Latex allergy - information for patients

What is latex?

Natural rubber latex is produced from the sap (liquid) of tropical rubber trees. This liquid is processed to make many household, industrial and medical rubber products.

Medical products containing latex include gloves, some urinary catheters, tourniquets and equipment for resuscitation. Non-latex substitutes can be found for all of these latex-containing items and increasingly, non-latex products are used, for example urinary catheters are now usually non-latex.

How does a latex allergy develop?

Latex allergy usually develops in people who have other allergies and who are exposed to latex regularly, often in the course of their work.

What is latex allergy?

There are two types of sensitivity to latex rubber. It is very important to distinguish these as the implications are different.

Type 1: This is a reaction to the sap (rubber) proteins due to IgE antibody (true latex allergy).

The symptoms are:

On contact with latex goods, symptoms appear quickly. They vary from mild to more severe and include:

• Itching and a rash (urticaria or hives) and / or swelling (angioedema).
• Watery and inflamed nose and eyes (rhinitis or conjunctivitis).
• Chest tightness and shortness of breath – in highly sensitive individuals.

In a small number of cases, anaphylaxis (a severe reaction) may occur; this may cause a fall in blood pressure, shock and severe difficulty breathing.

Type 4 Reactions are known as rubber dermatitis: this is a reaction to chemicals such as thiurams or carbamates used in the production of rubber goods. This causes contact dermatitis (rash or inflammation) and is different from latex allergy.

The symptoms are:

After prolonged contact the skin may become itchy, red and inflamed and start to blister or scale, similar to eczema. The reaction requires longer exposure than type 1 reaction and begins hours after contact, reaching a maximum after 24 - 48 hours and then subsiding. This does not produce an immediate reaction; and the reaction only occurs locally at the site of contact with rubber. It is usually mild and is not potentially dangerous.

Food allergies

About half of those with a type 1 latex allergy also have a food allergy. The most common allergies are to fruits eg bananas, kiwifruit or avocado, although other fruits and vegetables can cause allergic reactions. You do not need to avoid fruits and vegetables unless you have had an allergic reaction to them.

Avoiding latex

Latex can usually be avoided successfully. Below are a few examples. More detailed lists of latex goods and alternatives are available via web sites (see further information).

1. Avoid contact with latex. Note: if you have a mild allergy, brief exposure may cause no symptoms.
2. Some latex gloves are coated with cornstarch powder, the latex protein particles binds to the cornstarch producing an aerosol which can be inhaled. This mainly applies to healthcare and laboratory workers. This problem does not occur with powder-free latex gloves.
3. Medical and surgical procedures pose a high risk of exposure to latex; for example, during surgery, dental work or vaginal examinations such as smear tests or in labour. The highest risk is from contact with surfaces that allow more absorption of latex such as inside the mouth or vagina, and inside the body during surgery. You should inform the medical staff that you have latex allergy and the type of reactions you have had. The procedure can be performed under latex-free conditions. Latex free conditions are not always required for patients with rubber dermatitis but prolonged rubber contact should be avoided.
4. Rubber goods come in two different forms – the risk of each is different. In daily life thin stretchy rubber goods, for example, gloves, condoms, diaphragms and balloons as well as liquid latex, such as glues pose more of a risk than hard rubber goods such as hot water bottles or tyres, which may not cause symptoms.

Gloves

Latex sensitive individuals should never wear latex gloves. If the task is non-sterile, short in duration and does not lead to twisting or stretching of the glove, then vinyl non-sterile or nitrile gloves are a suitable alternative. For tasks that are more prolonged, complex or for sterile work you should wear nitrile gloves. For very complex procedures requiring fine dexterity, neoprene is the glove of choice.

As described above, exposure can occur from the air if powdered latex gloves are worn by others. Highly sensitive individuals should work only in an environment where non-powdered latex gloves are worn.

Gloves marked as ‘hypoallergenic’ still contain latex. Latex allergic individuals should not use them. For patients who have contact dermatitis, nitrile or vinyl gloves are usually suitable.

Treatment

This will depend on the severity, which varies widely. The majority of patients only suffer from a mild allergy.

Treatment with an oral antihistamine, for example, cetirizine or fexofenadine will be sufficient for most allergic reactions. Antihistamines are drugs which block the action of histamine, thus preventing or alleviating the major symptoms of an allergic response.

Patients with severe reactions are usually given an adrenaline (epinephrine) pen, for example, Jext or Epipen. You will be given more details about this if this is appropriate for you.

A letter stating you have latex allergy will be provided and must be shown to medical staff prior to any treatment in hospital, at your GP’s surgery or dentist. A Medic-Alert emblem to identify that you have latex allergy is also recommended.

Further information

• Health and Safety Executive - Latex allergies in health and social care (opens in a new tab)
• Anaphylaxis Campaign Medic-Alert (opens in a new tab)
  Telephone: 01252 542029 (helpline)
  Email Medic-Alert