Latex allergy
Encyclopedia
Latex allergy is a medical term encompassing a range of allergic reactions to natural rubber
latex
.
s. Such reactions account for a significant proportion of perioperative
anaphylactic
reaction, especially in children with myelomeningocele.
Testing for type I natural rubber latex allergy is through blood testing, such as RAST (radioallergosorbent test)
identifies what types of IgE proteins trigger allergic reactions. While the standard for allergen testing is the skin prick test, there is no approved skin testing reagent for latex in the United States, though some other countries do have approved skin testing reagents. Type I natural rubber latex allergy is caused from IgE (immune) mediated reactions to proteins found in the Hevea brasiliensis tree, a type of rubber tree.
Some people who are allergic to latex are also allergic to clothes, shoes, and other things that contain natural rubber latex—for example elastic bands, rubber gloves, condoms, pacifiers and baby-bottle nipples, balloons, cars, and clothing containing natural rubber based elastic.
. This involves a delayed skin rash
that is similar to poison ivy
with blistering and oozing of the skin (see urushiol-induced contact dermatitis
). This type is caused by a naturally occurring latex protein.
Type IV reactions are caused by the chemicals used to process the rubber. Patch testing needs to be done to verify which type of chemical triggers the reaction. Once the chemical is identified, then the person can choose products that are not processed with that chemical.
: The most common type of reaction. This causes dry, itchy, irritated areas on the skin, most often on the hands. It can be caused by the irritation of using gloves, or it can also be caused by exposure to other workplace products. Frequent washing of the hands, incomplete drying, exposure to hand sanitizers, and the talc
-like powder coatings (zinc oxide
, etc) used with gloves can aggravate symptoms. Irritant contact dermatitis is not a true allergy.
Estimates of latex sensitivity in the general population range from 0.8% to 8.2%, although not all will ever develop a noticeable allergic reaction.
, pineapple
, avocado
, chestnut
, kiwi fruit, mango
, passionfruit, strawberry
, and soy. Some but not all of these fruits contain a form of latex. The Asthma and Allergy Foundation of America
estimates that nearly 6 percent of the United States population have some type of food allergy and up to 4 percent have an allergy to latex. It can also cause reactions from foods touched by latex products in the most severe cases.
Some individuals who are highly allergic to latex have had allergic reactions to foods that were handled or prepared by people wearing latex gloves.
and banana
or fruits in general (latex-fruit syndrome).
Natural rubber latex contains several conformational epitope
s located on several enzymes like Hev b 1, Hev b 2, Hev b 4, Hev b 5 and Hev b 6.02.
FITkit
is a latex allergen testing method for quantification of the major natural rubber latex (NRL) specific allergens: Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02.
Rubber
Natural rubber, also called India rubber or caoutchouc, is an elastomer that was originally derived from latex, a milky colloid produced by some plants. The plants would be ‘tapped’, that is, an incision made into the bark of the tree and the sticky, milk colored latex sap collected and refined...
latex
Latex
Latex is the stable dispersion of polymer microparticles in an aqueous medium. Latexes may be natural or synthetic.Latex as found in nature is a milky fluid found in 10% of all flowering plants . It is a complex emulsion consisting of proteins, alkaloids, starches, sugars, oils, tannins, resins,...
.
Type I
The most serious and rare form, type I is an immediate and potentially life-threatening reaction, not unlike the severe reaction some people have to bee stingBee sting
A bee sting is strictly a sting from a bee . In the vernacular it can mean a sting of a bee, wasp, hornet, or yellow jacket. Some people may even call the bite of a horse-fly a bee sting...
s. Such reactions account for a significant proportion of perioperative
Perioperative
The perioperative period, less commonly spelled the peroperative period, is the time period describing the duration of a patient's surgical procedure; this commonly includes ward admission, anesthesia, surgery, and recovery. Perioperative generally refers to the three phases of surgery:...
anaphylactic
Anaphylaxis
Anaphylaxis is defined as "a serious allergic reaction that is rapid in onset and may cause death". It typically results in a number of symptoms including throat swelling, an itchy rash, and low blood pressure...
reaction, especially in children with myelomeningocele.
