Prevalencia de sensibilidad y alergia al látex en médicos de un programa de residencia de un hospital pediátrico de Buenos Aires / Prevalence of latex sensitivity and allergy among physicians of a residency program in a children ́s hospital of Buenos Aires

Introducción. Publicaciones internacionales estiman una prevalencia de sensibilización al látex (SL) en el personal de salud del 7 % al 17 %, y se desconocen los valores en la Argentina.Objetivos. Estimar la prevalencia de sensibilización y alergia al látex en médicos residentes de un hospital pediátrico mediante la prueba epicutánea de lectura inmediata y evaluar factores de riesgo asociados en dicha población.Población y métodos. Estudio de corte transversal. Se incluyeron los residentes, jefes e instructores de Pediatría, Ortopedia, Cirugía y Terapia Intensiva entre junio y octubre de 2017. En todos, se realizó un cuestionario (que evaluó enfermedades atópicas y otros factores de riesgo) y la prueba epicutánea de lectura inmediata. En un subgrupo (residentes de 1ero, 4to año, especialidades quirúrgicas y terapia) se dosó inmunoglobulina E total y específica para látex.Resultados. Se incluyeron 113 participantes. La prevalencia de SL fue del 7,96 % (intervalo de confianza del 95 %: 3,70-14,58); 4 participantes resultaron alérgicos al látex. El antecedente de síntomas relacionados con el látex se asoció significativamente con prueba epicutánea de lectura inmediata + (p = 0,0196; odds ratio 6,13; intervalo de confianza del 95 %: 1,44-26,04). No hubo asociación entre SL y año de residencia.Conclusiones. La prevalencia de SL hallada fue del 7,9 %. Se evidenció una relación significativa entre el antecedente de SRL y un resultado de prueba epicutánea de lectura inmediata positiva

Introduction. International publications estimate a 7 %-17 % latex sensitization (LS) prevalence among health care workers, but values in Argentina are unknown.Objectives. To estimate the prevalence of latex sensitization and allergy among residents of a children's hospital using the immediate-reading prick test and to assess associated risk factors in this population.Population and methods. Cross-sectional study. Residents, trainers, and Chief residents of the Departments of Pediatrics, Orthopedics, Surgery and Intensive Care were included between June and October 2017. All of them were administered a questionnaire (assessing atopic diseases and other risk factors) and underwent the immediate-reading prick test. Total and latex-specific immunoglobulin E levels were determined in a subgroup of individuals (first- and fourth-year residents, surgical specialties, and intensive care).Results. A total of 113 participants were included. LS prevalence was 7.96 % (95 % confidence interval: 3.70-14.58); 4 participants were allergic to latex. A history of latex-related symptoms (LRS) was significantly associated with a positive result in the immediate-reading prick test (p = 0.0196; odds ratio: 6.13; 95 % confidence interval: 1.44-26.04). There was no association between LS and the year of the residency program.Conclusions. The observed LS prevalence was 7.9 %. There was a significant relation between a history of LRS and a positive result in the immediate-reading prick tes

Estrategias para el cumplimiento del programa de formación en tres médicos residentes de Pediatría con alergia al látex / Strategies for compliance with the internship program among three pediatric interns with latex allergy

Introducción. La alergia al látex es frecuente en ámbitos hospitalarios. Objetivo. Describir la situación clínica de tres residentes de Pediatría con alergia al látex y las estrategias de prevención en las rotaciones de Terapia Intensiva Pediátrica y Neonatal. Pacientes, métodos y resultados. Las tres profesionales manifestaron exacerbación de síntomas durante la residencia. Se confirmó el diagnóstico con historia compatible e inmunoglobulina E específica positiva. Se realizó una entrevista semiestructurada para describir sus percepciones en relación con las estrategias de prevención, se capacitó al personal y se incorporaron guantes de nitrilo para los procedimientos. Las residentes realizaron las rotaciones sin presentar manifestaciones alérgicas. Refirieron como aspectos positivos sentirse cuidadas y mejor calidad de vida; como aspectos negativos, mala predisposición y resistencia al cambio en algunos compañeros. Las estrategias diseñadas permitieron que las residentes pudieran continuar su programa de formación.

