Occupational Allergy to Natural Rubber Latex (NRL)

Abstract

During the 1980s and 1990s, the need for protection of health care workers (HCW) from HIV and Hepatitis B and C viruses led to an increased use of powdered natural rubber latex (NRL) examination gloves that contaminated the room atmosphere with NRL-allergens adhering to cornstarch glove powder. Up to 17% of health care workers developed a sensitization to NRL, up to 5% developed occupational asthma after first suffering from urticaria of the hands as symptom of an immediate-type allergy to NRL when wearing powdered examination or surgical gloves. During the late 1990s and early 2000s, several studies showed that recommendations to use powder-free and low-allergen gloves as preventive measures led to successful secondary and primary prevention of NRL-allergy. By the mid-2000s, there was a steady decline of new cases, and in most Western countries, there are only few new cases in the health care community. There have also been reported cases in other professions using powdered NRL-gloves like food handlers and security screeners, but the epidemic among health care workers is history. Cave: Patients who have been diagnosed with type-I NRL-allergy might have a lifelong risk of developing an anaphylactic shock when being exposed to NRL-containing devices such as gloves during diagnostic or therapeutic medical, surgical or dental procedures. Negative skin-prick-tests and negative specific IgEantibodies to NRL-allergens do not rule out a relevant sensitization to NRL.