WORK-RELATED LATE ASTHMATIC RESPONSE INDUCED BY LATEX ALLERGY

Background: The occupational uses of latex gloves may De associated wi th asthma. Hypersensitivity to latex has been shown to be IgE-mediated . The asthmatic reaction to Inter is usually early; however, the natur al history of Enter asthma is still unknown. Objective: Tile purposes Of this study were to investigate asthmatic responses induced by natur al rubber. latex and to assess the long-term respiratory consequences of latex-induced asthma after removal from exposure. Methods: This rep ort describes the clinical and immunologic study of sis nurses with wo rk-related respiratory and skirt disorders induced by the use of latex gloves. To determine whether the symptoms induced by latex gloves wer e IgE-mediated, we assessed later IgE antibody levels by skin prick te sts (SPTs) and RASTs with Inter extracts. To confirm work-related late x reactions, we assessed respiratory symptoms, skin reactions, and FEV (1) respiratory symptoms, skit? reactions, and FEV(1) after a glove ex posure test and nt? inhalation provocation test with Inter gloves. All subjects were followed up for 7 months to 7 years after the first obs ervation. Results: All subjects had positive SPT and RAST responses to Inter extracts, positive double prick test responses to Inter gloves, and negative SPT responses to cornstarch and common allergens. Ten at opic and ID nonatopic control subjects had negative SPT responses to l atex and cornstarch extracts and,negative double prick test responses to Inter gloves. In three subjects later allergy was associated with a llergy to fruit (banana and chestnut). After the glove exposure test, four of six subjects had contact urticaria, all had rhinoconjunctiviti s, and two had a late asthmatic response. The inhalation provocation? test was performed on four subjects: all had rhinoconjunctivitis, two had urticaria and late asthmatic response, and one had laryngeal edema . A late asthmatic response was recorded in foul subjects. Three subje cts continued to have chronic asthma, and foul subjects had increased nonspecific bronchial responsiveness 7,months to 7 years after being a ssigned to duties not involving latex gloves. Conclusions: This study of six nurses shows that later is a potential cause of occupational as thma, I rhinoconjunctivitis, and urticaria-angioedema. Latex seems to include antigens that elicit IgE-mediated hypersensitivity and may cau se a late asthmatic reaction. Occupational asthma caused by latex may lead to permanent respiratory disability, even after removal from expo sure.