Hypersensitivity to latex in health care workers: report of five cases

Concern about transmission of acquired immunodeficiency syndrome and hepatitis has greatly increased the use of latex gloves. Latex allergy is a newly emerging problem with potential life-threatening sequelae among health care personnel. Patients are also at risk. We report on five cases of latex allergy in health care workers who were using latex gloves for variable lengths of time before their allergic reaction. All workers had a significant history of reactions to other allergens, including inhalants and food. Each individual had at least one systemic symptom that was directly attributed to latex exposure. Reactions to latex ranged from severe contact urticaria (all cases), bronchospasm (three cases), angioedema (two cases), and rhinorrhea (one case) to anaphylactic reactions that required immediate attention in three cases. Levels of specific IgE to latex (as measured by in vitro enzyme immunoassay) and total IgE were elevated in all five patients (total IgE > 100 kU/L). Long-term treatment included avoidance of latex, administration of antihistamines, and desensitization to other, nonlatex allergens. Health care workers should have increased awareness of latex allergy. At risk are health care workers with a history of other allergies and those with atopic dermatitis or eczema. In vitro testing may be useful, especially in persons with skin conditions such as eczema or urticaria or for persons with a history of systemic reactions to the latex allergen as reported in these five cases.