Latex Allergy Protocol
Latex is a natural product of the rubber tree and is used in many products in the health care field. With the increased use of latex in barrier protection and medical equipment, more and more nurses and patients are becoming hypersensitive to it.
Certain groups of people are at increased risk for developing latex allergy. These include people who have had or will undergo multiple surgical procedures (such as those with a history of spina bifida), health care workers (especially those who work in the emergency department or operating room), workers who manufacture latex and latex-containing products, and people with a genetic predisposition to latex allergy. Some studies also suggest that pregnant patients may have a higher risk of latex allergy than nonpregnant patients.1
People allergic to certain cross-reactive foods—including bananas, avocados, chestnuts, cherries, grapes, kiwis, passion fruit, tomatoes, and peaches—may also be allergic to latex. Exposure to latex elicits an allergic response similar to the one elicited by these foods.
For those with latex allergy, latex becomes a hazard when the protein in latex comes in direct contact with mucous membranes or is inhaled, which happens when powdered latex surgical gloves are used. People with asthma are at greater risk for developing worsening signs and symptoms from airborne latex.
The diagnosis of latex allergy is based on the patient’s history and physical examination. Laboratory testing should be performed to confirm or eliminate the diagnosis. Skin testing, such as the skin-prick or patch test, may be performed. The radioallergosorbent test (RAST) measures the serum level of latex-specific immunoglobulin E in the blood. Other serum blood tests include Pharmacia CAP, AlaSTAT, and HYTEC.
Latex allergy can produce a myriad of signs and symptoms, including generalized itching (on the hands and arms, for example); itchy, watery, or burning eyes; sneezing and coughing (hay fever–type symptoms); rash; hives; bronchial asthma, scratchy throat, or difficulty breathing; edema of the face, hands, or neck; and anaphylaxis.
To help identify the patient at risk for latex allergy, ask latex allergy–specific questions during the health history. (See Latex allergy screening.) If the patient’s history reveals a latex sensitivity, the doctor assigns him to one of three categories based on the extent of his sensitization:
Group 1 patients have a history of anaphylaxis or a systemic reaction when exposed to a natural latex product.
Group 2 patients have a clear history of an allergic reaction of a nonsystemic type.
Group 3 patients don’t have a previous history of latex hypersensitivity but are designated as high risk because of an associated medical condition, occupation, or crossover allergy.
If you determine that your patient has a sensitivity to latex, make sure that he doesn’t come in contact with latex because such contact could result in a life-threatening hypersensitivity reaction. Creating a latex-safe environment is the only way to safeguard your patient. Many facilities now designate nonlatex equipment, which is usually kept on a cart that can be moved into the patient’s room.
Latex Allergy Screening
To determine if your patient has a latex sensitivity or allergy, ask the following screening questions:
What is your occupation?
Have you experienced an allergic reaction, local sensitivity, or itching following exposure to any latex products, such as balloons, dishwashing gloves, or condoms?
Do you have shortness of breath or wheezing after blowing up balloons or after a dental visit?
Do you have itching in or around your mouth after eating a banana?
If your patient answers yes to any of these questions, proceed with the following questions:
Do you have a history of allergies, dermatitis, or asthma? If so, what type of reaction do you have?
Do you have any congenital abnormalities? If yes, explain.
Do you have any food allergies? If so, what specific allergies do you have? Describe your reaction.
If you experience shortness of breath or wheezing when blowing up latex balloons, describe your reaction.
Have you had any previous surgical procedures? Did you experience associated complications? If so, describe them.
Have you had previous dental procedures? Did complications result? If so, describe them.
Are you exposed to latex in your occupation? Do you experience a reaction to latex products at work? If so, describe your reaction.