Testing for type I natural rubber latex allergy is through blood testing, such as RAST (radioallergosorbent test)
RAST test
A RAST test is a blood test used to determine to what substances a person is allergic. This is different from a skin allergy test, which determines allergy by the reaction of a person's skin to different substances....
identifies what types of IgE proteins trigger allergic reactions. While the standard for allergen testing is the skin prick test, there is no approved skin testing reagent for latex in the United States, though some other countries do have approved skin testing reagents. Type I natural rubber latex allergy is caused from IgE (immune) mediated reactions to proteins found in the Hevea brasiliensis tree, a type of rubber tree.
Some people who are allergic to latex are also allergic to clothes, shoes, and other things that contain natural rubber latex—for example elastic bands, rubber gloves, condoms, pacifiers and baby-bottle nipples, balloons, cars, and clothing containing natural rubber based elastic.
Type IV (allergic contact dermatitis)
Also known as allergic contact dermatitisContact dermatitis
Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....
. This involves a delayed skin rash
Rash
A rash is a change of the skin which affects its color, appearance or texture. A rash may be localized in one part of the body, or affect all the skin. Rashes may cause the skin to change color, itch, become warm, bumpy, chapped, dry, cracked or blistered, swell and may be painful. The causes, and...
that is similar to poison ivy
Poison ivy
Toxicodendron radicans, better known as poison ivy , is a poisonous North American plant that is well known for its production of urushiol, a clear liquid compound found within the sap of the plant that causes an itching rash in most people who touch it...
with blistering and oozing of the skin (see urushiol-induced contact dermatitis
Urushiol-induced contact dermatitis
Urushiol-induced contact dermatitis is the medical name given to allergic rashes produced by the oil urushiol, which is contained in various plants, including the plants of the genus Toxicodendron , other plants in the family Anacardiaceae Urushiol-induced contact dermatitis (also called...
). This type is caused by a naturally occurring latex protein.
Type IV reactions are caused by the chemicals used to process the rubber. Patch testing needs to be done to verify which type of chemical triggers the reaction. Once the chemical is identified, then the person can choose products that are not processed with that chemical.
Irritant contact dermatitis
It can also cause irritant contact dermatitisContact dermatitis
Contact dermatitis is a term for a skin reaction resulting from exposure to allergens or irritants . Phototoxic dermatitis occurs when the allergen or irritant is activated by sunlight....
: The most common type of reaction. This causes dry, itchy, irritated areas on the skin, most often on the hands. It can be caused by the irritation of using gloves, or it can also be caused by exposure to other workplace products. Frequent washing of the hands, incomplete drying, exposure to hand sanitizers, and the talc
Talc
Talc is a mineral composed of hydrated magnesium silicate with the chemical formula H2Mg34 or Mg3Si4O102. In loose form, it is the widely-used substance known as talcum powder. It occurs as foliated to fibrous masses, its crystals being so rare as to be almost unknown...
-like powder coatings (zinc oxide
Zinc oxide
Zinc oxide is an inorganic compound with the formula ZnO. It is a white powder that is insoluble in water. The powder is widely used as an additive into numerous materials and products including plastics, ceramics, glass, cement, rubber , lubricants, paints, ointments, adhesives, sealants,...
, etc) used with gloves can aggravate symptoms. Irritant contact dermatitis is not a true allergy.
Those at greatest risk
- Children with Spina bifidaSpina bifidaSpina bifida is a developmental congenital disorder caused by the incomplete closing of the embryonic neural tube. Some vertebrae overlying the spinal cord are not fully formed and remain unfused and open. If the opening is large enough, this allows a portion of the spinal cord to protrude through...
