Latex Allergy

Aka: Latex Allergy, Latex Hypersensitivity, Rubber Sensitivity

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II. Epidemiology

  1. Health care personnel: 5-10%
  2. Asymptomatic Latex Allergy: 50%

III. Causes

  1. Reaction to Natural Rubber Latex

IV. Types

  1. Irritant Contact Dermatitis (non-immunologic)
  2. Delayed Hypersensitivity (Type IV) or Allergic Contact Dermatitis
  3. Immediate Hypersensitivity (Type I): Urticaria, Angioedema, Anaphylaxis

V. Risk Factors

  1. Neural Tube Defects
  2. Occupational exposure (e.g. healthcare workers)
  3. Atopic Dermatitis (RR 4)
  4. History of Hand Dermatitis (allows latex penetration)
  5. Food allergies with cross-reactivity to Natural Rubber Latex
  6. Multiple surgery history
    1. Each successive surgery increases overall risk
      1. In Neural Tube Defect history, each surgery increases increases Latex Allergy risk by 13 fold
    2. Latex is the most common cause of Anaphylaxis during surgery
      1. Child: Anaphylaxis occurs in 0.01% of pediatric surgeries and latex accounts for 76% of triggers
      2. Adult: Anaphylaxis occurring in adult surgeries is triggered by Latex Allergy in up to 40% of cases

VI. Symptoms

  1. Irritant Contact Dermatitis (non-immunologic)
    1. Stinging or burning
    2. Pruritus
    3. Skin fissuring
  2. Delayed Hypersensitivity (Type IV) or Allergic Contact Dermatitis (occurs 24-48h after exposure)
    1. Local erythematous rash in contact with latex
    2. Pruritus
    3. Swelling
    4. Blistering, weeping, or crusting
  3. Immediate Hypersensitivity (Type I) with potentially life-threatening systemic Hypersensitivity
    1. Occurs with skin, mucosal or even airborne contact
    2. Generalized Rash
    3. Urticaria
    4. Pruritus
    5. Eye and nose irritation
      1. Allergic Rhinitis type symptoms
    6. Throat swelling
    7. Respiratory symptoms
      1. Wheezing
      2. Shortness of Breath
      3. Chest tightness
    8. Palpitations
    9. Anaphylaxis

VII. Associated Conditions

  1. See Food Allergy (Banana, Kiwi, Avocado)
  2. See Natural Rubber Latex

VIII. Diagnosis

  1. Skin Prick Testing for Latex Allergy
    1. Available in Europe but not in the United States
    2. Would be a first-line test if available in the United States
  2. Serum IgE levels
    1. Variable efficacy
  3. Glove provocative test (glove challenge test)
    1. Progressive exposure every 15 minutes to each finger of a glove and ultimately the entire hand
    2. Negative test for Latex Allergy if the entire glove can be worn for 15 minutes without reaction
    3. Test has variable efficacy and there is a risk of Anaphylaxis
  4. Skin Patch Testing
    1. Indicated for Type IV Delayed Hypersensitivity Reaction
    2. Skin rechecked at 30 minutes, 24 hours and 48 hours after patch application

IX. Management

  1. Avoid further Natural Rubber Latex exposure
  2. Mild Latex Allergy (Contact Dermatitis)
    1. Avoid common latex exposures (e.g. latex gloves)
  3. Severe Latex Allergy (systemic reaction, Anaphylaxis)
    1. Avoid all latex exposure
      1. Rubber latex vial stoppers (venipuncture tubes) or syringe plungers
        1. Only insert needle through stopper once
      2. Medications with latex in Vaccine packaging
        1. https://www.cdc.gov/vaccines/pubs/pinkbook/downloads/appendices/B/latex-table.pdf
    2. Medic alert bracelet
    3. Epinephrine self-injection pen (e.g. EpiPen)

X. Prevention

  1. Avoid the use of Natural Rubber Latex gloves
    1. Use powder free latex gloves if not possible to eliminate latex gloves from facility
  2. Systemic Hypersensitivity has very serious implications
    1. Requires avoidance of healthcare setting
    2. Career change may be indicated for healthcare worker
  3. Health care institutions should strongly consider limiting latex products in their facilities (especially latex gloves)
    1. Evidence exists for cost savings in switching to non-latex gloves
    2. LaMontagne (2006) Occup Environ Med 63(5): 359-64 [PubMed]
    3. Tarlo (2001) J Allergy Clin Immunol 108(4): 628-33 [PubMed]
  4. Use alternatives to latex gloves (Dr Moses' favorites):
    1. Nitrile Powder Free gloves (non-sterile)
    2. Sterile gloves
      1. Duraprene for procedures not requiring signficant tactile Sensation (e.g. dermatologic procedures)
      2. Regent Medical - Biogel Neotech for procedures requiring tactile Sensation (e.g. Vasectomy)

XI. References

  1. Pollart (2009) Am Fam Physician 80(12): 1413-20 [PubMed]
  2. Taylor (2004) Dematol Ther 17(4): 289-301 [PubMed]
  3. Nettis (2002) Clin Exp Allergy 32(3): 441-7 [PubMed]

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Related Studies

Ontology: Latex allergy (C0577628)

Definition (MEDLINEPLUS)

Latex is a milky fluid that comes from the tropical rubber tree. Hundreds of everyday products contain latex. Repeated exposure to a protein in natural latex can make you more likely to develop a latex allergy. If your immune system detects the protein, a reaction can start in minutes. You could get a rash, asthma and in rare cases shock from latex exposure.

