The prevalence of anti-latex IgE antibodies among registered nurses

doi:10.1016/S0091-6749(96)70087-8

Journal of Allergy and Clinical Immunology

Volume 98, Issue 3, September 1996, Pages 535-544

https://doi.org/10.1016/S0091-6749(96)70087-8 Get rights and content

Abstract

BACKGROUND: Recent studies have reported that the prevalence of latex allergy among volunteer populations of health care workers ranges from 2% to 25%. To date, no epidemiologic study has investigated the prevalence of latex allergy and its relationship to possible risk factors among nurses. METHODS: Registered nurses (n = 741) in a large metropolitan hospital participated in a latex allergy prevalence study. Latex exposure data were obtained through self-administered questionnaires. Blood samples were classified as positive or negative for anti-latex IgE antibodies. Associations between potential risk factors for latex allergy and anti-latex antibodies were assessed. RESULTS: The participation rate was 90.6% among eligible nurses. Sixty-five samples were positive for a prevalence of 8.9% (95% confidence interval, 6.7 to 10.8). No differences in latex positivity among five nursing specialties were noted. Logistic regression indicated that after adjusting for age and sex, the following factors were significantly associated with latex seropositivity: nonwhite race (odds ratio [OR] = 4.2), reported histories of penicillin allergy (OR = 2.2), pruritic skin (OR = 2.2), conjunctivitis (OR = 3.0), localized urticaria (OR = 1.8), hay fever (OR = 2.1), avocado allergy (OR = 9.9), and ragweed allergy (OR = 3.4). CONCLUSIONS: The prevalence of latex sensitization appeared to be substantial (8.9%) among the nurses studied, and the prevalence did not vary by nursing specialty. The factors associated with latex positivity in the logistic regression model correctly classified 81.3% of the nurses with a sensitivity and specificity of 66.7% and 82.7%, respectively. (J ALLERGY CLIN IMMUNOL 1996;98:535-44.)

Section snippets

Subjects

The Latex Study among Registered Nurses is a cross-sectional study of the seroprevalence of anti-latex IgE antibodies undertaken at Henry Ford Hospital (HFH), Detroit, Michigan, among staff nurses working in the patient care delivery units. Names and demographic information for the population were provided by the hospital personnel department. Invitation letters to participate were mailed on July 7, 1993 via United States mail to all staff registered nurses (n = 945), employed as of May 5, 1993

Study population

Of the initial population selected for the study (n = 945), 818 nurses (86.6%) were eligible to participate. Reasons for being considered ineligible included termination of employment (n = 82), leave of absence (n = 33), a non-latex-related death (n = 1) after starting enrollment, and job title misclassification (n = 11). During the 4-month enrollment period, 741 nurses enrolled in the study for an overall participation rate of 90.6%. No difference in participation rate by nursing specialty was

DISCUSSION

The prevalence of anti-latex IgE antibodies was 8.9% in the 741 registered nurses studied. This prevalence is consistent with previous reports of 2.2% to 15.4% prevalence of latex sensitivity among nurses.4, 5, 6, 7, 8, 9 The factors that were most closely associated with the presence of anti-latex IgE were nonwhite race; self-reported allergy to penicillin; pruritus, conjunctivitis, and localized urticaria on latex exposure; a history of hay fever; and allergies to avocado or ragweed.