Introduction. Latex allergy is common in the hospital setting. Objective. To describe the clinical situation of three pediatric interns with latex allergy and the prevention strategies implemented during clinical clerkships in pediatric and neonatal intensive care units. Patients, methods, and outcomes. The three interns referred symptom exacerbation during their internship program. Diagnosis was confirmed based on a compatible history and positive specific immunoglobulin E. A semi-structured interview was done to describe perceptions about prevention strategies, the personnel were trained, and nitrile gloves were provided for carrying out procedures. Interns completed their clinical clerkships without having allergic reactions. Positive aspects referred by interns were that they felt cared for and experienced an improved quality of life; negative aspects were a bad predisposition and resistance against change among some other interns. Strategies designed to this end permitted interns to continue their internship program.

Globos de látex de caucho natural: objetos peligros a desterrar de las instituciones de salud / Natural rubber latex balloons: dangerous objects to be banned from health institutions

Los globos de látex de caucho natural y los guantes de examinación del mismo material inflados como globos, que se entregan a los pacientes para aliviar el estrés de la atención sanitaria en las instituciones de salud tanto públicas como privadas, pueden provocar reacciones de hipersensibilidad de tipo I y son una de las causas más comunes de aspiración fatal. La suelta de globos contaminan el ambiente y agravan la extinción de la fauna y de la vida marina. Los pacientes sensibilizados o alérgicos al látex que participan en los festejos donde se utilizan globos de látex corren el riesgo de una reacción anafiláctica, potencialmente fatal. Aconsejarles no concurrir a dichos eventos, implica impedirles el disfrute de las actividades recreativas que es un derecho de la infancia manifestado en la Declaración de los Derechos del Niño. Muchos hospitales de países desarrollados ya cuentan con una política de prohibición de los globos de látex en sus instituciones, que podría replicarse en nuestro medio por las ventajas que conlleva y su muy bajo costo de implementación (AU)

Natural rubber latex balloons and examining gloves of the same material blown up as balloons to entertain patients to alleviate the stress of care at public and private health institutions, may cause reactions of type-1 hypersensitivity and are the most common cause of fatal asphyxia. Balloons that are released up into the air contaminate the environment and aggravate the extinction of fauna and marine life. Patients who are sensitized or allergic to latex and participate in celebrations in which latex balloons are used are at risk of a potentially fatal anaphylactic reaction. To advise them not to participate in these events means to stop them from enjoying recreational activities which is a right manifested in the Declaration of the Rights of the Child. In many hospitals in developed countries a policy of prohibition of latex gloves is already in place. This prohibition may be replicated in our environment considering its advantages and very low cost of implementation (AU)

A novel arctigenin-containing latex glove prevents latex allergy by inhibiting type I/IV allergic reactions / 中国天然药物

The present study aimed at developing a natural compound with anti-allergic effect and stability under latex glove manufacturing conditions and investigating whether its anti-allergic effect is maintained after its addition into the latex. The effects of nine natural compounds on growth of the RBL-2H3 cells and mouse primary spleen lymphocytes were determined using MTT assay. The compounds included glycyrrhizin, osthole, tetrandrine, tea polyphenol, catechin, arctigenin, oleanolic acid, baicalin and oxymatrine. An ELISA assay was used for the in vitro anti-type I/IV allergy screening; in this process β-hexosaminidase, histamine, and IL-4 released from RBL-2H3 cell lines and IFN-γ and IL-2 released from mouse primary spleen lymphocytes were taken as screening indices. The physical stability of eight natural compounds and the dissolubility of arctigenin, selected based on the in vitro pharnacodynamaic screening and the stability evaluation, were detected by HPLC. The in vivo pharmacodynamic confirmation of arctigenin and final latex product was evaluated with a passive cutaneous anaphylaxis (PCA) model and an allergen-specific skin response model. Nine natural compounds showed minor growth inhibition on RBL-2H3 cells and mouse primary spleen lymphocytes. Baicalin and arctigenin had the best anti-type I and IV allergic effects among the natural compounds based on the in vitro pharmacodynamic screening. Arctigenin and catechin had the best physical stability under different manufacturing conditions. Arctigenin was the selected for further evaluation and proven to have anti-type I and IV allergic effects in vivo in a dose-dependent manner. The final product of the arctigenin-containing latex glove had anti-type I and IV allergic effects in vivo which were mainly attributed to arctigenin as proved from the dissolubility results. Arctigenin showed anti-type I and IV allergic effects in vitro and in vivo, with a good stability under latex glove manufacturing conditions, and a persistent anti-allergic effect after being added into the latex to prevent latex allergy.