Your doctor may use a physical exam and skin and blood tests to diagnose it. There are medicines to treat a reaction, but it is best to try to avoid latex. Common latex products include

  • Gloves
  • Condoms
  • Balloons
  • Rubber bands
  • Shoe soles
  • Pacifiers

You can find latex-free versions of these products.
Definition (MSH) Allergic reaction to products containing processed natural rubber latex such as rubber gloves, condoms, catheters, dental dams, balloons, and sporting equipment. Both T-cell mediated (HYPERSENSITIVITY, DELAYED) and IgE antibody-mediated (HYPERSENSITIVITY, IMMEDIATE) allergic responses are possible. Delayed hypersensitivity results from exposure to antioxidants present in the rubber; immediate hypersensitivity results from exposure to a latex protein.
Concepts Pathologic Function (T046)
MSH D020315
SnomedCT 213000008, 300916003, 419412007
Spanish alergia a la goma, alergia al caucho (trastorno), alergia al caucho, Alergia al látex, alergia al látex (trastorno), alergia al látex, Alergia a la Goma, Alergia al Látex, Hipersensibilidad al Látex
Swedish Latexallergi
English Latex allergy, Allergies, Latex, Allergy, Latex, Latex Allergies, Latex Allergy, Natural Rubber Latex Allergy, Allergies, Rubber Latex, Allergy, Rubber Latex, Rubber Latex Allergies, Rubber Latex Allergy, Allergies, Rubber, Allergy, Rubber, Rubber Allergies, Rubber Allergy, Hypersensitivities, Latex, Hypersensitivity, Latex, Latex Hypersensitivities, Latex Hypersensitivity, Latex Hypersensitivity [Disease/Finding], latex sensitivity, rubber allergies, latex hypersensitivity, latex allergies, latex allergy, Latex allergy (disorder), rubber allergy, Allergy to rubber (disorder), Allergy to rubber
Czech alergie na gumu, přecitlivělost ke kaučuku, alergie na latex, latex - hypersenzitivita, Alergie na latex
Finnish Lateksiyliherkkyys
Russian LATEKS, GIPERSENSIBILIZATSIIA, REZINA, GIPERSENSIBILIZATSIIA, ALLERGIIA K LATEKSU, АЛЛЕРГИЯ К ЛАТЕКСУ, ЛАТЕКС, ГИПЕРСЕНСИБИЛИЗАЦИЯ, РЕЗИНА, ГИПЕРСЕНСИБИЛИЗАЦИЯ
Italian Allergia al lattice di gomma, Allergia alla gomma, Allergia al lattice di gomma naturale, Allergia al lattice, Ipersensibilità al lattice
Polish Alergia na gumę, Nadwrażliwość na lateks, Alergia lateksowa, Alergia na lateks
Japanese ラテックスアレルギー, アレルギー-ラテックス, ﾗﾃｯｸｽｱﾚﾙｷﾞｰ, ゴムアレルギー, ラテックス過敏症, ラバーアレルギー, 過敏症-ラテックス
Dutch allergie voor latex, Allergie, latex-, Latexallergie, Overgevoeligheid voor latex, Rubberallergie, Overgevoeligheid, latex-
German Latexallergie, Gummi-Allergie, Latex-Allergie, Allergie, Latex-, Hypersensitivität, Latex-, Latex-Hypersensitivität
Hungarian Latexallergia
Portuguese Alergia ao latex, Alergia à Borracha, Alergia ao Látex, Hipersensibilidade ao Látex
Norwegian Gummiallergi, Lateks hypersensitivitet, Lateksalleregi, Hypersensitivitet, gummi, Lateks overfølsomhet
French Allergie au latex, Allergie au caoutchouc, Hypersensibilité au caoutchouc, Hypersensibilité au latex
Derived from the NIH UMLS (Unified Medical Language System)

Ontology: Rubber sensitivity (C0856604)

Concepts Disease or Syndrome (T047)
English Rubber sensitivity
Czech Přecitlivělost na gumu
Dutch rubbergevoeligheid
French Sensibilité au caoutchouc
German Gummi Empfindlichkeit
Hungarian Latextúlérzékenység
Italian Sensibilità alla gomma
Japanese ゴム過敏症, ｺﾞﾑｶﾋﾞﾝｼｮｳ
Portuguese Sensibilidade ao látex
Spanish Sensibilidad al caucho
Derived from the NIH UMLS (Unified Medical Language System)

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