Contrary

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Type I Hevea brasiliensis rubber latex allergy is managed by avoidance, using synthetic and alternative latex (such as Parthenium argentatum, guayule) products. This study investigates the ability of high-dose occupational exposure to guayule shrub/homogenate/latex to induce guayule-specific antibody responses in employees (Yulex Corporation). Participants completed an allergy history/guayule exposure questionnaire and provided annual blood samples from 2006 to 2008. Sera were analyzed for IgG and IgE anti-guayule (protein from homogenate, commercial-grade latex and non-ammoniated total plant proteins) using solid phase immunoassays (negative = IgG < 1 μg/ml, IgE < 1 ng/ml). Guayule-specific IgG antibody (range: 2.0–9.7 μg/ml) was detected in 3 of 16 (19%) highly exposed employees in the pilot plant and R&D/applications laboratory. Antibody levels related to relative cumulative-years (e.g. >3) of reported guayule homogenate/latex exposure. Equivocal IgG antibody responses (1.0–2.0 μg/ml) were detected in 2 of 5 (40%) of administrators with infrequent guayule homogenate/latex contact. No guayule-specific IgE antibody or guayule-associated allergic reactions were detected. We conclude that protein from guayule and in guayule latex can be immunogenic but not allergenic in occupationally exposed workers.
Latex allergy, a special risk for patients of otorhinolaryngology and head and neck surgery?
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A total of 206 patients of the otorhinolaryngology (ORL) department and 204 of the visceral surgery department of the Ludwig Maximilians University of Munich were preoperatively evaluated for latex-specific sensitization. A prick test, a questionnaire, and an enzyme-linked immunosorbent assay immunoprecipitation for IgE antibodies were performed. Latex is a widely spread allergen, and it does not only concern healthcare populations. Within the ORL surgery group, 43 (20.9%) patients were sensitized against latex allergen, and 2 of them were reported to manifest symptoms in consorting with latex. In the cohort of visceral surgery patients, we detected only 23 patients (11.3%) with sensitization against latex. Moreover, most patients were positively detected with the skin prick test (86.4%), whereas the enzyme-linked immunosorbent assay method was less sensitive (18.3%). Patients of the ORL department were considerably more frequently exposed to latex protein particles than patients of the visceral surgery department. This difference attributes to their significant difference in mean age: 44 years in the ORL patients group versus 58 years in the visceral patients cohort. Furthermore, we did not find any correlation to the number of past operations—although undergoing any surgical procedures is a well-known risk factor in other studies about latex sensitization in surgical patients.
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Citation Excerpt :
The results were then summarized by using the Breslow-Day heterogeneity test.11 The rate of sensitization and clinical allergy to NRL among HCWs and the general population is presented in Table I.12-67 The data of all of these studies are detailed in Tables E1 and E2 found in the Online Repository at www.jacionline.org.
Natural rubber latex is a recognized allergen, but a recent meta-analysis failed to find any association between latex exposure and allergy in health care workers (HCWs).
A meta-analysis was carried out under the auspices of the French National Regulatory Authority to assess the allergic risk induced by latex gloves in HCWs.
The risk of work-related exposure to latex for the development of latex allergy was assessed. Prevalence and incidence rates of latex sensitization or allergy were compared in HCWs and in the general population. Exposure-response relationships were assessed in HCWs.
Latex allergy was found in 4.32% (range, 4.01% to 4.63%) of HCWs and in 1.37% (range, 0.43% to 2.31%) of the general population. Latex-positive skin prick test responses ranged from 2.1% to 3.7% in the general population and from 6.9% to 7.8% for the HCWs. HCWs exposed to latex showed an increased risk of hand dermatitis (odds ratio [OR], 2.46; 95% CI, 2.11-2.86), asthma or wheezing (OR, 1.55; 95% CI, 1.15-2.08), rhinoconjunctivitis (OR, 2.73; 95% CI, 1.97-3.81), and at least one generic symptom (OR, 1.27; 95% CI, 1.09-1.47). Sensitization to latex was significantly associated with asthma and rhinoconjunctivitis. By contrast, exposure to latex was not associated with a significantly increased risk of positive skin prick test responses to latex (OR, 1.47; 95% CI, 0.94-2.30).
HCWs have an increased risk of sensitization and allergic symptoms to latex.
Prevention of latex allergy in HCWs is needed.
The benefits of latex-free gloves in the operating room environment
2020, British Journal of Nursing
Latex allergy in clinical practice: An overview
2019, Indian Journal of Public Health Research and Development
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^☆: From ^aDivision of Biostatistics, Research Epidemiology and Computing, Henry Ford Health Sciences Center, Detroit; ^bDepartment of Emergency Medicine, Henry Ford Hospital, Detroit; ^cAllergy Research Laboratory, Henry Ford Hospital, Detroit; ^dDepartment of Epidemiology, University of Michigan School of Public Health, Ann Arbor; and ^e Department of Biostatistics, University of Michigan School of Public Health, Ann Arbor.

^☆☆: Supported by a grant from the Baxter Health Care Corporation.

^★: Reprint requests: Mary Grzybowski, PhD, Department of Emergency Medicine, Henry Ford Hospital, 2799 West Grand Blvd., Detroit, MI 48202-2608.

^★★: 0091-6749/96 $5.00 + 0 1/1/73108

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The prevalence of anti-latex IgE antibodies among registered nurses☆,☆☆,★,★★

Abstract

Section snippets

Subjects

Study population

DISCUSSION

Rev Fr Allergol

J Clin Immunol

J ALLERGY CLIN IMMUNOL

Lancet

J ALLERGY CLIN IMMUNOL

J ALLERGY CLIN IMMUNOL

J ALLERGY CLIN IMMUNOL

Contact urticaria to rubber

Br J Dermatol

Recommendations for prevention of HIV transmission in health-care settings

MMWR Morb Mortal Wkly Rep

Anaphylaxis associated with latex allergy during barium enema examinations

AJR Am J Roentgenol

Incidence of immediate allergy to latex gloves in hospital personnel

Contact Dermatitis

Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves

Anesthesiology

Prevalence of latex allergy in high risk medical personnel

J ALLERGY CLIN IMMUNOL

Latex allergy in hospital employees

Ann Allergy