Brown RH. Schauble JF. Hamilton RG., Prevalence of latex allergy among anesthesiologists: identification of sensitized but asymptomatic individuals. Anesthesiology 1998;89(2):292-9.
Occupational exposure to natural rubber latex has led to sensitization of health-care workers. However, the prevalence of latex allergy among occupationally exposed workers in American hospitals has not been reproducibly determined. The authors determined the prevalence of and risk factors for latex sensitization among a cohort of highly exposed health-care workers that included 168 of 171 eligible anesthesiologists and nurse anesthetists working in the Department of Anesthesiology and Critical Care Medicine at Johns Hopkins. A clinical questionnaire was administered, and testing was performed using a characterized non-ammoniated latex reagent for puncture skin testing, a Food and Drug Administration-approved assay to quantify latex specific immunoglobulin E antibody in serum, and, when required for clarification, a validated two-stage (contact-inhalation) latex glove provocation procedure. The authors found the prevalence of latex allergy with clinical symptoms and latex sensitization without clinical symptoms was 2.4% and 10.1%, respectively. The prevalence of irritant or contact dermatitis was 24%. The risk factors identified for latex sensitization were atopy (P = 0.012); history of allergy to selected fruits, such as bananas, avocados, or kiwis (P = 0.015); and history of skin symptoms with latex glove use (P = 0.006). The authors conclude the prevalence of latex sensitization among anesthesiologists is high (12.5%) with 10.1% of the healthcare workers having occult (asymptomatic) latex allergy. Hospital employees may be sensitized to latex even in the absence of perceived latex allergy symptoms. The authors conclude the data support the need to transform the health-care environment into a latex-safe one that minimizes latex exposure to patients and hospital staff.