Nurse Anesthetists Warn of Latex Exposure

People allergic to natural rubber latex (NRL) should avoid not only latex gloves but also fruits and vegetables that contain the same allergy-producing proteins found in NRL, according to an advisory issued by the American Association of Nurse Anesthetists (AANA, Park Ridge, IL, USA).

NRL allergies afflict 8-25% of health-care workers, usually from contact with gloves made of NRL. Allergies to latex, the sap of the rubber tree, is an antigenic response to the proteins found in NRL. The three recognized reactions are nonallergic irritant contact dermatitis, type IV cell-mediated allergies, and type I IgE-mediated allergies. The first, a minor skin rash, can affect regular wearers of powdered and nonpowdered latex gloves. The second reaction, type IV, represents a delayed hypersensitivity to one or more of the more than 300 chemicals used to manufacture latex. Sufferers develop contact dermatitis and may acquire antibodies that can trigger a type I latex allergy.

People with a type I reaction have an immediate hypersensitivity to actual latex proteins, which manifests itself in two subgroups. One causes hives, itchy eyes, asthma, nausea, and skin rashes, while the second and more serious causes anaphylaxis. Skin prick, skin patch, and radioallergosorbent (RAST) tests screen for latex allergies. Skin prick tests can induce anaphylactic shock and should be performed only under the supervision of an allergy specialist with emergency backup equipment. RAST tests identify specific IgE antibodies to latex in the blood and confirm an NRL allergy diagnosis.

Surgical procedures can cause some of the most severe reactions because latex comes into direct contact with moist areas of the body and internal surfaces causing faster, easier absorption of the allergen. Inhalation of airborne proteins, released when powdered gloves get snapped off, can enter the eyes or mucous membranes and cause a reaction.
In addition, bananas, avocados, kiwis, plums, peaches, cherries, apricots, figs, papayas, tomatoes, potatoes, and chestnuts can trigger a reaction in latex-sensitive individuals because they contain the same allergy-producing proteins found in NRL. Genetically engineered fruits and vegetables contain the same DNA markers as latex and should also be avoided.




Related Links:
American Association of Nurse Anesthetists