OCCUPATIONAL ASTHMA CAUSED BY NATURAL-RUBBER LATEX

IgE-mediated sensitization to protein allergens of natural rubber late x (NRC) can induce immediate hypersensitivity reactions ranging from m ild urticaria to life-threatening anaphylaxis after cutaneous, mucosal or visceral exposure. Elutable allergens from NRL gloves adsorb to th e cornstarch powder particles, become airborne, and have the potential to cause respiratory reactions, Recent studies indicate that asthma i s a frequent manifestation of NRL allergy among workers manufacturing NRL materials and among health-care providers using NRL gloves. NRL-in duced asthma should receive increasing attention as it can lead to per manent respiratory sequelae and occupational disability. The need for early and accurate diagnosis is outlined and the different diagnostic approaches are reviewed. Specific issues pertaining to the management of affected subjects and to the prevention of exposure to airborne NRL are discussed. Areas of future research should include: 1) further ch aracterization of relevant NRL allergens; 2) development and validatio n of methods for quantitative assessment of allergen content in NRL de vices and workplace environments; 3) standardization of allergen extra cts used for diagnostic purposes; 4) prospective evaluation of the nat ural history and risk factors of NRL-induced asthma; and 5) analysis o f effectiveness and cost of preventive strategies.