Latex: a new occupational hazard for physicians

Identification of latex sensitive individuals can be life saving. The American College of Allergy and Immunology has put forth the following recommendations: 1) Just as patients are routinely asked preoperatively about allergy to medications prior to treatment, a careful history should be obtained from every patient prior to any procedure involving contact with latex. Any patient who has a history of rash, itching, hives, rhinitis, swelling, or eye irritation or asthmatic symptoms after touching a balloon, rubber glove or any latex containing object is at risk for anaphylaxis. Previous medical history, of unexplained allergic or anaphylactic reactions during a medical procedure, may indicate sensitization. 2) Health care providers or other workers who give a history of only mild latex-glove eczema rarely have anaphylactic events. However, a history of work-related conjunctivitis, rhinitis, asthma, or urticaria may indicate allergic sensitization and increased risk for more severe reactions in the future. 3) The utility of screening tests for predicting anaphylaxis remains controversial. Suitable reagents for skin prick tests for latex are not commercially available at this time. Inasmuch as prick testing appears to carry a substantial risk of inducing anaphylaxis, this test must be considered experimental and it should only be done by experienced physicians with resuscitative equipment and personnel immediately available. Serum tests for latex-specific IgE, currently performed on a research basis at several laboratories, may confirm a suspected diagnosis in many cases but presently lack sensitivity to identify all patients with true latex allergy.(ABSTRACT TRUNCATED AT 250 WORDS)