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Allergen: A substance that triggers an allergic reaction.

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Allergic Rhinitis: An allergy affecting the mucus membrane of the nose. Seasonal allergic rhinitis is often called "hay fever."

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Allergist: A doctor that diagnoses, treats, and manages allergy-related conditions.

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Ana-Kit: A device used to inject epinephrine during an anaphylaxis attack.

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Anaphylaxis: A life-threatening allergic reaction that involves the entire body. Anaphylaxis may result in shock or death, and thus requires immediate medical attention

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Animal dander: The small scales or pieces of skin, often containing proteins secreted by oil glands, which are shed by an animal. These proteins are the major causes of allergies to pets.

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Antibiotics: A class of medications used to treat bacterial infections. Certain antibiotics, such as penicillin, may cause an allergic reaction in some people.

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Antibody: A protein in the immune system that recognizes and attacks foreign substances in the body.

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Anticonvulsant: A medication used to prevent or treat seizures. Certain anticonvulsants may cause an allergic reaction in some people.

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Antihistamines: A class of medications used to block the action of histamines in the body and prevent the symptoms of an allergic reaction.

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Asthma: An inflammatory disorder of the airways, causing periodic attacks of wheezing, coughing, chest tightness, and shortness of breath.

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Atopic dermatitis: A chronic skin rash, also known as "eczema," that often appears in the first few years of life.

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Basophil: An immune system cell that attaches to antibodies and circulates through out the blood.

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Beta-blockers: A class of blood pressure medications that ease the heart's pumping action and widen the blood vessels. Beta-blockers counteract the effects of epinephrine used for emergency treatment of anaphylactic shock and should not be used during immunotherapy.

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Bronchial tubes: The lower sections of the airway that lead into the lungs.

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Challenge test: A test used to confirm an allergy to specific substance. A doctor will administer small but increasing amounts of a suspected allergen until an allergic response is noticed. Due to the risk of anaphylaxis, this should only be performed under a controlled setting.

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Conjunctivitis: Inflammation of the conjunctiva, or the mucous membrane surrounding the eye. Also known as pinkeye.

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Contact dermatitis: An allergic reaction resulting from skin contact to an allergen.

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Corticosteroid: An anti-inflammatory medication used to treat the itching and swelling associated with some allergic reactions.

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Cromolym sodium: An anti-inflammatory nasal spray used to treat and sometimes prevent allergic rhinitis.

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Decongestants: A class of medications used for nasal congestion. Decongestants are available in oral doses, nasal sprays, or eye drops (for conjunctivitis).

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Dust mites: A microscopic organism that lives in dust.

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Eczema: See Atopic dermatitis.

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Eosinophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Epinepherine: A medication used for immediate treatment of anaphylaxis by raising blood pressure and heart rate back to normal levels. Epinepherine is also known as adrenaline.

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EpiPen: A device used to inject epinephrine during an anaphylaxis attack.

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Heparin: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Histamine: A chemical released by basophils and mast cells that causes nearby tissues to become swollen and inflamed.

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Hives: See urticaria.

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Hypertension: High blood pressure. When blood pushes against artery walls harder than normal.

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Immunoglobulin E: A type of antibody responsible for most allergic reactions.

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Immunotherapy: A series of shots that help build up the immune system's tolerance to an allergen.

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Insulin: A hormone that regulates blood sugar levels. Diabetics who take insulin derived from animals may have allergic reactions.

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Intradermal test: A test where an allergen is injected just underneath the skin. Intradermal tests are generally used when results from a skin prick test are unclear.

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Late Phase: The period 4 - 24 hours after exposure to an allergen where tissue damage may occur.

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Leukotrienes: Inflammatory substances that are released by mast cells during an allergic response or asthma attack.

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Lymphocyte: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Mast cell: An immune system cell which attaches to antibodies and is located in the tissue that lines the nose, bronchial tubes, gastrointestinal tract, and the skin

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Neocromil sodium: An inhaled medication used to treat inflammation involved with asthma.

