AN EPIDEMIC OF OCCUPATIONAL ALLERGY TO LATEX IVOLVING HEALTH-CARE WORKERS

IgE-mediated sensitivity to natural rubber latex is being recognized m ore frequently among health care workers. Between January 1990 and Jun e 1993, we evaluated 342 consecutive Mayo Medical Center employees who reported symptoms suggestive of latex allergy. All were interviewed a nd underwent puncture skin testing with extracts of rubber gloves. In some cases, latex-specific IgE antibodies were measured by immunoassay . One hundred four of the 342 employees evaluated (30%) were latex-all ergic. Risk factors for sensitization included frequent use of disposa ble gloves, presence of prior atopic disease, and prior or current han d dermatitis. The peak onset of symptoms occurred in late 1989 and ear ly 1990 and did not correlate with a peak in glove usage at our medica l center, which continued to rise. Most sensitized employees (78%) rep orted contact urticaria from rubber gloves, and over two thirds also e xperienced allergic rhinitis, conjunctivitis, or asthma when working i n areas where large numbers of gloves were being used. Sixteen episode s of rubber-induced anaphylaxis were documented in 12 employees; six e pisodes occurred after latex skin testing and were easily reversed wit h appropriate therapy. Our findings substantiate a local epidemic of l atex allergy among medical center employees. Epidemiologic studies are needed to assess the effects of various interventions to reduce occup ational exposure to latex allergens. Although prick skin testing with concentrated latex glove extracts presents some risk of systemic react ion, pending availability of commercial diagnostic extracts, such test ing is generally safe when performed by skilled laboratory personnel. Skin testing is warranted to investigate health care workers suspected of being latex-sensitive.