March 27, 2015 | Health System Risk Management
Allergic reactions from natural rubber latex gloves were first described in 1933 and were reported sporadically after that. However, it was not until the Centers for Disease Control and Prevention (CDC) implemented universal precautions in the late 1980s, and the annual number of surgical gloves imported into the United States increased from 800 million to more than 20 billion, that the number of reports of latex-induced allergic reactions began to rise dramatically. As the exposure to latex products continued to grow—some healthcare workers wear as many as 40 to 50 pairs of gloves a day, and surgical gloves may be worn for hours at a time—so did the incidence and severity of reported allergic reactions. In 1989, the first death from exposure to latex was reported, followed by reports of intraoperative anaphylaxis from latex exposure. (ASA)
By 1997, the U.S. Food and Drug Administration (FDA) had received more than 1,700 reports of severe allergic reactions to medical devices containing latex, including the deaths of 16 children with spina bifida who reacted to latex cuffs on the tip of barium enema catheters (FDA). According to the American Academy of Allergy, Asthma, and Immunology (AAAAI), there are hundreds of cases of anaphylaxis due to latex allergy every year (AAAAI).
There are three clinical reactions to natural rubber latex, collectively referred to as "latex sensitivity" for the purpose of this article. Two are true allergic reactions to proteins in latex—type I immediate hypersensitivity, which can result in life-threatening anaphylaxis, and type IV delayed hypersensitivity, which primarily affects the skin exposed to the latex. The third is nonallergic irritant contact dermatitis, which, unlike the allergic reactions, will not spread beyond the area of latex contact. See Three Possible Reactions to Latex, for detailed descriptions of the effects of these reactions. The diagnosis of latex allergy or irritant contact dermatitis is based on medical history, physical exam, and various laboratory and clinical tests; laboratory testing alone is insufficient to make a diagnosis (Kelly).
Exposure to latex proteins can cause...