LATEX ALLERGIES
Latex, the sap of the Hevea brasiliensis tree, has been used in the
manufacture of medical equipment since 1888 when the first surgical rubber
gloves were manufactured. The possibility of
severe latex (natural rubber) allergy in individuals with spina bifida was
first raised in 1989. Since that time research studies have shown that
between 18 and 73% of children and adolescents with spina bifida are
sensitive to latex as measured by history or blood test. The type of
allergic reaction experienced can range from watery and itchy eyes and/or
sneezing and coughing, to hives (a blotchy, raised, itchy, rash) to
swelling of the trachea (windpipe) and even to life-threatening changes in
blood pressure and circulation (anaphylactic shock).
Although the cause of rubber allergy in
individuals with spina bifida is not known, it is theorized that
sensitization may occur from the early, intense, and constant exposure to
rubber products through multiple surgeries, diagnostic tests and
examinations, also from bladder and bowel programs.
Exposure to latex can occur when products containing rubber come in
contact with a person's skin or mucous membranes such as the mouth, eyes,
genitals, bladder or rectum. Serious reactions can also occur when latex
enters the bloodstream. Some cases of severe reaction following injection
of medication through latex stoppers, IV ports or syringes have been
reported. In addition, the powder from balloons or gloves can absorb
particles and become airborne causing reactions when breathed by a latex
sensitive person. Food that has been handled by latex gloves may also
cause a reaction, and people who have allergic reactions to latex may also
be allergic to certain foods, including bananas, chestnuts, avocados and
kiwi fruit.
Although a lot has been learned about
rubber allergy in the last few years, the problem is really just beginning
to be studied and understood. Interestingly, health care workers such as
nurses, doctors, and dentists, individuals born with severe bladder
abnormalities, and some people who have had multiple surgical procedures
are also at increased risk for rubber allergy although their risk is much
lower than it is for individuals with spina bifida.
The Food and Drug Administration and the
Centers for Disease Control are investigating the problem of rubber
allergy and current efforts are aimed at finding the component(s) of latex
responsible for causing this allergy, developing methods of producing
"safe", non allergy causing rubber, and labeling products indicating
natural rubber (latex) content.
Since the story of rubber allergy is just
beginning, and, without a doubt new understanding will emerge over the
next several years, recommendations made now may need to be revised.
Because of the life-threatening nature of this allergy a list of current
recommendations is included. Individuals with spina bifida and their
families are urged to consider the following recommendations and to
discuss them with members of their health care team.
1) All individuals with spina bifida
should be considered at high risk for having an allergic reaction to
rubber and should avoid contact with rubber products, particularly
during medical or surgical procedures. Only non-latex gloves and
catheters should be used. Alternative products, usually made of
silicone, plastic or vinyl, can be safely substituted.
Individuals who have experienced allergic reactions during surgical or
medical procedures should consider wearing a medic-alert bracelet or
necklace, carrying auto-injectable epinephrine and sterile non-latex
gloves for emergency use, and discussing latex allergy with all health
care and community providers including school, day care and camp. In
addition, consultation with an allergist familiar with the problem is
recommended to fully evaluate the risks and the possible need for
preoperative treatment with special medications to suppress the
potential for severe allergic reaction. Avoidance of all
latex-containing items, especially in the operating room, is strongly
recommended.
The following commonly encountered items may contain latex and pose a
risk to the latex sensitive individual: Healthcare items which may
contain latex: gloves, catheters, tourniquets, elastic bandages, ace
wraps, I.V. tubing injection ports, medication vials, adhesive tape,
bandaids.
2) Home/community items which may contain latex: balloons, pacifiers,
dental dams, rubber bands, elastic in clothing, beach toys, Koosh balls,
baby bottle nipples, condoms, diaphragms, diapers, art supplies.
*Please note that this is only a partial list and it is strongly
recommended that individuals with spina bifida and their families ask
about the composition of products used in their care. A more complete list
is available upon request from the Spina Bifida Association of America.
Catherine Shaer, M.D.,
Director Spina Bifida Program
Children's National Medical Center
Washington DC
Elli Meeropol, R.N., M.S.
Clinical Nurse Specialist
Shriners Hospital
Springfield MA
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Copyright © 2000 Spina Bifida Association of America. All rights reserved.
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