Influence of occupational exposure to latex on the prevalence of sensitization and allergy to latex in a Swiss hospital

Background: Replacement of powdered latex gloves has been recommended in or der to prevent the development of latex allergy in health care workers. The conclusion that occupational exposure to latex gloves represents a risk fa ctor for latex allergy is mainly based on studies without exposure controls . Atopy is also thought to be a risk factor for the development of latex al lergy. Objective: To determine the prevalence of atopy, sensitization to la tex; and symptoms following latex exposure in professionally exposed and no nexposed hospital personnel by means of a cross-sectional study. Methods: S ix hundred randomly sampled individuals working in medicine and surgery dep artments and in surgery theaters and 300 sex- and age-matched individuals c lassified as administrative personnel were selected from the employee data base of the Geneva University Hospital. A questionnaire about exposure to l atex and symptoms following this exposure was sent to all individuals. Skin prick test reactions and serum IgE to latex as well as standard environmen tal allergens were determined in both groups. Results: Respiratory and skin (local) symptoms but not objective tests of latex sensitization (positive skin prick test and specific IgE to latex) were significantly associated wi th occupational exposure to latex (p < 0.001). Only among atopics subjects was 15 years or more of occupational exposure associated with a significant ly higher prevalence of local symptoms than among those who were exposed fr om 1 to 9 years (odds ratio: 3.2; 95% confidence interval: 1.6-6.5). Atopy was significantly associated with sensitization to latex (odds ratio: 10.3; 95% confidence interval: 4.0-26.6) but not with local symptoms. Tests of l atex sensitization were both frequently positive, less frequently negative, resulting in low kappa values. Conclusion: These results support the curre nt preventive health care recommendation to replace powdered latex gloves. In atopics, increasing years of occupational exposure increase the risk of developing latex allergy. In contrast to questionnaires about local symptom s, skin prick tests and specific serum IgE to latex are of limited value in epidemiologic studies of latex allergy. Copyright (C) 2001 S. Karger AG, B asel.