Alergia al látex en el período perioperatorio / Latex allergy in the perioperative period

Latex or natural rubber latex is a processed plant-based product, extracted from the tropical tree Hevea Brasiliensis. This raw material is widely used in about 40.000 medical and daily-used products. Latex allergy is a relevant pathology in surgical environments that arose after the establishment of universal precautions during the nineties. Risk groups include health-care workers and children with spine bifida who have a prevalence ranging between 2.9-17 percent and 30-70 percent, respectively. Latex allergy occurs in a variety of ways in health facilities including hypersensitivity reaction type IV or type I. In the former, chemical substances added to latex trigger the allergic reactions; where allergic dermatitis is the most-frequently found case. In the latter, the reactions are triggered by the contact with latex proteins causing from urticarial to anaphylactic shock and death. Diagnosis of latex allergy is based on a clinical history and/or physical examination associated with a confirmatory test as prick test (latex allergy type I) or cutaneous patches (latex allergy type IV). Nowadays, there is no definitive cure for the latex allergy and its treatment is based on allergen avoidance.

El látex o caucho natural es un producto vegetal procesado que se obtiene a partir del árbol tropical Hevea Brasiliensis. Esta materia prima es ampliamente usada, estando presente en hasta 40.000 productos médicos y de uso diario. La alergia al látex es una patología relevante en el ámbito quirúrgico, que surgió posterior a la instauración de las precauciones universales en la década del 90. Dentro de los grupos de riesgo se encuentran trabajadores de la salud y pacientes con espina bífida con una prevalencia que oscila entre 2,9 a 17 por ciento y 30 a 70 por ciento, respectivamente. La presentación clínica de alergia al látex tiene un espectro amplio, pudiendo presentarse como reacciones por hipersensibilidad tipo IV o tipo I. En el primer grupo, las reacciones son gatilladas por los químicos adicionados al látex, siendo la dermatitis alérgica de contacto su presentación más frecuente. En el segundo grupo, las reacciones son secundarias al contacto con proteínas del látex, pudiéndose manifestar desde urticaria hasta shock anafiláctico y muerte. El diagnóstico de alergia al látex se basa en una historia clínica y/o examen físico compatible asociado a un examen confirmatorio, como el prick test (alergia al látex tipo I) y el parche cutáneo (alergia al látex tipo IV). Actualmente no existe una cura definitiva para la alergia al látex y su tratamiento se basa en evitar la exposición al alérgeno.

Prevalencia del síndrome látex-frutas en el estudiante de postgrado de la facultad de odontología de la universidad central de venezuela / Prevalence of the syndrome latex-fruits in dentists of the school of dentristy of the universidad central de venezuela

Los individuos alérgicos a látex pueden presentan reacciones mediadas por inmunoglobulina E (IgE) principalmente a frutas como cambur (banana, plátano), aguacate (palta), castaña y kiwi, lo cual se conoce como síndrome látex-frutas (SLF). Conocer la prevalencia del síndrome látex-frutas en una población conformada por los estudiantes de postgrado de la Facultad de Odontología de la Universidad Central de Venezuela (UCV) previamente diagnosticados con hipersensibilidad tipo I al látex. Se realizó un cuestionario a 27 participantes para conocer los antecedentes de atopia y reacciones alérgicas a frutas y vegetales así como también los factores de riesgo. También se diagnosticó la hipersensibilidad tipo I a aguacate, cambur, kiwi y tomate, mediante la prueba cutánea por técnica de punción superficial como prueba in vivo y un método ELISA utilizando el ENEASystem III como prueba in vitro. Estas dos pruebas diagnósticas arrojaron un total de 11/27 (41%) participantes con el síndrome látex-frutas. Referente a los factores considerados como de riesgo, 6 (55%) tenían antecedentes de atopia, 4 (36%) reportaron antecedentes familiares de alergia y 8 (73%) habían sido sometidos a intervenciones quirúrgicas. En este estudio se encontró una alta prevalencia del síndrome látex-frutas en la población estudiada. Los datos obtenidos sugieren un comportamiento dependiente entre la atopia y los otros factores de riesgo y el síndrome látex-frutas.

The individuals who are allergic to latex reactions are mediated by immunoglobulin E (IgE) mainly of fruit such as banana, avocado, chestnuts and kiwi, which is known as latex-fruit syndrome (LFS). To determine the prevalence of the latex-fruit syndrome in a group of dentists at the School of Dentistry at the Central University of Venezuela (UCV) previously diagnosed with type I hypersensitivity to latex. We conducted a questionnaire to find out the history of atopia, symptoms and allergic reactions to fruits and vegetables and the risk factors. Also we diagnosed type I hypersensitivity to avocado, banana, kiwi and tomato through the skin test technique of "prick by prick " as in vivo test and an ELISA method using the ENEASystem III as evidence in vitro. These two diagnostic tests yielded a total of 11/27 (41 %) participants with the latex-fruit syndrome. Concerning the factors considered as risk, 6 (55 %) had atopia, 4 (36 %) family history of allergy and 8 (73 %) had surgical interventions. This study found a high prevalence of the latex-fruit syndrome in the group studied. The data obtained suggest a behavior dependent between the atopia and other factors of risk and the syndrome latex - fruit.

