Prevalence and risk factors of adverse reactions to natural rubber latex among nursing personnel

Victoria J McGreevy Steelman

Allergic reactions to products containing natural rubber latex (NRL), ranging in severity from contact dermatitis, rhinoconjunctivitis to asthma and anaphylaxis, are becoming increasingly common among healthcare workers. These reactions may be life threatening. Yet, little is known about the prevalence or risk factors for development of sensitization in nursing staff. Specific aims of this study were to: (1) determine prevalence of symptoms resulting from exposure to NRL and (2) identify risk factors (allergic predisposition, air latex content, glove use, frequency of NRL exposure in workplace, non-workplace exposures) for severity of symptoms to NRL contact among nursing staff. Hypotheses were, nursing staff: (1) with other allergies or dermatitis are more likely to exhibit greater severity of symptoms NRL; (2) working in areas with higher percent recirculated air, lower air change rates, more NRL in the air, and more gloves used will exhibit greater severity of symptoms to NRL exposure; (3) with specific work-related behaviors (staff nurse, dayshift, hrs worked, hrs wearing gloves), and/or with more frequent non-workplace exposures to NRL (contraceptives, surgeries, exams) are more likely to exhibit greater severity of symptoms to NRL. A cross-sectional, predictive study of 1232 nursing personnel was undertaken. Data were collected using the Latex Allergy Questionnaire (LAQ), air sampling, and glove usage and ventilation system records. Severity of symptoms scores correlated with the amount of latex-specific IgE levels found via a radioallergosorbent test, thus supporting the validity of the outcome measure. Variables statistically significant and positively correlated with higher severity of symptoms scores (p $<$.01) included: female gender, Hispanic race, allergy, dermatitis and eczema, adult-onset asthma, hours per day wearing gloves, and glove selected. Quantity of powdered gloves used in the nursing unit (exam, total) was also positively correlated with severity of symptoms scores (P =.026). The amount of latex in the air was associated with the type of glove used by the sample collector and the quantity of powdered exam gloves used in the nursing unit. These findings support that latex allergy is an occupationally acquired condition and that atopic nursing personnel are at greater risk. Based on findings, studies were recommended to evaluate the effectiveness of interventions to reduce identified risk factors in the workplace.

Prevalence and risk factors of adverse reactions to natural rubber latex among nursing personnel

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