Latex sensitization: Occupational versus general population prevalence rates

Background Natural rubber latex (NRL) has become an important occupational health concern in recent years, particularly among health care workers. It has been suggested in same reports that the prevalence of latex sensitizati on among occupationally exposed groups is not different from that in the ge neral population. Methods The findings of prevalence studies conducted among occupationally-e xposed and general population groups were reviewed to determine whether the re is evidence to support this suggestion. Results Numerous surveys of HCWs have demonstrated that the prevalence of s ensitization to latex ranged in most studies from 5 to 12%; sensitization o f HCWs may produce clinical effects including urticaria, rhinoconjunctiviti s, occupational asthma, and potentially life-threatening anaphylactic shock . More than a decade ago, data from Finland indicated that the prevalence o f latex allergy in the general population was less than 1%. Recent reports from Finland have confirmed this, with observations that 0.7-1.1% Of large series of patients were NRL-allergic, while among 804 unselected patients, the prevalence of latex skirt prick test (SPT) positivity was 0.12%. In con trast, other studies have suggested that from 4 to 6.4% of individuals test ed were positive for serum latex-specific IgE antibodies. However; the spec ificity of these assays has been reported to be low. In three recent studie s based on SPTs, published in 1997, the prevalence of positive reactions to latex was about 1% or less. The prevalence was 0.7% (95% CI 0.3-1.4) among 758 apprentices in Quebec, Canada; and 1.1% among more than 3,000 children tested in Finland (1.0% confirmed on latex we test). There were no first- and second-year dental students with positive latex SPTs in Ontario, Canada . Conclusions These recent investigations provide further evidence consistent with earlier studies based on skin testing that the prevalence of latex se nsitization in occupationally-unexposed groups is quire low (<1%). The mark ed differences in the findings based on serological assays may relate to th e nonspecificity of these assays and deserve further investigation. Am. J. Ind. Med. 35:196-200, 1999. (C) 1999 Wiley-Liss, Inc.