EXPOSURE TESTING WITH POWDERED LATEX GLOV ES OF 60 HEALTH-CARE WORKERS WITH LATEX ALLERGY

Background and objective: Type 1 sensitization to natural rubber latex occurs in up to 22% of health care workers. Most sensitizations are d ue to the use of powdered latex gloves. Work place-associated exposure tests were performed to ascertain how frequently persons who develope d breathing difficulties, rhinitis/conjunctivitis or obstructive respi ratory tract illness when using powdered latex gloves are allergic to latex. Patients and methods: 60 persons (48 women and 12 men; mean age 29 +/- 7 years) with type 1 sensitization to natural rubber latex wer e studied. The past history was obtained through a questionnaire speci ally designed for those with latex allergy. Diagnostic measures includ ed pride tests with different latex allergens, measuring the concentra tions of total and latex-specific IgE and exposure trials, related to the work place, with powdered vinyl and latex gloves. Results: The pri ck tests with various latex allergens produced significant skin reacti ons in 59 subjects, 58 had latex-specific IgE antibodies (0.47 kU/l->1 00 kU/l). Exposure tests with powdered latex gloves produced rhinitis in 55 and conjunctivitis in 38 persons, urticaria in 3 and cough in 19 . Whole-body plethysmography demonstrated a significant rise in respir atory tract resistance in 13, a reduction in 1-second expiratory volum e of at least 20% in 15. Abnormal values in both tests were noted in 8 subjects. Conclusion: The breathing difficulty reported by all subjec ts was in most cases due not to bronchial obstruction but to obstructe d nasal breathing. In cases with breathing difficulty on exposure to l atex gloves a latex allergy should be considered as the cause. Powdere d latex gloves present a danger to health care personnel and should no longer be used.