. About 68% will have a reaction. - Industrial rubberRubberNatural rubber, also called India rubber or caoutchouc, is an elastomer that was originally derived from latex, a milky colloid produced by some plants. The plants would be ‘tapped’, that is, an incision made into the bark of the tree and the sticky, milk colored latex sap collected and refined...
workers, exposed for long periods to high amounts of latex. About 10% have an allergic reaction. - Health care providerHealth care providerA health care provider is an individual or an institution that provides preventive, curative, promotional or rehabilitative health care services in a systematic way to individuals, families or communities....
s. Given the ubiquitous use of latex products in health care settings, management of latex allergy presents significant health organizational problems. Healthcare workers who frequently use latex gloves and other latex-containing medical supplies such as physicians, nurses, aides, dentists, dental hygienists, operating room employees, laboratory technicians, and hospital housekeeping personnel are at risk for developing latex allergy. Between about 4% to 17% of healthcare workers have a reaction, this usually presents as Irritant Contact Dermatitis, and can develop through allergic sensitivity to a status of full anaphylaxis shock; with health workers losing their vocation. In the surgical setting, however, the risk of a potentially life-threatening allergic reaction by a patient has been deemed by Johns Hopkins HospitalJohns Hopkins HospitalThe Johns Hopkins Hospital is the teaching hospital and biomedical research facility of Johns Hopkins University School of Medicine, located in Baltimore, Maryland . It was founded using money from a bequest by philanthropist Johns Hopkins...
to be sufficiently high to replace all latex surgical glovesMedical glovesMedical gloves are disposable gloves used during medical examinations and procedures that help prevent contamination between caregivers and patients. Medical gloves are made of different polymers including latex, nitrile rubber, vinyl and neoprene; they come unpowdered, or powdered with cornstarch...
with synthetic alternatives. - People who have had multiple surgical procedures, especially in childhood.
Estimates of latex sensitivity in the general population range from 0.8% to 8.2%, although not all will ever develop a noticeable allergic reaction.
Latex and foods
Some people who have latex allergy may also have an allergic response to any of a number of plant products, usually fruits. This is known as the latex-fruit syndrome. Fruits (and seeds) involved in this syndrome include bananaBanana
Banana is the common name for herbaceous plants of the genus Musa and for the fruit they produce. Bananas come in a variety of sizes and colors when ripe, including yellow, purple, and red....
, pineapple
Pineapple
Pineapple is the common name for a tropical plant and its edible fruit, which is actually a multiple fruit consisting of coalesced berries. It was given the name pineapple due to its resemblance to a pine cone. The pineapple is by far the most economically important plant in the Bromeliaceae...
, avocado
Avocado
The avocado is a tree native to Central Mexico, classified in the flowering plant family Lauraceae along with cinnamon, camphor and bay laurel...
, chestnut
Chestnut
Chestnut , some species called chinkapin or chinquapin, is a genus of eight or nine species of deciduous trees and shrubs in the beech family Fagaceae, native to temperate regions of the Northern Hemisphere. The name also refers to the edible nuts they produce.-Species:The chestnut belongs to the...
, kiwi fruit, mango
Mango
The mango is a fleshy stone fruit belonging to the genus Mangifera, consisting of numerous tropical fruiting trees in the flowering plant family Anacardiaceae. The mango is native to India from where it spread all over the world. It is also the most cultivated fruit of the tropical world. While...
, passionfruit, strawberry
Strawberry
Fragaria is a genus of flowering plants in the rose family, Rosaceae, commonly known as strawberries for their edible fruits. Although it is commonly thought that strawberries get their name from straw being used as a mulch in cultivating the plants, the etymology of the word is uncertain. There...