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Neutrophil: A specific type of immune cell that can cause tissue damage in the late phase of an allergic reaction.

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Otitis media: A middle ear infection. Otitis media with effusion occurs when fluid builds up within the ear.

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Radioallergosorbant Test (RAST): A blood test that measures the amount of IgE antibody produced when the sample is mixed with a specific allergen.

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Rhinitis: An inflammation of the nasal passageways, particularly with discharge.

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Sinusitis: An inflammation or infection of one or more sinuses. The sinuses are hollow air spaces located around the nose and eyes.

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Skin prick test: A test where a needle is used to scratch the skin with a small amount of allergen. A response can usually be seen within 15 - 20 minutes.

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Urticaria: Raised areas of the skin that are often red, warm, and itchy. Urticaria is also known as hives.

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Urushiol: An oil found on poison ivy, oak, and sumac.

Latex products are manufactured from a milky fluid derived from the rubber tree, Hevea brasiliensis. Several chemicals are added to this fluid during the processing and manufacture of commercial latex. Some proteins in latex can cause a range of mild to severe allergic reactions. Currently available methods of measurement do not provide easy or consistent identification of allergy-causing proteins (antigens) and their concentrations.

Until well-accepted standardized tests are available, total protein serves as a useful indicator of the exposure of concern. The chemicals added during processing may also cause skin rashes. Several types of synthetic rubber are also referred to as "latex," but these do not release the proteins that cause allergic reactions.

Products containing latex

A wide variety of products contain latex: medical supplies, personal protective equipment, and numerous household objects. Most people who encounter latex products only through their general use in society have no health problems from the use of these products. Workers who repeatedly use latex products are the focus of this alert. The following are examples of products that may contain latex:

Emergency equipment
Blood pressure cuffs
Stethoscopes
Disposable gloves
Oral and nasal airways
Endotracheal tubes
Tourniquets
Intravenous tubing
Syringes
Electrode pads
Protective supplies
Gloves
Surgical masks
Goggles
Dental dams
Rubber aprons
Office supplies
Rubber bands
Erasers
Hospital supplies
Anesthesia masks
Catheters
Wound drains
Injection ports
Rubber tops of multidose vials
Respirators
Household items
Automobile tires
Motorcycle and bicycle handgrips
Carpeting
Swimming goggles
Racquet handles
Shoe soles
Expandable fabric (waistbands)
Dishwashing gloves
Hot water bottles
Condoms
Diaphragms
Balloons
Pacifiers
Baby bottle nipples

Individuals who already have latex allergy should be aware of latex-containing products that may trigger an allergic reaction. Some of the listed products are available in latex-free forms.

Latex in the workplace

Workers in the health care industry (physicians, nurses, dentists, technicians, etc.) are at risk for developing latex allergy because they use latex gloves frequently. Also at risk are workers with less frequent glove use (hairdressers, housekeepers, food service workers, etc.) and workers in industries that manufacture latex products.

"It doesn't interfere too much in my life. I just have to remember to use vinyl gloves, and the hospital where I work doesn't mind if I order them."

-- Michael, age 21

Types of reactions to latex

Three types of reactions can occur in persons using latex products:

  • Irritant contact dermatitis
  • Allergic contact dermatitis (delayed hypersensitivity)
  • Latex allergy

Irritant contact dermatitis

The most common reaction to latex products is irritant contact dermatitis -- the development of dry, itchy, irritated areas on the skin, usually the hands. This reaction is caused by skin irritation from using gloves and possibly by exposure to other workplace products and chemicals. The reaction can also result from repeated hand washing and drying, incomplete hand drying, use of cleaners and sanitizers, and exposure to powders added to the gloves. Irritant contact dermatitis is not a true allergy.

