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Home : No Latex : Article
Latex Allergy Problems Skyrocketed in the Past Decade
Gail Pisarcik Lenehan, EdD, RN, CS Editor, Journal of Emergency Nursing
Nurses have been wearing rubber gloves since the 1890s, with few problems. So why the attention to latex allergy? In an effort to keep up with the exploding demand for gloves following the call for universal precautions in 1987, manufacturers may have cut corners.
Allergenic proteins loosely adhere to latex gloves. The gloves may not have been washed and processed to remove excess proteins, leaving them more allergenic-- sometimes thousands of times more allergenic. These same gloves were worn dramatically more often after the AIDS crisis.
Coinciding with all this was a switch from talc, a heavy substance, to cornstarch, which readily binds with latex proteins, is easily aerosolized, and stays in the air for many hours.
In 1988, reports of reactions, ranging from itchy hands or eyes to asthma and anaphylaxis, began to come in to the FDA, OSHA, and NIOSH. Problems associated with latex have since become epidemic. In 1986, a year before universal precautions, 12 bracelets citing latex allergy were requested; at the end of 1997, there were a total of 7,447 such bracelets.
There is cause for concern among nurses across the country, since 10 percent to 17 percent of all nurses seem to be affected. ER nurses, OR nurses, and OB/GYN nurses and others who wear latex gloves, particularly powdered ones, and who change gloves frequently, have been particularly hard hit. (When gloves are put on or taken off, they propel latex laden cornstarch into the air to be breathed.)
Nurses aren't the only ones to be affected. One out of ten physicians beginning residencies at one Wisconsin hospital tested positive for latex allergy. With patients, there are legal, as well as ethical, dimensions. There is the potential for missing a diagnosis, improperly examining or treating a latex allergic patient, or for worsening an anaplylactic reaction with latex laden air or latex catheters.
As for patients, increasing reports of serious anaphylaxis, particularly intraoperatively, have been associated with latex contact with mucosa and respiratory tract of those who have become allergic. Two primary risk factors—frequent exposure to latex and prior allergies/asthma—are so common that many are at risk.
Promising new synthetics offer alternatives to latex products, including gloves (some synthetic, non-latex gloves offer superior protective qualities and are cost-effective), and many clinical strategies have been developed across the country to protect health care workers, office staff and patients.
More than 400,000 requests for a June 1997 NIOSH Alert, "Preventing Allergic Reactions to Natural Rubber Latex in the Workplace," were received within two weeks of its publication.
Latex allergy has many implications for emergency nurses who need to be able to identify patients and co-workers who have the allergy, protect them while they are in the emergency department and alert the floors to their needs. They also need to know how to safely treat such patients, in offices and hospitals.
In response to the growing epidemic of latex allergy, and the need for education, ENA is featuring a lecture by Anne Phelan Bowen, RN, MS, on "Good Riddance to Latex! Latex Allergy....Beyond the Basics...Creating the Safest Environment for Our Patients and Ourselves."
A Member of the Massachusetts ENA Task Force on Latex Allergy, she will give a practical lecture and help de-mystify and offer practical approaches to latex allergy. Bowen is the Outreach Coordinator at Children's Hospital, a progressive hospital which has become essentially latex safe over the last several years.
Exhibitors of Latex-Free Products
As part of ENA's on-going effort to keep emergency departments safe, ENA would like to commend the following companies for their effort in creating and supplying latex-free products:
- Acme United Corporation
- Andover Coated Products
- Bard Medical
- Ethox Corporation
- I.V. House Intravenous Site Protectors
- Mason Tayler Medical
- Tri-State Hospital Supply Corporation
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