, and soy. Some but not all of these fruits contain a form of latex. The Asthma and Allergy Foundation of America
Asthma and Allergy Foundation of America
The Asthma and Allergy Foundation of America is a non-profit organization dedicated to finding a cure for and controlling asthma, food allergies, nasal allergies and other allergic diseases. AAFA's mission is also to educate the public about these diseases...
estimates that nearly 6 percent of the United States population have some type of food allergy and up to 4 percent have an allergy to latex. It can also cause reactions from foods touched by latex products in the most severe cases.
Some individuals who are highly allergic to latex have had allergic reactions to foods that were handled or prepared by people wearing latex gloves.
Alternatives
- Synthetic elastic such as elastane or neopreneNeopreneNeoprene or polychloroprene is a family of synthetic rubbers that are produced by polymerization of chloroprene. Neoprene in general has good chemical stability, and maintains flexibility over a wide temperature range...
do not contain the proteins from the Hevea brasiliensis tree that trigger type I reactions.
- Products made from guayuleGuayuleParthenium argentatum, commonly known as the Guayule , is a flowering shrub in the aster family, Asteraceae, that is native to the southwestern United States and northern Mexico. It can be found in the US states of New Mexico and Texas and the Mexican states of Zacatecas, Coahuila, Chihuahua, San...
natural rubber emulsions also do not contain the proteins from the Hevea rubber tree, and have only trace amounts of other proteins, indicating a very low potential for causing sensitization to this material.
- Chemical treatment to reduce the amount of antigenic proteins in Hevea latex has yielded alternative materials, such as VytexVytex Natural Rubber LatexVytex Natural Rubber Latex is a brand of natural rubber latex produced and marketed by Vystar Corporation. Vytex NRL is an alternative material to petroleum-based synthetics and traditional, or Hevea, natural rubber latex...
, which reduce exposure to latex allergens while otherwise retaining the properties of natural rubber.
Latex allergens
Hevein-like protein domains are a possible cause for allergen cross-reactivity between latexLatex
Latex is the stable dispersion of polymer microparticles in an aqueous medium. Latexes may be natural or synthetic.Latex as found in nature is a milky fluid found in 10% of all flowering plants . It is a complex emulsion consisting of proteins, alkaloids, starches, sugars, oils, tannins, resins,...
and banana
Banana
Banana is the common name for herbaceous plants of the genus Musa and for the fruit they produce. Bananas come in a variety of sizes and colors when ripe, including yellow, purple, and red....
or fruits in general (latex-fruit syndrome).
Natural rubber latex contains several conformational epitope
Epitope
An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells. The part of an antibody that recognizes the epitope is called a paratope...
s located on several enzymes like Hev b 1, Hev b 2, Hev b 4, Hev b 5 and Hev b 6.02.
FITkit
FITkit
FITkit is an immunological test for measuring natural rubber latex allergens from a variety of rubber products, such as gloves.-Description:...
is a latex allergen testing method for quantification of the major natural rubber latex (NRL) specific allergens: Hev b 1, Hev b 3, Hev b 5 and Hev b 6.02.
See also
- Food allergyFood allergyA food allergy is an adverse immune response to a food protein. They are distinct from other adverse responses to food, such as food intolerance, pharmacological reactions, and toxin-mediated reactions....
- Food intoleranceFood intoleranceFood intolerance or non-allergic food hypersensitivity is a term used widely for varied physiological responses associated with a particular food, or compound found in a range of foods....
- List of allergies
- Oral Allergy SyndromeOral allergy syndromeOral allergy syndrome or OAS is a type of food allergy classified by a cluster of allergic reactions in the mouth in response to eating certain fruits, nuts, and vegetables that typically develops in adult hay fever sufferers....
External links
- The American Latex Allergy Association
- UK Latex Allergy Support Group
- NIOSH Latex Allergy Alert from the U.S. Centers for Disease Control and PreventionCenters for Disease Control and PreventionThe Centers for Disease Control and Prevention are a United States federal agency under the Department of Health and Human Services headquartered in Druid Hills, unincorporated DeKalb County, Georgia, in Greater Atlanta...
- Asthma and Allergy Foundation of America