What is Latex Allergy?
Latex is a substance sourced from the sap of rubber trees, known as Hevea brasiliensis, and it is utilized in manufacturing many products that we use every day. It’s especially common in healthcare, forming a large part of the materials used, like catheters, balloons, and most familiarly, gloves.
There are hundreds of substances in natural rubber latex that could potentially trigger an allergic reaction, with 15 official ones identified and named from Hev b1 to Hev b15. These natural proteins in rubber can trigger an allergy, ranging from silent sensitization, where one becomes sensitive to latex without obvious symptoms, to type I IgE-mediated hypersensitivity, an immediate allergic reaction.
During latex processing, manufacturers add chemical antioxidants, which can also cause a delayed allergic reaction known as type IV hypersensitivity. One of the most common triggers for a severe allergic reaction called anaphylaxis in operating rooms is latex allergy. The chances of being allergic to latex have grown with the increased use of latex gloves since the 1980s to prevent the spread of infections.
The production of latex gloves has expanded significantly, leading to a rise in latex allergies. Further, latex allergy has become a known problem among healthcare workers, often experienced while wearing gloves or inhaling the tiny particles that become airborne.
What Causes Latex Allergy?
People who work in the medical field, like doctors, nurses, and dentists, or those who work with chemicals or in labs, often wear gloves. They come into contact with latex more regularly than most people because many medical supplies, such as stethoscopes, IV tubes, syringes, and even condoms, are made from latex.
This frequent contact with latex can lead to them developing a sensitivity to it. Over time, this sensitivity can turn into a full-blown latex allergy. The more they come into contact with latex, the greater the chances of developing this allergy. Gloves, condoms, and catheters are the most common sources of latex exposure.
Latex proteins can also pass from gloves onto the skin, or even food, causing allergic reactions in people already sensitive to it. There’s also a connection between latex allergies and allergies to fresh fruits and veggies like avocados, bananas, chestnuts, kiwis, celery, and pears. If you’re allergic to these foods, there’s a higher chance you might also be allergic to latex, and vice versa.
Another way people can be exposed to latex is through the air, by inhaling latex particles. This can come from places you might not expect, like the cornstarch on latex gloves or dust from car tires.
Risk Factors and Frequency for Latex Allergy
Latex allergy is a condition that varies greatly in occurrence. In general, about 1 to 2 percent of people are affected by this allergy. One particular study found that healthcare workers who are exposed to latex have a higher chance of developing the allergy compared to the general public. However, the way this allergy shows itself is about the same in healthcare workers and the regular public. This allergy is more common in developing countries where there are more latex products in use.
Latex allergy often shows up as contact urticaria, a type of skin swelling. It’s the most common cause of this work-related condition. Additionally, it’s the second leading cause of intraoperative anaphylaxis, a severe allergic reaction, during surgery, after muscle relaxants.
Epidemiologic studies, which look at the patterns of health in different populations, have found that certain groups are at a higher risk of developing a latex allergy. For example, people with spina bifida, a birth defect affecting the spine, are more susceptible.
- Between 20% to 65% of people with spina bifida are hypersensitive to latex.
- The increased sensitivity is likely due to exposure from various surgeries and procedures.
- Also, people with urological abnormalities that require repeated catheterization have an increased risk of latex allergy.
Signs and Symptoms of Latex Allergy
It’s crucial to get a detailed medical history and perform a physical exam to identify patients who might have a latex allergy. People more likely to show symptoms include those frequently exposed to latex in healthcare or labs, those with specific food allergies or spina bifida, and individuals who underwent many surgeries or procedures as kids. However, a latex allergy can often be confused with irritant dermatitis or allergic contact dermatitis.
Irritant dermatitis brings about skin redness, while allergic contact dermatitis results from a delayed allergic reaction. This type of dermatitis also causes skin redness, but with itching and hives after exposure. It’s important to note that this isn’t a true latex allergy, and substituting non-latex products may still trigger the same response.
A true latex allergy will cause an immediate allergic reaction. This could result in itchy skin and hives, as well as swelling, asthma, and even severe bodywide reactions such as anaphylaxis. Workers who use gloves, especially in healthcare, are most likely to experience allergic rhinitis and asthma due to inhaling particles. Patients in the operating room typically show skin rashes and bronchospasm, but the most common reaction is a cardiovascular collapse.
