If you think that you're not allergic to latex because you and your co-workers have been using latex products for years with no ill effects, think again. A latex allergy is an acquired allergy — the more you're exposed to latex, the more likely you are to develop adverse reactions to it, and the more serious those reactions can become. Making your work environment latex-safe is the one true way to avoid the latex problem.

A historic problem
Latex allergy is a serious health risk for 3 percent to 17 percent of healthcare workers. In the late 1980s, when the HIV/AIDS crisis began, the demand for latex gloves skyrocketed. With more healthcare workers wearing latex gloves, greater numbers of workers predisposed to latex sensitivity have come in contact with the gloves that can do them harm.

To keep up with the increased demand, manufacturers changed the way they made latex gloves. Since the late 1980s, gloves are unlikely to have been washed enough to remove excess proteins, leaving them more allergenic, according to Gordon Sussman, MD, and Milton Gold, MD, in Guidelines for the Management of Latex Allergies and Safe Latex Use in Health Care Facilities, issued by the American College of Allergy, Asthma & Immunology.

Also, manufacturers have switched from talc to cornstarch to lubricate the inside of the gloves. Airborne particles are a major route of latex protein exposure and cornstarch is easily aerosolized. It readily binds with latex proteins that cause allergic reactions and stays in the air for many hours.

Protection for all
It's difficult to completely avoid latex items at work, home and in the community, but by making the work environment as latex-free as possible, you're saving yourself and co-workers from acquiring a potentially fatal allergy. It's up to you to fight for the safe environment that your staff deserves. Here's some practical advice:

• Make it official. Ban latex gloves and go powder-free. Use alternative products made of nitrile, vinyl or polyvinyl chloride whenever possible. If a non-latex alternative isn't available at your facility, cover latex items with non-latex wrap. Create a written policy that defines latex allergy, the signs and symptoms of a latex allergy reaction, who is at risk, where to get latex-free items and what to do in the event of a severe allergic reaction.
• Make it a team effort. You cannot make your facility latex-safe alone. All areas of your facility should be involved in the initiative. Make sure upper management has all the facts and understands the regulatory requirements regarding latex allergy. To make your case, research position statements on latex allergy and investigate the regulatory requirements pertaining to a safe work environment (see "Latex Allergy Resources" on page 32). Analyze the cost savings realized by using standardized purchasing. If you buy latex-free products from one or just a few companies, your costs will be lower due to increased usage and purchasing power.
• Test employees. Screen every new employee for latex allergies during pre-employment physicals. A blood test measures the immune system's response to latex by assessing the amount of allergy-type antibodies in the bloodstream, known as immunoglobulin E (IgE) antibodies. A skin test exposes skin on the forearm or back to a small amount of latex to see if an allergic reaction takes place. A person allergic to latex will develop a reaction or raised bump on the tested area. Only specialized allergy centers perform skin tests for latex allergy.
  • Track symptoms. Employees noticing symptoms of a latex allergy should report the symptoms and be tested for the allergy. Many healthcare workers don't think they have a latex allergy because they don't know the causes and symptoms. Ask employees presenting with symptoms if they've ever been tested for a latex allergy or if a physician has ever mentioned that they may have a rubber allergy. Do they have hay fever allergies? Are they allergic to bananas, avocados or kiwi fruit? Are they asthmatic? Also ask employees if they have experienced redness or swelling after a dental exam or after touching rubber gloves, balloons or toys.
  • Take precautionary steps. Latex-allergic employees should notify co-workers of their allergy and wear a medical ID badge or bracelet notifying others of their condition, especially during emergencies. Promote hand hygiene and encourage staff to wash their hands frequently.

    Any employee exposed to a latex product should not touch her eyes, nose or mouth because mucosa is a route of exposure. Healthcare workers should wear well-fitting facemasks to avoid inhaling latex proteins. Train and encourage employees to recognize the items in your facility that contain latex.

    • Be prepared for emergencies. Stock injectable epinephrine for severe allergic reactions.

    Protection equals prevention
    The risk of latex allergy lies not only in the products you use, but also in the air you breathe. OSHA regulations mandate that every facility is safe for employees and accountable for the work environment that it creates. In order to protect your employees, you must prevent latex exposure.

    On the Web

    Latex Allergy Resources U.S. Department of Labor Occupational Safety and Health Administration (OSHA) OSHA Technical Information Bulletin: Potential For Allergy to Natural Rubber Latex Gloves and Other Natural Rubber Products www.osha.gov/dts/shib/shib012808.html American College of Allergy, Asthma & Immunology Guidelines for the Management of Latex Allergies and Safe Latex Use in Health Care Facilities www.acaai.org/public/physicians/latex.htm American College of Allergy, Asthma & Immunology Latex allergy: An Emerging Healthcare Problem www.acaai.org/public/physicians/itxpos.htm National Institute for Occupational Safety and Health (NIOSH) NIOSH Alert: Preventing Allergic Reactions to Natural Rubber Latex in the Workplace DHHS (NIOSH) Publication No. 97-135 www.cdc.gov/Niosh/latexalt.html