Powdered latex gloves and latex allergy : from the potential risk to the solutions.

Latex allergy has become an increasing concern to patients andhealth professionals because of the overwhelming use of latexgloves (56 millions surgical gloves and 1 billion examinationgloves utilized in 2000) and latex devices. Health professionalsbeing sensitized to latex proteins in up to 17%, have become awareof this problem and develop strategies for reliable diagnosis,treatment and prevention.Latex is almost exclusively obtained from the tree Heveabrasiliensis (Euphorbiaceae family). Rubber is an importantindustrial and consumer product encountered in many householditems and medical devices. During the past decade, immediate-typeallergy to natural rubber latex proteins (latex allergy) has emergedas a serious health issue. Increasing numbers of cases have beenpublished and allergy to latex has become the second leading causeof anaphylaxis during anaesthesia. The characterization of latexallergens and cross reactive proteins has led to a better knowledgeof the disease. Major new insights involve both diagnosis andprevention measures.Frequent, prolonged wearing of natural rubber latex gloves,especially amongst physicians, nurses and health professionals, andworkers using rubber is a major risk factor for such sensitization.Moreover, natural rubber latex allergy is common in patients whohave had multiple surgical procedures or in those with spina bifida.The appropriate treatment for allergy remains the total eviction ofthe allergen, whatever it may be. In the case of latex allergens inhospitals for example, total avoidance of such a component seemsto be utopia. However, the avoidance of inhaled allergens by theexclusion of powdered latex gloves is a validated alternative. Thisis the method that we have chosen at the Montpellier UniversityHospital and demonstrated that simple latex prevention measures inthe workplace such as the replacement of powdered latex gloves bynon-powdered latex gloves for all health care workers and latex freegloves for latex allergic health care workers lead to symptom reliefand a dramatic decrease of latex specific IgE.