Latex allergy: an emerging / Alergia ao látex: um problema emergente / Alergia al latex: an emergentes

Objectives: The current review presents the pathogenic mechanisms, diagnostic and therapeutic and preventive measures to avoid the development of complications related to latex allergy. Method: Literature search electronically from articles already published on the basis of the NCBI / PUBMED / MEDLINE. Results: Manifestations of latex allergy are related to immediate hypersensitivity such as urticaria, angioedema, asthma or even anaphylaxis, or delayed hypersensitivity by a mechanism such as allergic contact dermatitis or primary irritation. Conclusion: Prevention of exposure, replacement and use of latex-free products such as synthetic gloves are essential for those affected. Adjustments in the workplace should be done with gloves without talc, low in allergens or synthetic gloves. These preventive measures significantly reduce the prevalence of allergic reactions.

Objetivos: A revisão atual apresenta os mecanismos imunopatológicos, diagnóstico e medidas terapêuticas e preventivas para evitar o desenvolvimento de complicações relacionadas à alergia ao látex. Método: Pesquisa bibliográfica por meio eletrônico a partir de artigos já publicados, na base do NCBI/PUBMED/MEDLINE. Resultados: As manifestações de alergia ao látex estão relacionadas com hipersensibilidade imediata como a urticária, o angioedema, a asma ou até anafilaxia, ou por mecanismo de hipersensibilidade tardia como a dermatite de contato alérgica ou por irritação primária. Conclusão: Prevenção à exposição, substituição e utilização de produtos livres de látex, como luvas sintéticas são essenciais para os afetados. Adaptações no local de trabalho devem ser feitas com uso de luvas sem talco, com baixo teor de alérgenos ou luvas sintéticas. Estas medidas preventivas reduzem significativamente a prevalência de reações alérgicas.

Objetivos: En esta revisión presentamos los mecanismos patogénicos, diagnóstico y medidas terapéuticas y preventivas para evitar el desarrollo de complicaciones relacionadas con la alergia al látex. Método: La búsqueda bibliográfica electrónica de artículos ya publicados sobre la base de la Revista / PubMed / MEDLINE. Resultados: Las manifestaciones de la alergia al látex se relacionan con la hipersensibilidad inmediata como urticaria, angioedema, asma o incluso anafilaxia o hipersensibilidad retardada por un mecanismo como la dermatitis de contacto alérgica o irritación primaria. Conclusión: Prevención de la exposición, la sustitución y el uso de látex libres de productos tales como guantes sintéticos son esenciales para las personas afectadas. Ajustes en el lugar de trabajo se debe hacer con guantes sin talco, con bajo contenido de alergenos o guantes sintéticos. Estas medidas preventivas reducen significativamente la prevalencia de las reacciones alérgicas.

Síndrome Látex-frutas y su importancia en odontología / Latex-fruit syndrome and its importance in dentistry

Diversos estudios han demostrado que entre un 20% y un 60% de los individuos alérgicos a látex presentan reacciones mediadas por inmunoglobulina E (IgE) a una amplia variedad de alimentos, principalmente a frutas como el cambur (banana, plátano) el aguacate, la castaña y el kiwi, lo cual se conoce como síndrome látex-frutas. El odontólogo debe conocer esta reacción cruzada de alergia a fin de evitar situaciones que puedan poner en riesgo al paciente si no se toman las medidas que garanticen un ambiente seguro libre de látex

Studies have shown that between 20% and 60% of individuals allergic to latex have IgE-mediated reactions (IgE) to a wide variety of foods, mainly fruits like banana, avocado, sweet chestnut and kiwi, which is called latex-fruit syndrome. The dentist should be aware of this allergy cross-reaction to avoid situations that may endanger the patient if not taken measures to ensure a safe environment free of latex

Guia prático para o manejo da anafilaxia-2012 / Practical guide to the management of anaphylaxix-2012

