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LauraKorhonen

Latex Allergy

Suspect latex allergy in a person who gets allergic symptoms from products containing rubber, such as gloves, balloons, babies' dummies, condoms or medical instruments.
Every patient scheduled to undergo surgery should beforehand be asked about symptoms suggestive of latex allergy.

Latex allergy is an immediate (type I) hypersensitivity reaction to proteins of the rubber tree. Delayed (type IV) hypersensitivity reaction to chemicals added to natural rubber latex is called rubber chemical allergy. The symptom of delayed allergy is eczema.
About 1% of the population are approximated to suffer from latex allergy, health care personnel and people who have undergone multiple operations more often than general population.
In the 2000's, the prevalence of latex allergy has decreased among health care personnel, along with the introduction of powder-free gloves and the reduction of protein content of latex gloves.

The following products, for example, may contain latex:
- gloves (examination or household gloves, sterile gloves)
- healthcare equipment, such as catheters, balloons, sphygmomanometer tubing
- in dentistry cofferdam protection
- many everyday rubber products, such as children's dummies and teats, condoms, rubber bands, balloons, mattresses, toys.

Symptoms of immediate allergy, such as
- redness and itching of the skin, urticaria, mucosal oedema
- rhinitis, nasal congestion, redness and tearing of the eyes
- dyspnoea, cough, wheezing
- faintness, paleness, decrease in blood pressure.
Symptoms vary from mild allergic symptoms to severe anaphylaxis.
Sometimes latex allergy can be also the cause of chronic eczema, such as hand eczema.

15 different allergens have been identified in latex.
Some allergens in latex have cross-reactions with pollens, such as with birch pollen.
Some allergens of latex cross-react also with some fruits and vegetables (e.g. banana, avocado, chestnut, kiwi)
The established cross allergies vary based upon the latex allergen the patient is sensitized to.
The clinical significance and need for an elimination diet depend on the patient's symptoms. Only food substances that bring about symptoms should be avoided.

Essentially based on history of immediate symptoms associated with latex exposure.
- A positive allergy test result to latex may also be due to cross-reaction and hence does not necessarily mean real latex allergy.
If real latex allergy is suspected based on the patient's symptoms, consider referring the patient to a specialist for more thorough investigations.
Sensitization may be examined by skin prick tests and by determining specific IgE antibodies against latex and its different proteins (allergenic components).
Provocation tests (skin, lung) are sometimes required.

It is essential to avoid contact with products containing natural rubber latex.
Persons who have had a severe allergic reaction need an adrenaline auto-injector Anaphylaxis.
Staff members with latex allergy can use low allergenic latex gloves if these do not cause any symptoms.
When handling patients with latex allergy it is essential to use gloves and other equipment completely free of natural rubber latex.

Dramburg S, Hilger C, Santos AF, et al. EAACI Molecular Allergology User's Guide 2.0. Pediatr Allergy Immunol 2023;34 Suppl 28():e13854 [PubMed]
Nucera E, Aruanno A, Rizzi A, et al. Latex Allergy: Current Status and Future Perspectives. J Asthma Allergy 2020;13():385-398 [PubMed]
Wu M, McIntosh J, Liu J. Current prevalence rate of latex allergy: Why it remains a problem? J Occup Health 2016;58(2):138-44 [PubMed]
Blaabjerg MS, Andersen KE, Bindslev-Jensen C, et al. Decrease in the rate of sensitization and clinical allergy to natural rubber latex. Contact Dermatitis 2015;73(1):21-8 [PubMed]