Assessment of adverse reactions to latex gloves use among nurses at Mankweng Hospital, Limpopo Province, South Africa

Adverse reaction to latex is a common problem among nurses and other health care workers. The aim of the present study was to determine the prevalence of adverse reactions to latex amongst nurses at Mankweng Hospital. A cross sectional study was carried out amongst 235 nurses at Mankweng Hospital using a self-administered questionnaire to collect information about history of allergic reaction; family history; signs and symptoms of adverse reactions after using latex gloves. Among 155 nurses who responded to the questionnaire (66 response rate); 41 (26) had a family history of allergic reactions; with asthma as the commonest allergic condition reported. Fifty four respondents (n= 54; 35) reported having had signs and symptoms of adverse reaction after using latex gloves. The most common features associated with adverse reaction to latex gloves were sneezing (n=32; 21); itching nose (n=24; 16); itching eyes (n=21; 14); runny nose (n=18; 12); cough (n=16; 11); skin redness (n=13; 9); skin redness (n=13; 9); hives (n=12; 8); scratchy throat (n=9; 6); light headedness (n=10; 7) and swelling and rash in area(s) of contact (n=11; 7). There was significant association between family history and occurrence of adverse reaction to latex gloves (p=0.029). Accordingly; this study concludes that adverse reaction to latex gloves is prevalent among nurses at Mankweng Hospital; and poses the potential for harmful effects to nurses. These effects may vary in severity from skin problems to anaphylactic shock. It is therefore important to educate nurses about the prevalence; presentation and prevention of adverse reaction to latex

Allergic contact dermatitis among construction workers detected in a clinic that did not specialize in occupational dermatitis / Dermatite alérgica de contato entre pedreiros, num serviço não especializado em dermatoses ocupacionais

BACKGROUND: Contact dermatitis is one of the common work-related dermatoses. Among bricklayers, cement can cause both allergic contact dermatitis and primary contact irritative dermatitis. The personal protective equipment (rubber gloves) may favor the development of allergic contact dermatitis. OBJECTIVES: 1) to evaluate the frequency of allergic contact dermatitis among construction workers between January 2005 and December 2009; 2) to determine the major sensitizing agents in the study group; and 3) to compare the data obtained from the construction workers to that of a group of patients who were not construction workers. METHODS: A retrospective analysis of patch tests. Patients were separated into two groups: 1) bricklayers and 2) non-bricklayers. RESULTS: Of the 525 patch tests analyzed, 466 (90%) were from non-bricklayers and 53 (10%) from bricklayers. The hands were affected in 38 (61%) of them. 13 patients (24%) had irritative contact dermatitis and 40 (76%) had allergic contact dermatitis. The group of construction workers had a high frequency of sensitization to cement, and 29 (54.7%) had sensitization to rubber vulcanizing agents. 23 patients (43.4%) had sensitization to both cement and rubber. CONCLUSIONS: Among the bricklayers the presence of allergic contact dermatitis to rubber and cement in the same patient is common and demonstrates the importance of the patch test.

FUNDAMENTOS: A dermatite de contato é uma das dermatoses comumente relacionadas ao trabalho. Entre os pedreiros o cimento pode causar tanto a Dermatite Alérgica de Contato quanto a Dermatite de Contato por Irritação Primária. Os equipamentos de proteção individual (luvas de borracha) podem favorecer o desenvolvimento de Dermatite Alérgica de Contato. OBJETIVOS: 1) avaliar a freqüência de Dermatite Alérgica de Contato entre os pedreiros entre Janeiro de 2005 e Dezembro de 2009; 2) determinar os principais agentes sensibilizantes; e 3) comparar os resultados obtidos entre o grupo de pedreiros com um grupo sem pedreiros. MÉTODOS: análise retrospectiva de testes de contato. Pacientes foram separados em 2 grupos: 1) pedreiros e 2) não pedreiros. RESULTADOS: dentre os 525 testes de contato analisados, 466 (90%) eram de não pedreiros e 53 (10%) de pedreiros. As mãos foram acometidas em 38 (61%). 13 pacientes (24%) tinham Dermatite de Contato por Irritação Primária e 40 (76%) tinham Dermatite Alérgica de Contato. O grupo de pedreiros apresentou alta freqüência de sensibilização ao cimento, e 29 (54,7%) tinham sensibilização a agentes vulcanizadores da borracha. 23 pacientes (43,4%) pedreiros tinham sensibilização tanto ao cimento quanto à borracha. CONCLUSÕES: entre os pedreiros a presença de Dermatite Alérgica de Contato ao cimento e à borracha no mesmo paciente foi comum e demonstrou a importância do teste de contato.

Alergia a látex en trabajadores de salud del Hospital Nacional Guillermo Almenara Irigoyen - EsSalud / Latex allergy in health workers at the National Hospital Guillermo Almenara Irigoyen - Essalud