Anafilaxia representa uma das mais dramáticas condições clínicas da medicina, tanto pela imprevisibilidade de aparecimento quanto pelo potencial de gravidade na sua evolução. A ocorrência de anafilaxia determina enorme impacto na qualidade de vida das pessoas afetadas, dos seus familiares, cuidadores e amigos. As principais causas de anafilaxia são medicamentos, alimentos e veneno de insetos. Estudos epidemiológicos recentes sugerem aumento da incidência de anafilaxia. Aprofundar o conhecimento de causas e mecanismos de anafilaxia tem sido preocupação constante da especialidade de Imunoalergologia. Nos ambulatórios de Alergia e Imunologia Clínica são atendidas com regularidade pessoas que sofreram reações alergicas agudas graves e que necessitam de orientação especializada. Não é raro verificar que muitas superaram vários episódios agudos sem receber o diagnóstico correto, assim como a orientação específica para procurar atendimento especializado. Cada reação anafilática representa risco, que é variavel dependendo das caracteristicas do paciente e do agente desencadeante. A falta de informação de médicos e pacientes contribui para aumentar a chance de novas ocorrências, expondo estes a riscos muitas vezes preveníveis. O Guia Prático para o Manejo da Anafilaxia-2012 tem o objetivo de difundir o conhecimento sobre anafilaxia entre médicos e profissionais da saúde, pacientes, familiares, professores, escolas e autoridades de saúde pública. Este documento não é um protocolo de atendimento a pacientes com reações anafiláticas, nem pretende formular rotinas clínicas ou interferir na autonomia e no discernimento do médico ao avaliar e orientar pacientes que estão aos seus cuidados. O documento contém de forma muito concisa o conhecimento atual sobre o tema e a experiência pessoal de especialistas no manejo dessas situações, fornecendo informação para o aprimoramento pessoal. Aborda-se o diagnóstico e tratamento emergencial da anafilaxia, assim como, a avaliação e o tratamento após a crise. Cuidados básicos e atitudes preventivas que são fundamentais na orientação de pacientes e familiares são analisadas.

Anaphylaxis is one of the most dramatic clinical conditions of Medicine, by the unpredictability of emergence and by the potential of severity in its evolution. Anaphylaxis determines an enormous impact on the quality of life of people affected, their families, caregivers and friends. The most frequent cause of anaphylaxis are drugs, foods, and stinging insect venoms. Recent epidemiological surveys have suggested increased incidence of anaphylaxis. Development of the knowledge of the causes and mechanisms of anaphylaxis has been a constant concern of the specialist of Immunoallergology. In Allergy and Clinical Immunology clinics are frequent to consult people who have suffered severe acute allergic reactions that require expert guidance. Many patients had suffered previous episodes without receiving the correct diagnosis as well as specific guidance to seek specialized care. Each allergic crisis represents a health risk, which is variable depending on the characteristics of the patient and the triggering agent. The lack of information from doctors and patients contributes to increase the chance of new episodes, exposing patients to preventable risk. The Practical Management of Anaphylaxis-2012 aims to spread knowledge of anaphylaxis among physicians, healthcare professionals, patients, families, teachers, schools, and public health authorities. This document is not a protocol of care to patients with anaphylactic reactions, nor is it intended to formulate practical clinical routines and, its objective should not interfere with the autonomy and the discernment of the physician to evaluate and treat patients who are to their care. The document contains very concisely the current knowledge about the subject and the personal experience of specialists in the management of these situations, providing information for personal improvement. Deals with the diagnosis and emergency treatment of anaphylaxis, as well as the assessment and treatment after the crisis. Basic and preventive care who are fundamental attitudes for patients and families are analyzed.

Research in type Ⅳ hypersenstivity induced by latex gloves in clinical murses / 中国实用护理杂志

Objective To determine the prevalence of latex glove(LG)-induced type Ⅳ hypersensitivity in clinical nurses. Methods 100 clinical nurses were selected,among whom 69 nurses were set as the latex glove hypersensitivity group,and the other 31 nurses did not show hypersensitivity to latex glove (the control group).The two groupe underwent a patch testing with a modified European standard series of allergens supplied by Chemotechnique Diagnostics.The positive allergens were compared between the two groups. Results The positive rate of patch testing in patients of the latex glove hypersensitivity group was superior to that in the control group (73.9％ vs 25.8％).Cobalt chloride and potassium dichromate were the most common allergens in both groups,while only formaldehyde and para-phenylenediamine were more susceptible in the latex glove hypersensitivity group compared with that in the control group.26.1％ of the latex glove hypersensitivity group was responsive to rubber additives,but in the control group the results were negative.Conclusions The hand dermatitis of female nurses with LG allergy is mainly caused by exposure to daily necessities.The prevalence of LG-induced type Ⅳ hypenensitivity is relatively high in clinical murses.

