Outcomes of a natural rubber latex control program in an Ontario teaching hospital

Background: Allergy to natural rubber latex (NRL) has been frequently repor ted in health care workers. However, there is little published evidence of the outcome of hospital intervention programs to reduce exposure and detect cases of sensitization early. Objective: This study assesses the effects of intervention to reduce NRL al lergy in an Ontario teaching hospital with approximately 8000 employees. Methods: A retrospective review assessed annual numbers of employees visiti ng the occupational health clinic, allergy clinic, or both for manifestatio ns of NRL allergy compared with the timing of introduction of intervention strategies, such as worker education, voluntary medical surveillance, and h ospital conversion to low-protein, powder-free NRL gloves. Results: The number of workers identified with NRL allergy rose annually, f rom 1 in 1988 to 6 in 1993. When worker education and voluntary medical sur veillance were introduced in 1994, a further 25 workers were identified. No nsterile gloves were changed to low-protein, powder-free NRL gloves in 1995 : Diagnoses fell to 8 workers that year, and 2 of the 3 nurses who had been off work because of asthma-anaphylaxis were able to return to work with pe rsonal avoidance of NRL products. With a change to lower protein, powder-fr ee NRL sterile gloves in 1997, allergy diagnoses fell to 3, and only I new case was identified subsequently up to May 1999. No increased glove costs w ere incurred as a result of consolidated glove purchases. Conclusions: This program to reduce NRL allergy in employees was effectivel y achieved without additional glove costs while reducing expenses from time off work and workers' compensation claims.