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Allergy & Asthma Advocate: Fall 2008The Low-down on Latex Allergy  Balloons are fun and rubber gloves and condoms are designed to protect. But for the 3 million or more Americans with latex allergy, these products can cause dangerous reactions. Latex is a milky sap produced by rubber trees, particularly the tree Hevea brasiliensis. The sap is blended with chemicals during manufacturing to give latex its elastic quality. The first documented case of latex allergy occurred in 1979 and throughout the 1980s latex allergy was a growing concern. There are several theories as to why latex allergy increased in this decade. The HIV epidemic resulted in the adoption of strict precautions for health care workers, leading to an increased use of latex gloves. Latex condom use also increased during this time period. Changes in latex manufacturing may also be related. The U.S. Food and Drug Administration recently approved a new natural rubber latex from the desert plant ‘guayule’ which may be safer for allergic patients and healthcare workers. Synthetic latex products are also safe for people with latex allergy. Approximately 50 percent of people with latex allergy have a history of another type of allergy. Certain fruits and vegetables (such as bananas, chestnuts, kiwi, avocado and tomato) can cause allergic symptoms in some latex-sensitive individuals. It is estimated that 1 percent to 6 percent of the general population has an allergy to natural rubber latex, commonly found in rubber gloves, balloons and condoms. Certain groups of people who are frequently exposed to latex have a greater risk of allergy, such as healthcare workers where prevalence is estimated at 5 percent to 17 percent. Children born with spina bifida and others who undergo multiple surgeries also have an increased risk. In allergic people, there are three types of reactions that can occur upon contact with latex gloves. The least serious of these reactions is irritant contact dermatitis. This condition has a gradual onset over the course of several days and can be caused by hand washing, antiseptics, and chemicals in gloves. The skin gets red, cracked and scaling can occur. Another reaction is allergic contact dermatitis, or delayed hypersensitivity. This reaction occurs 48-96 hours after contact and is usually triggered by added chemicals in the rubber. The skin gets red and itchy and vesicles, blisters, or crusting can occur. While irritating, this condition is not lifethreatening. The most serious reaction is immediate hypersensitivity. Symptoms can occur within minutes and include hives (local and systemic), angioedema, nausea, vomiting, cramps, bronchospasm and anaphylaxis. People with this type of allergy have had previous contact with latex and develop an allergic response to latex proteins. Every year, there are over 200 cases of anaphylaxis, a life-threatening allergic reaction, due to latex allergy. The best way to prevent allergic reactions is to avoid contact with latex. Substitutes for latex gloves, such as vinyl or nitrile gloves, should be used at all times by people with latex allergy. Natural skin condoms are available but while they protect against pregnancy, they do not shield HIV or other sexually-transmitted diseases.
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