Testing for Latex Allergy
The process of diagnosing a latex allergy starts by discussing your medical history. Your doctor will also match any physical signs and symptoms you are experiencing with your history. While there are a number of tests that can confirm latex allergy, two common ones include a blood test and the skin prick test.
In the blood test, the doctor looks for certain antibodies (a type of protein our bodies produce in response to harmful substances) called IgE. They use a special substance in a lab to detect these antibodies. However, this test does sometimes produce a “false positive,” meaning the test says you’re allergic when you actually aren’t.
The skin prick test is a different method for diagnosing allergies. In this test, the doctor lightly pricks your skin and applies a small amount of latex. They then watch to see if a raised, red bump (known as a wheal) forms. This test is generally considered the most accurate for diagnosing type 1 hypersensitivity to latex (a fast and severe allergic reaction), but it is not available in the United States because the specific type of latex used in the test has not been approved.
Treatment Options for Latex Allergy
The most important step in dealing with people who are at risk for latex allergies is to identify those who are at high risk. This involves looking at the person’s history and doing a physical examination. Once we know who is at risk, it’s crucial to prevent them from being exposed to latex.
However, if someone at risk does get exposed to latex and shows symptoms, they’ll need treatment. The treatment depends on their specific reaction. If the reaction is irritant dermatitis (a type of skin irritation), the first step is to get rid of the latex and clean the affected area. Topical steroids, which are creams or ointments applied directly to the skin, can be used to help reduce inflammation. It’s also recommended to get advice from a dermatologist, which is a doctor who specializes in skin conditions.
Delayed type IV hypersensitivity reactions, which are a type of allergic reaction, are treated in the same way. However, in these cases, there’s also a recommendation to test for a type of antibody called IgE in the blood. If someone has a type I systemic reaction, which is an immediate and potentially severe allergic reaction, the latex exposure should be removed immediately. These individuals should be monitored and treated for any life-threatening conditions.
The first part of managing latex allergies should be to screen for high-risk individuals and prevent them from exposure. There are also alternatives to latex available. These include materials such as neoprene, polyvinyl chloride, silicone, and vinyl. Furthermore, the introduction of gloves that are free of powder and latex has greatly reduced the number of people affected by latex allergies.
What else can Latex Allergy be?
Medical conditions such as irritant contact dermatitis can often be confused with a latex allergy because they look similar. However, this isn’t an actual allergic reaction. Instead, it’s a reaction where the skin has been irritated due to rubbing or coming in contact with certain chemicals. Thus, you might not necessarily develop a reaction to latex if you have such a condition. Patients like these would only need protection for their skin but not necessarily need to avoid exposure to latex.
What to expect with Latex Allergy
At the moment, there’s no cure for being sensitive to or having allergic reactions to latex. Symptoms like skin irritation can be easily managed with steroid creams, but the main way to reduce instances of latex allergies is through prevention. This includes educating people about which products contain latex and what substitutes are available to them.
If you’re admitted to the hospital, it’s critically important to let the staff know that you have a latex allergy. With the right education and preventive measures, patients can expect positive outcomes. But if these precautions aren’t taken, you may continue to experience allergy symptoms and this could affect your overall quality of life.
Possible Complications When Diagnosed with Latex Allergy
People who come into contact with latex often or have been heavily exposed to latex are more likely to experience a severe allergic reaction, known as anaphylaxis. Anaphylaxis can severely affect many organs within the body, it can compromise the airway and even lead to the collapse of the circulatory system, resulting in a life-threatening event known as cardiopulmonary arrest. The treatment for such severe allergic reactions requires removal of the allergen, ensuring the airway is open and functional, immediate administration of the medication epinephrine, and replenishment of body fluids.
Risks and Treatment Measures:
- More frequent or heavy exposure to latex increases anaphylaxis risk
- Anaphylaxis can cause multiorgan involvement and critical health threats
- Airway compromise and cardiovascular collapse can lead to cardiopulmonary arrest
- For treating anaphylaxis, allergen removal is needed
- Early administration of the medicine, epinephrine is needed
- Fluid resuscitation is an essential part of the treatment
Preventing Latex Allergy
Teaching patients about allergies is key in preventing allergic reactions. Patients need to understand which foods might trigger a reaction due to their sensitivity to latex, and also be aware of any products that could contain latex. It’s equally important for the patient to let all the healthcare providers taking care of them know that they have this allergy. Patients should be given alternatives to any products that contain latex, and using these alternatives correctly can lower their chances of having a reaction.
