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Published on: June 4, 2017
A comparative analysis of latex allergy in the healthy versus high-risk pediatric population
K Faust1, C Shrewsbury, K Zaglaniczny
1Henry Ford Hospital/University of Detroit Mercy Graduate Program of Nurse Anesthesia, USA.
Insights
Natural latex sensitivity is more common in high-risk pediatric surgical patients (17.3%) compared to the general pediatric population (8.6%). A survey of risk factors did not predict latex sensitivity, highlighting the need for latex-reduced environments in at-risk children.
Area of Science:
- Allergy and Immunology
- Pediatric Surgery
- Epidemiology
Background:
- Increasing frequency of natural latex allergic reactions.
- Identified high-risk populations for latex sensitivity, including pediatric surgical patients.
- Previous research highlighted risk factors like spina bifida, bowel/bladder programs, atopy, and multiple surgeries.
Purpose of the Study:
- Determine the prevalence of latex sensitivity in healthy pediatric patients.
- Compare latex sensitivity incidence between healthy and high-risk pediatric populations.
- Assess if a survey of known risk factors predicts positive serum latex antibodies.
Main Methods:
- Prospective, descriptive correlational study.
- Convenience sample of 400 pediatric patients (ages 1-18).
- AlaSTAT latex allergy testing performed on all participants; risk stratification via survey.
Main Results:
- Latex sensitivity incidence was significantly higher in the high-risk group (17.3%) versus the general pediatric population (8.6%) (P = .01).
- The pre-study survey of risk factors was not predictive of positive serum latex antibodies.
- No significant difference in latex sensitivity was found between the healthy pediatric population and the low-risk group from the survey.
Conclusions:
- High-risk pediatric surgical patients exhibit a greater incidence of latex sensitivity.
- Preoperative screening questions about surgical history are crucial for identifying at-risk children.
- Implementing latex-reduced environments for children with repeated latex exposure is recommended to decrease reaction risk and sensitization.
Abstract:
Allergic or hypersensitivity reactions to natural latex have been reported with increasing frequency. Many specific populations have been identified as high risk for latex sensitivity. This research focused on the pediatric surgical population. Previous research had identified children with spina bifida, children requiring bowel or bladder programs, children with a history of atopy, and children with multiple surgical exposures as high risk. The purposes of this study were to identify the prevalence of latex sensitivity in the healthy pediatric population, to compare the incidence with that of an identified high-risk population, and to determine if a survey of known risk factors for latex sensitivity was predictive of positive serum latex antibody. This was a prospective, descriptive correlational study utilizing a convenience sample size of 400 pediatric patients aged 1 to 18 years, conducted at Henry Ford Hospital and Children's Hospital of Michigan. Children were identified as high or low risk from the survey results, and all had AlaSTAT latex allergy testing (Diagnostic Products Corporation, Los Angeles, Calif). The survey was not predictive for the positive serum latex antibody. The incidence of latex sensitivity was found to be greater in the high-risk group (17.3%) than in the general pediatric population (8.6%) using the chi 2 test (P = .01). Latex-reduced environments for children likely to have repeated latex exposure may decrease the risk of reaction and more importantly decrease sensitization for them. From an anesthetic standpoint, a fairly standard preoperative question is, "What are the number and types of surgeries a patient has undergone in the past?" This information can alert the healthcare worker to how much exposure the child has had and whether a latex-reduced environment might be required to avert a latex reaction.
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