Prevalence and risk factors for latex glove allergy in clinical nurses / 中国实用护理杂志

Objective To determine the prevalence and risk factors for latex glove allergy in clini-cal nurses. Methods A serf-administered questionnaire was used to collect the information about latex glove-related allergy among clinical nursing staff in 4 general hospitals in Zhanjiang, and the risk factors were calculated with logistic regression analysis. Results Latex glove-related symptoms were reported in 16.9% of 1469 nurses. Age, employment seniority, and positive rate of personal and family history of ana-phylaetie diseases in sensitized nurses were superior to those in unsensitized ones. The positive personal and family history of hypersensitivity diseases, allergy to drugs or other materials, and working time in a room were high risk factors for the development of latex glove allergy, but the average number of gloves used in a working day was the protective factor. Conclusions Clinical nurses belong to high risk latex sensitization population, and the main risk factor is the atopie subjects.

Latex Allergy in Atopic Dermatitis / 대한피부과학회지

BACKGROUND: Allergy against natural rubber latex is an increasing problem in recent years, especially in health care workers, children with spina bifida. Many studies reported atopic dermatitis could be also one of risk factors of latex allergy. OBJECTIVE: Purposes of this study were not only to access the prevalence of latex sensitization in patients with atopic dermatitis, but to evaluate the relationship between latex sensitization and clinical allergy. METHODS: Of the total of 110 patients, 80 patients were atopic dematitis and 30 patients were controls. A questionaire-based history was taken, skin prick tests (SPTs) with latex glove extract and commercial latex allergen and several commercial fruit extracts were done. If SPT to latex was positive, use test performed. Patch tests for delayed type hypersensitivity were carried out with a small piece of latex glove, commercial latex allergens and rubber additives. RESULTS: Eighteens (22.5%) of 80 atopic dermatitis reported symptoms whenever they used rubber products. In skin prick test, 3 of 80 (3.8%) patients with atopic dermatitis were positive to latex glove extration solutions and also the commercial latex antigens. Reactions to fruit extracts including mixed nuts, potato, tomato, banana were 8.8%, 6.3%, 6.3%, 5.0%, respectively. Use test was done with all of 4 patients positive to SPT, and only one of them showed positive reaction. There is no positive result in latex glove or latex extraction in patch tests. CONCLUSION: There were no differences in latex sensitivities between patients with atopic dermatitis and healthy people. In patch tests, ZnBDC and mercapto mix were the highst rate of reaction addictives of NRLs.

A Study of the Latex Allergy in Operating Room Nurses / 대한피부과학회지

BACKGROUND: Allergy to natural rubber latex has become an important occupational health concern in recent years, particularly among health care workers. Studies have estimated that the prevalence of latex allergy ranged from 2.8% up to 12.1% of health care workers. Latex sensitization is more common in operating rooms or with special care nurses whose jobs require frequent glove use. OBJECT: The present study was undertaken to assess the prevalence of latex sensitivity in operating room nurses, and to evaluate the relationship between questionnaire responses and skin tests. METHODS: Eighty operating room nurses working in the Hallym Medical Center and 27 healthy controls were included in this study. The questionnaire was completed by a dermatology doctor during an interview. Skin prick tests(SPT) were carried out on the volar surface of the forearm using latex glove extract solution, commercial latex extract and several commercial fruit extracts. If SPT was positive, use test was performed. Patch tests for delayed type hypersensitivity were carried out with small piece of latex glove(as is), commercial latex antigen and rubber additives. RESULTS: 1. Twenty two(27.5%) of 80 operating room nurses reported at least one symptom when wearing gloves. Although the symptom development was increased as glove-wearing time increased, but the difference was not statistically significant. The history of atopy and dental care did not influence the prevalence of symptoms. Subjects with hand eczema had significantly higher prevalence of symptoms than without hand eczema. 2. In SPT, 9(11.3%) of 80 operating room nurses were positive to latex glove extract solution. This level was significantly higher than healthy controls who showed positive reaction in only one. The history of hand eczema and dental care did not influence the prevalence of symptoms. Although the difference was not statistically significant, the symptom development was increased as glove-wearing time and years of experience increased. The percentage of skin reactions to latex was 2.6 times higher in nurses with atopy than without atopy, but the difference was not statistically significant. Reactions to fruit extracts including tomato, banana, mixed nut and potato were 5.0%, 3.8%, 2.5% and 1.3%, respectively. Use test was done with 7 of 9 showing positive reaction to SPT, and all of them showed positive responses. 3. Patch tests revealed positive results for latex gloves in 3 (3.8%), for commercial latex extract in 2 (2.5%) and for thiuram mix in 1 (1.3%) of 80 operating room nurses. But there were no positive results with ZnBDC, ZnEDC, TMTD, mercapto mix and mercaptobenzothiazole in nurses. For all allergens in patch test, any healthy subjects did not show positive results. CONCLUSION: Twenty two(27.5%) of 80 operating room nurses reported at least one symptom when wearing gloves. The most commonl compained symptom was itching, which was ceported in all of them. Localized wheal, generalized wheal and pain were reported in 8.8%, 5.0% and 2.5%, respectively. However, anaphylaxis was not reported. As the positive rate was 3.8% in patch test and 11.3% in SPT using latex glove extract, most of the symptoms related to the wearing of latex gloves appeared to be due to irritation. It could be considered that latex allergy could be induced by repeated wearing of latex gloves in operating room nurses.

