Allergic reactions due to glove-lubricant-powder in health-care workers

Eight glove-wearing hospital personnel were evaluated for suspected type I-like allergic manifestations due to corn-starch powder. All subjects were clinically examined, the presence of atopy was assessed by administration of a questionnaire, the on-off test was verified (the clinical feature behavior was verified with regard to the beginning and the cessation of the work shift), levels of specific serum IgE for maize and latex were measured, and prick tests for the same allergens were performed. The on-off test was positive for everyone. The symptom associated with glove use was urticaria, which was also associated in one case with intermittent dyspnea and in another with oculorhinitis, angioedema, and asthma. Five workers were atopic. The serum IgE test found three positive responses to maize, three positive responses to both latex and maize, and two negative responses to both. However, in the two patients testing negative to IgE, the prick tests were positive: one for maize and the other for both maize and latex. All workers evaded further relapses by avoiding exposure to powdered gloves. There is general agreement that corn-starch powder may cause irritant dermatitis and that it may be a vehicle for other allergens. This study seems to suggest that corn-starch powder may act as a type I allergen itself. Further studies on a larger number of subjects and further research on the chemical properties of corn-starch powder, in particular on its protein content, are needed to confirm this hypothesis.