Antecedentes: El personal sanitario, especialmente aquellos que laboran en sala de operaciones constituye uno de los principales grupos de riesgo para desarrollar alergia a los guantes de látex, sin embargo no existen datos de alergia al látex en trabajadores de salud en Perú. El objetivo de este estudio es analizar la prevalencia de hipersensibilidad al látex Tipo I (alergia) y Tipo IV en personal sanitario de sala de operaciones del HNGAI y describir las características de los trabajadores alérgicos. Material y métodos: Se aplicó un cuestionario auto administrado sobre actividad laboral, antecedentes de atopía, y reporte de manifestaciones alérgicas en relación al uso de guantes de látex. Se realizaron pruebas cutáneas con extracto de látex y aeroalergenos y se realizaron determinaciones séricas de Ig E Total. Resultados: 75 trabajadores de sala de operaciones contestaron el cuestionario y se realizaron las pruebas alérgicas. Se encontró una prevalencia de sensibilización a látex del 9.3 por ciento y de alergia a látex Tipo I del 2.6 por ciento. Se encontraron 27 (36 por ciento) casos de dermatitis de contacto en relación al uso de guantes de látex (hipersensibilidad Tipo IV). No se encontró asociación con significancia estadística entre el estado de atopía, más años de servicio laboral, y mayor número de uso de guantes de látex por día con la alergia al látex. Conclusiones: Los hallazgos tanto en la prevalencia de sensibilización e Hipersensibilidad Tipo I a los guantes de látex (alergia a látex) y de Hipersensibilidad Tipo IV a los aditivos del caucho, en un hospital peruano nos lleva a tomar medidas preventivas como la utilización de guantes con bajo contenido proteico y sin polvo y de guantes libres de látex en el personal con sensibilización y/o alergia o hipersensibilidad a los guantes de látex.

Fundamentos sobre o conhecimento dos aditivos químicos presentes nas luvas de borracha / Fundamentals of the knowledge about chemical additives present in rubber gloves

FUNDAMENTOS: Uma das causas mais frequentes de dermatite de contato alérgica, de origem ocupacional, são os aditivos da borracha, presentes nos Equipamentos de Proteção Individual. Os aditivos das luvas natural e sintética mais alergênicos são tiurams, mercaptos e carbamatos. OBJETIVO: levantar o nível de conhecimento em relação aos aditivos químicos utilizados na fabricação das luvas de borracha sintética. MÉTODOS: Foi aplicado um questionário aberto a profissionais que trabalham com fabricação, pesquisa, prescrição e comercialização das luvas. Foi adotado o método de pesquisa qualitativa. RESULTADOS: Foram entrevistadas 30 pessoas: 4 pesquisadores na área de Medicina do Trabalho, 5 médicos do Trabalho, 2 técnicos de segurança do Trabalho, 1 médico do sindicato de trabalhadores da borracha, 1 engenheiro de Segurança do Trabalho, 1 engenheira de Produção do setor de fabricação de luvas de borracha, 4 empresários importadores de luvas, 1 empresário fabricante de luvas, 3 empresários que comercializavam Equipamentos de Proteção Individual, 3 vendedores de lojas de Equipamentos de Proteção Individual, 2 empresários de lojas que comercializavam produtos para alérgicos e 3 dermatologistas. CONCLUSÃO: O conhecimento da composição química das luvas é pequeno. A rotulagem das luvas, com a descrição da composição química, facilitaria a escolha do melhor tipo de luva para cada pessoa. Esta ação, de baixo custo para as empresas, seria um ganho, do ponto de vista da saúde pública, e teria grande repercussão nos usuários de luvas de borracha.

BACKGROUNDS: One of the most frequent causes of allergic contact dermatitis of occupational origin are rubber additives, which are present in Personal Protective Equipment (PPE). The most allergenic additives of natural and synthetic gloves are thiurams, carbamates and mercapto group. OBJECTIVE: To investigate the state of knowledge about the chemical additives used in the manufacture of synthetic rubber gloves. METHODS: This was a qualitative research study in which professionals working in the manufacture, research, prescription and commercialization of gloves answered an open questionnaire. RESULTS: 30 individuals were interviewed: 4 researchers in occupational medicine, 5 occupational physicians, 2 occupational safety technicians, a rubber workers' union physician, an occupational safety engineer, a pro duction engineer of rubber gloves, 4 importers of gloves, a manufacturer of gloves, 3 businessmen who sell PPE, 3 salesclerks working in stores that sell PPE, 2 businessmen who own stores that sell products for allergic indivi duals, and 3 dermatologists. CONCLUSION: Knowledge of the chemical composition of rubber gloves is scant. The labeling of gloves, with the description of their chemical composition, would facilitate choosing the best type of glove for each person. This low-cost action to businesses would be a gain from the standpoint of public health, with huge repercussions for users of rubber gloves.

Hydrophobic allergens from the bottom fraction membrane of Hevea brasiliensis.

Several proteins of rubber latex have been recognized as allergens causing immediate hypersensitivity in humans. In this study, a bottom fraction membrane (BFM) protein preparation from Hevea brasiliensis trees grown in southern Thailand was used to detect specific IgE in four groups of serum samples. The first group included 170 samples of latex glove factory workers (LGWs); group 2 consisted of the sera of 35 health care workers (HCWs) who were repeatedly exposed to powdered latex gloves; groups 3 and 4 were 31 positive and 22 negative sera, respectively, obtained from Johns Hopkins University School of Medicine, Baltimore, USA, tested for IgE to latex allergen. It was found that 56/170 (33%), 5/35 (14%), 11/31 (35.5%) and 1/22 (4.5%) samples of the LGWs, HCWs, CAP+ and CAP- groups had significant IgE to the BFM proteins, respectively. However, of all subjects only one subject of group 1 had experienced allergic morbidity consisting of eczema, conjunctivitis and asthma. The IgE of this subject bound to a 55 kDa component in the rubber latex BFM preparation. Thus, this protein may be regarded as a novel, although minor, latex allergen. Further investigation is needed to characterize the component and to pinpoint its allergenic role.

Urticaria: uma revisao sobre os aspectos clinicos e ocupacionais / Urticaria: a review on clinical and occupational aspects

A urticaria, manifestacao clinica de uma serie de patologias, apresenta um perfil epidemiologico relativamente desconhecido para os profissionais da saude, em razao de suas caracteristicas peculiares, porque somente uma parcela dos casos (os de grande intensidade, os intercorrentes ou cronicos) chega aos servicos de saude...