Prevalence of Latex Sensitization in Atopic Dermatitis Patients: Results of Skin Prick Test and RAST to Latex / 대한피부과학회지

BACKGROUND: Natural rubber latex has become an important health concern in recent years, particularly in risk groups. Atopic dermatitis is well known risk factor for latex allergy, but there is no data or study of latex allergy in Korea. OBJECTIVE: The purpose of this study was to investigate the prevalence of latex sensitization in atopic dermatitis patients. METHODS: A total of 154 patients presenting with various diseases for allergologic evaluation was studied. A questionnaire-based history was taken, skin prick tests(SPT) with latex glove extract were done. In SPT positive patients, serum total IgE and latex-specific IgE by radioallergosorbent test(RAST) were measured, and a use test was also performed. RESULTS: A total of 77 subjects(50%) was atopic. There were positive SPT reactions to latex in 13/77(16.9%). There were only 7 positive to the latex RAST in SPT positive patients. Except one patient, there were no clinically relevant latex allergy by history and challenge tests. CONCLUSION: The results of this study suggest that the prevalence of latex sensitization in atopic dermatitis patients is quite high(16.9%), and in latex allergy diagnosis, SPT is more sensitive than RAST.

Adverse Reactions to Surgical Latex Gloves in Korea / 간호학회지

This study was conducted to determine the prevalence rate of adverse reactions to latex gloves. The study compared allergic reactions to ordinary latex gloves with four types of hypoallergenic gloves among operating room nurses at a teaching hospital in Seoul, Korea. Data were collected from 63 operating room nurses by a questionnaire and direct observation of a skin prick test. Among respondents, 25 nurses with adverse reactions to latex gloves were selected for the skin prick and exposure tests with five latex gloves (1 ordinary glove, and 4 hypoallergenic gloves) using a repeated measures design of counterbalancing method. Study Results are as follows: (1) The response rate of the questionnaire was 96.8%, and the prick test was performed in 61 out of 63 nurses. (2) Common symptoms of allergic reactions to latex gloves were rash (49.2%), skin itching (44.3%), dizziness (31.1%), and eye itching (26.2%). (3) The prevalence rate of adverse reactions was 80.3%, and that of latex allergy was 9.8%. (4) Atopic subjects had more latex allergy than the non-atopics. (5) There was no difference in the incidence rate of latex allergy among the five gloves by the skin prick test. But with the skin exposure test, ordinary latex gloves had a higher incidence rate of latex allergy than the hypoallergenic gloves (p<0.0001).

A Case of Contact Urticaria from a Latex Glove Occurred to an Operationg Room Nurse

The prevalence of latex allergies has been on the increase along with the greater use of rubber products in daily life, medical, dental and occupational settings. Allergic reactions to latex can take two clinical forms of either contact dermatitis or immediate hypersensitivity reactions, which are provoked by the natural latex proteins or chemical additives used in the manufacturing process, respectively. A 25-year-old female, an operating room nurse, complained of recurrent pruritic erythematous wheals on both hands after the wearing of latex rubber gloves. The prick test and the usage Mlit't to the latex gloves were positive, and the RAST was class 3. To the best of our knowledge, is the first case report of contact urticaria from latex rubber gloves in Korean dermatologic literature.

