due to NRL (but individuals who have atopic dermatitis may have ongoing symptoms due to pre-existing allergic rhinitis). Efforts to decrease the incidence of NRL allergy have been encouraging, and some patients diagnosed with NRL allergy may return to work in a latex-safe environment.
-
1.
Yunginer, JW. Addressing occupational allergy to natural rubber latex among health care workers. Ann Allergy Asthma Immunol. 2002;88:541–542.
-
2.
Kibby T and Akl M. Prevalence of latex sensitization in a hospital employee population. Ann Allergy Asthma Immunol. 1997;78:41–44.
-
3.
Sussman GL, Liss GM, Deal K, Brown S et al. Incidence of latex sensitization among latex glove users. J Allergy Clin Immunol. 1998;101:171–178.
-
4.
Brehler R and Kutting B. Natural rubber latex allergy: A problem of interdisciplinary concern in medicine. Arch Intern Med. 2001;161:1057–1064.
-
5.
Yunginger JW. Latex allergy in the work-place: an overview of where we are. Ann Allergy Asthma Immunol. 1999;83:630–633.
-
6.
Heilman DK, Jones RT, Swanson MC, Yunginger JW. A prospective, controlled study showing that rubber gloves are the major contributor to latex aeroallergen levels in the operating room. J Allergy Clin Immunol. 1996;98:325–330.
-
7.
Hamilton RG, Biagini RE, Kreig EF and the Multi-Center latex Skin Testing Study Task Force. Diagnostic performance of Food and Drug Administration-cleared serologic assays for natural rubber latex-specific IgE antibody. J Allergy Clin Immunol. 1999;103: 925–930.
-
8.
Hamilton RG, Adkinson NF and the Multi-Center latex Skin Testing Study Task Force. Diagnosis of natural rubber latex allergy: Multicenter latex skin testing efficacy study. J Allergy Clin Immunol. 1998;102:482–490.
-
9.
Tiles SA. Occupational latex allergy: controversies in diagnosis and prognosis. Ann Allergy Asthma Immunol. 1999;83:640–644.
-
10.
Blanco C, Carrillo T, Ortega N, Alvarez M, Dominguez C, Castillo R. Comparison of skin-prick test and specific serum IgE determination for the diagnosis of latex allergy. Clin Exp Allergy. 1998;28: 971–976.
-
11.
Allemer H, Brehler R, Chen Z, Raulf-Heimsoth M, et al. Reduction of latex aeroallergens and latex-specific IgE antibodies in sensitized workers after removal of powdered natural rubber latex gloves in a hospital. J Allergy Clin Immunol. 1998;102:841–6.
-
12.
Charous BL, Blanco C, Tarlo S, Hamilton RG et al. Natural rubber latex allergy after 12 years: Recommendations and perspectives. J Allergy Clin Immunol. 2002;109:31–34.
-
13.
Bolinger ME., Mudd K, Keible LA, Hess BL et al. A hospital-based screening program for natural rubber latex allergy. Ann Allergy Asthma Immunol. 2002;88:560–567.
-
14.
Saary MJ, Kanai A, Alghadeer H, Holness DL, Tarlo SM. Changes in rates of natural rubber latex sensitivity among dental school students and staff members after changes in latex gloves. J Allergy Clin Immunol. 2002;109:131–135.
| All Time | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 666 | 644 | 63 |
| Full Text Views | 22 | 21 | 0 |
| PDF Downloads | 0 | 0 | 0 |