Chemical sensitivity dermatitis

Allergic contact dermatitis (delayed hypersensitivity, also sometimes called chemical sensitivity dermatitis) results from exposure to chemicals added to latex during harvesting, processing, or manufacturing. These chemicals can cause skin reactions similar to those caused by poison ivy. As with poison ivy, the rash usually begins 24 - 48 hours after contact and may progress to oozing skin blisters or spread away from the area of skin touched by the latex.

Latex allergy

Latex allergy (immediate hypersensitivity) can be a more serious reaction to latex than irritant contact dermatitis or allergic contact dermatitis. Certain proteins in latex may cause sensitization (positive blood or skin test, with or without symptoms). Although the amount of exposure needed to cause sensitization or symptoms is not known, exposures at even very low levels can trigger allergic reactions in some sensitized individuals.

Reactions usually begin within minutes of exposure to latex, but they can occur hours later and can produce various symptoms. Mild reactions to latex involve skin redness, hives, or itching. More severe reactions may involve respiratory symptoms such as runny nose, sneezing, itchy eyes, scratchy throat, and asthma (difficult breathing, coughing spells, and wheezing). Rarely, shock may occur; but a life-threatening reaction is seldom the first sign of latex allergy. Such reactions are similar to those seen in some allergic persons after a bee sting.

Who is at risk?

Workers with ongoing latex exposure are at risk for developing latex allergy. Such workers include health care workers (physicians, nurses, aides, dentists, dental hygienists, operating room employees, laboratory technicians, and hospital housekeeping personnel) who frequently use latex gloves and other latex-containing medical supplies. Workers who use latex gloves less frequently (law enforcement personnel, ambulance attendants, funeral-home workers, fire fighters, painters, gardeners, food service workers, and housekeeping personnel) may also develop latex allergy. Workers in factories where latex products are manufactured or used can also be affected.

Atopic individuals (persons with a tendency to have multiple allergic conditions) are at increased risk for developing latex allergy. Latex allergy is also associated with allergies to certain foods especially avocado, potato, banana, tomato, chestnuts, kiwi fruit, and papaya. People with spina bifida are also at increased risk for latex allergy.

Diagnosing latex allergy

Latex allergy should be suspected in anyone who develops certain symptoms after latex exposure, including nasal, eye, or sinus irritation; hives; shortness of breath; coughing; wheezing; or unexplained shock. Any exposed worker who experiences these symptoms should be evaluated by a physician, since further exposure could result in a serious allergic reaction. A diagnosis is made by using the results of a medical history, physical examination, and tests.

Taking a complete medical history is the first step in diagnosing latex allergy. In addition, blood tests approved by the Food and Drug Administration (FDA) are available to detect latex antibodies. Other diagnostic tools include a standardized glove-use test or skin tests that involve scratching or pricking the skin through a drop of liquid containing latex proteins. A positive reaction is shown by itching, swelling or redness at the test site. However, no FDA-approved materials are yet available to use in skin testing for latex allergy. Skin testing and glove-use tests should be performed only at medical centers with staff who are experienced and equipped to handle severe reactions.

Testing is also available to diagnose allergic contact dermatitis. In this FDA-approved test, a special patch containing latex additives is applied to the skin and checked over several days. A positive reaction is shown by itching, redness, swelling, or blistering where the patch covered the skin.

Occasionally, tests may fail to confirm a worker who has a true allergy to latex, or tests may suggest latex allergy in a worker with no clinical symptoms. Therefore, test results must be evaluated by a knowledgeable physician.

Treating latex allergy

Once a worker becomes allergic to latex, special precautions are needed to prevent exposures during work as well as during medical or dental care. Certain medications may reduce the allergy symptoms, but complete latex avoidance (though quite difficult) is the most effective approach. Many facilities maintain latex-safe areas for affected patients and workers.

Created by the National Institute of Occupational Safety and Health. Illustration copyright A.D.A.M., Inc.

 

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Review Date: 4/4/2007

Reviewed By: Alan Greene, M.D., F.A.A.P., Department of Pediatrics, Packard Children's Hospital, Stanford University School of Medicine; Chief Medical Officer, A.D.A.M., Inc.


The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.

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