Chapter 29LATEX

Carol A. Epling*


Contemporary awareness of the problem of occupational latex hypersensitivity (LH) began in 1979 with Nutter’s report of a case of contact urticaria produced by latex gloves.1 Over the next 10 years there were a few literature reports of occupational latex allergies, but the problem remained a minor curiosity to occupational physicians. About 1990, however, the trickle of reports expanded into a steady stream, and LH became recognized as a significant occupational problem, particularly for healthcare workers.

Various theories have been advanced to explain this phenomenon. Perhaps the most plausible is that occupational exposure to latex antigens was low until the implementation of universal precautions in the late 1980s prompted an increase of more than 10-fold in the use of powdered natural rubber latex gloves. As the usage increased, manufacturers reduced quality control in an attempt to keep pace with demand, and new manufacturers with little experience entered the market. This led to a marked rise in the antigen content of latex gloves. The juxtaposition of elevated antigen content and increased wear time probably increased the latex antigen exposure of the typical healthcare worker by more than an order of magnitude. Meanwhile, the prevalence of latex-related problems rose markedly throughout the 1990s. While case reporting may have increased somewhat due to greater physician awareness, there can be little doubt that ...

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