Latex Allergy

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What is Latex Allergy?

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Latex allergy has become an important health concern in recent years, especially in the occupational setting for health care workers, such as nurses, doctors and allied health professionals. Latex barrier products are now in widespread use following the adoption of universal precautions for infection control, which has been associated with an increased number of people suffering from latex allergy. Latex allergy cannot be cured, however awareness of the problem and avoidance of latex for sensitised individuals remains the mainstay of treatment.

Natural rubber latex is derived from the sap of Hevea brasiliensis. It is the main constituent of over 40,000 medical and consumer products and is used in a wide variety of settings ⁷. Lists 1-3 detail some of the products that commonly contain latex.

List 1: Uses of natural rubber latex

Latex concentrate (more likely to cause allergic reactions)

Gloves (40%)

Adhesives (16%)

Thread (12%)

Foam (12%)

Carpets (7%)

Imitation leather (7%)

Other (6%) (includes condoms, medical products, babies teats and dummies)

Bulk (dry) natural rubber (less likely to cause allergic reactions)

Tyres (70%)

Latex goods (12%)

Shoes (5%)

Engineering (3%)

Cables and tubes (2.5%)

Vehicles (1.5%)

Other (6%)

List 2: Common medical devices that may contain latex
Note that some of these products are now available in latex free alternatives.

Bite blocks

Blood pressure cuffs

Bulb syringes

Catheters*

Dental coffer dams*

Elastic bandages

Electrode pads

Endotracheal tubes and airways

Enema syringes*

Ventriculo-peritoneal shunts

Finger cots

IV access injection ports

Manual resuscitators

Penrose surgical drains

Pulse oximeters

Stethoscope tubing

Stretcher mattresses

Tourniquets

Vascular stockings
* Reported as a cause of latex allergy

List 3: Common househould items that may contain latex
Note that some of these products are now available in latex free alternatives

Adhesives

Balloons*

Carpet backing

Condoms*

Contraceptive diaphragms

Elasticated fabrics*

Feeding nipples

Household gloves*

Disposable nappies and incontinence pads

Infant dummies (pacifiers) and teats for formula feeding

Rubber bands

Shoes

Bandages

Balls

Erasers

Hot water bottles

Carpet backing

Sports equipment
* Reported as a cause of latex allergy

In contrast to natural rubber latex, synthetic rubber latex is produced from petrochemicals and does not contain allergenic latex proteins. Products containing synthetic rubber latex (such as most latex paints, nitrile or neoprene gloves) do not cause allergic reactions.

Reactions to natural rubber latex can manifest in 3 different forms. The most severe and important form is an immediate Type-1 hypersensitivity reaction, which is covered here.

Other reactions to latex include:

atopic dermatitis
">Allergic Contact Dermatitis, which is a type-4 hypersensitivity reaction which results in eczematous lesions often associated with vesicle formation, after which the skin can become dry, crusted and thickened. Chemical additives such as accelerators and antioxidants are commonly implicated. A change to gloves which do not contain the implicated chemical, or use of cotton lining gloves for protection usually reduces the problem.

Irritant dermatitis is a non-allergic skin rash characterised by redness, dryness, scaling, vesicle formation and cracking. These changes are caused by sweating or irritation of the glove with the powder residue, or from irritation from frequent washing, soaps and detergents.

Who gets Latex Allergy?

Less than 1% of the general population is allergic to latex, however certain people are at increased risk of developing latex allergy, including children with neural tube defects (such as spina bifida) or other congenital abnormalities requiring repeated surgery or catheterisation, and health care professionals who are exposed to latex in the workplace. The incidence of latex allergy is increasing along with the increasing frequency of allergies across the board.

Predisposing Factors

Most people with latex allergy have had frequent exposure to latex over a number of years. Most of these people are nurses, doctors, dentists or other health professionals who are exposed to latex in the workplace, or patients who have had multiple operations or other medical interventions (such as urinary catheterisations or diagnostic procedures), including children with spina bifida or other congenital defects such as renal abnormalities. People who are already allergic to other substances (for example, grass pollen or dust mite) are more likely to become allergic to latex.

Progression

Most people with latex allergy have been exposed to latex over several years. With the exception of gloves and balloons, most latex products in daily life do not contain enough allergen to cause significant problems.

Almost half of people with a latex allergy will also develop an allergy to certain fruits, most commonly avocado, banana or kiwi fruit. They will often get itching and/or swelling in the mouth and throat after eating these fruits.

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