Considerações sobre a alergia ao látex / Latex allergy considerations

A alergia ao látex mediada pela IgE é significativa em todo o mundo. ela é ainda menos prevalente, por razões desconhecidas, em regiões trocipais. No Brasil não existe até o presente estudos epidemiológicos definitivos. A fator de alongamento da borracha (Hev b 1) de 14,6kD é o principal epítopo desta alergia, sendo produzido na manufatura atual do látex proveniente da Hevea brasiliensis. Os fatores de risco para a alergia do tipo I ao látex (urticária de contato, angioedema, asma, rinite, conjuntivite e anafilaxia) são: atopia, dermatite de contato nas mãos, contato profissional freqüente (ambientes médicos, odontológicos, cirúrgicos, radiológicos e da indústria de produção), pacientes com spina bifida e portadores de malformações urogenitais, que requerem cateterismos vesicais e cirurgias freqüentes. Há reações de alergenicidade cruzada com frutas tropicais (kiwi, banana, abacate, maracujá, manga, pêssego, mamão, entre outras) e também nozes e crustáceos. Progressivamente outros aliementos também estão sendo "incriminados", e suas antigenicidades cruzadas com proteínas do látex estão em fase de estudos. O uso freqüente do látex na área da Saúde e a necessidade da prevenção de doenças infecto-contagiosas como a Aids, torna o problema da alergia uma preocupação internacional da maior relevância. Há materiais alternativos de poliuretano e de vinil adequados para a utilização na população alérgica ao látex. Evitar o uso do látex em procedimentos médicos e cirúrgicos pode ser o melhor caminho na busca da prevenção de tal sensibilização.

IgE mediated allergic reactions are worldwide present. They are less frequent in tropical regions for unknown reasons. Latex is extracted from Hevea braliliensis and the main epitope is Hev b 1 (14.6kD rubber elongation factor). Risk factors for latex allergy (contact urticaria, angioedema, asthma, rhinitis, conjunctivitis and anaphylaxis) are: atopy, hand contact dermatitis, professional exposure, and patients with spina bifida and congenital urogenital malformations. There is cross-reactivity with tropical fruits (kiwi, bananas, abacate, "fruit de la passion", mangoes, peaches, papaya), and also to other foods like chestnuts and shellfish. The modern widespread use of latex in Medicine requires special attention to the potentialdevelopment of latex sensitization. Latex-free environment and alternative materials (polyurethane and vynil) should be considered.

Epidemiology of latex allergy among healthcare personnel at Siriraj Hospital.

AIIergic reactions to latex allergens, ranging from contact dermatitis, urticaria, angioedema, rhinoconjunctivitis, asthma and life-threatening anaphylaxis, have been increasingly recognized among healthcare workers. However, this problem has neither been studied nor reported in Thailand. The objectives of this study are : to (a) delineate the prevalence of latex allergy among healthcare workers in Thailand ; (b) determine the risk factors for the development of latex allergy among hospital personnel in Thailand ;(c) study clinical presentation of latex allergy among those with and without positive latex skin testing ; and (d) undertake a preliminary electrophoretic pattern study of latex proteins contained in latex extracts made from latex gloves commonly used in Siriraj Hospital. The method included a questionnaire survey which was completed by 405 health personnel. The questionnaire pertained to allergy history to latex products. Skin-prick testing, using latex glove extracts, was performed in 227 subjects. Sodium dodecyl sulphate polyacryamide gel electrophoresis (SDS-PAGE) was performed with protein extract preparations from latex gloves. The results showed that 50 subjects reported experiences of one or more latex-related allergic symptoms amounting to a prevalence of 12.4 percent (95 per cent confidence interval {CI}, 9.2 to 15.6). Seven of 227 participants (3.16 per cent) had positive skin-prick tests to latex. The following risk factors were significantly associated with latex allergy : age more than 35 years old (odds ratio {OR} = 2.58; 95 per cent CI = 1.35- 4.93), having a history of prior atopic diseases (OR = 2.06; 95 per cent CI = 1.08-3.93), and having worked with latex gloves for more than 10 years (OR = 2.00; 95 per cent CI = 1.05 –3.82). The most commonly reported symptoms of latex allergy were skin reactions (98 percent). Other symptoms such as rhinitis, conjunctivitis, asthma and anaphylaxis were encountered with lower frequencies. A preliminary study of the electrophoretic pattern of latex glove extracts revealed distinguishable protein bands at 14 kd, 20 kd and 30-43 kd. In conclusion, latex allergic symptoms are common complaints among healthcare personnel in Thailand. Severe symptoms, including anaphylaxis, were noted in one patient. Potential risk factors identified are age more than 35 years old, history of prior atopic diseases, and long contact duration with latex gloves. Measures to cope with such problems will need to be designed for such individuals in the future.