Latex Allergy Treatments
The third, most serious, and least common syndrome is immediate (type I)
hypersensitivity. It is mediated by an immunoglobulin E (IgE) response specific
for latex proteins. As noted, latex proteins are highly allergenic, and they
are variable between lots from different plantations, factories, and
manufacturers. Cross-linking of IgE molecules on mast cell and basophil cell
membranes by latex protein allergens triggers the release of histamine and
other mediators of the systemic allergic cascade in sensitized individuals.
Exposure can occur following skin, mucous membrane, or visceral/peritoneal
contact. It also can follow inhalation of latex-laden particles or bloodstream
exposure to soluble latex proteins following intravascular access procedures.
Powdered latex examination gloves have been the most frequent source of
sensitization in adults, causing cutaneous and inhalational exposures.
(Fortunately, their use is decreasing as many hospitals move toward
powder-free, "low-allergen," or nonlatex glove products.)
Sensitization is more common in atopic individuals. Symptoms generally begin
within minutes of exposure. The spectrum of clinical manifestations includes
localized or generalized urticaria, rhinitis, conjunctivitis, bronchospasm,
laryngospasm, hypotension, and full-blown anaphylaxis. Type I allergy has been
implicated clearly in intraoperative and intraprocedure anaphylaxis, and it can
be fatal without emergent treatment.
In the US: Latex allergy is present in 1-5% of the general
population, with an increased prevalence in atopic individuals. Latex allergy
is increased in populations with chronic occupational exposure to latex. It is
found in 2-17% of HCWs and in at least 10% of rubber industry workers. Symptoms
of latex allergy have been described in 14% of a group of EMS providers and in
54% of a pediatric ED staff. Atopy raises the risk of occupational
The highest prevalence of latex allergy (20-68%) is found in patients with
spina bifida or congenital urogenital abnormalities. Sensitization in these
patients apparently follows multiple urinary tract, rectal, and thecal
procedures, as well as multiple surgeries during early childhood. Patients with
spina bifida also may have a genetic predisposition for latex sensitization.
Patients with spina bifida and human leukocyte antigen (HLA) alleles DRB and
DQB1 were more likely to have a specific IgE response to a common latex
antigen. Again, within this risk group, atopic children are at increased
Other patients with a history of multiple surgeries or other latex-exposing
procedures are also at increased risk relative to the general population.
Patients with cerebral palsy, mental retardation, or quadriplegia also appear
to have increased risk of latex allergy, probably because of repeated medical
Finally, the prevalence of latex allergy is increased in persons with
allergies to avocado, banana, chestnut, kiwi, papaya, peach, or nectarine.
Cross-reacting antigens have been found between these tropical fruits and
Internationally: The risk patterns described above are
similar in other developed countries. One study from Germany suggests that the
incidence of type I latex allergy has risen faster recently among HCWs than
Type IV hypersensitivity, possibly due to recent manufacturing changes that
lessen exposure to accelerators but not to latex proteins. Workers with
occupational exposure during harvesting and/or processing latex in developing
countries where H brasiliensis is grown have an increased risk
relative to the general populations.