Outcome of a latex avoidance program in a high‐risk population for latex allergy – a five‐year follow‐up study

Reider, Norbert; Kretz, Benjamin; Menardi, G; Ulmer, Hanno; Fritsch, Peter

doi:10.1046/j.1365-2222.2002.01390.x

Cited by 17 publications

(16 citation statements)

References 45 publications

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“…The incidence of sensitization to NRL is still unknown, but estimated to be less than 1–2% in the general population (1,4,8,17,21–23,25,30,55) Anyone who routinely wears NRL gloves or is regularly exposed to NRL in an occupational setting may be at risk of developing latex allergy (1,24). The risk of sensitization tends to decrease with age (56).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…Children with spina bifida and meningomyelocele have the highest prevelance of latex allergy ranging from 20% to 65% (1,3,16,25,56). This is related to repeated mucosal exposure to NRL via multiple surgical, therapeutic and diagnostic procedures and atopic predisposition (1,21,30,49).…”

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

“…Primary latex avoidance programs have been shown to be effective in reducing the risk of latex sensitization in high‐risk healthcare workers (97,98). There is evidence that secondary latex avoidance programs may also be effective, leading to a decrease in latex‐specific IgE levels (30,55,56) and to a complete resolution of allergy symptoms (33,81). We still consider these patients as NRL allergic for all medical care.…”

Section: Therapy: Preventionmentioning

confidence: 99%

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Latex allergy: diagnosis and management

2004

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Latex allergy is an IgE-mediated immediate hypersensitivity response to natural rubber latex (NRL) protein with a variety of clinical signs ranging from contact urticaria, angioedema, asthma, and anaphylaxis. Major allergens include dipped latex products such as gloves and balloons. In highest risk for NRL allergy are patients with spina bifida, but health care workers and others who wear latex gloves are also at risk. NRL allergic patients may also react to fruits/foods, especially banana, kiwi, and avocado. Diagnosis is made by a positive latex RAST and/or skin prick test or challenge test to NRL. Allergen avoidance and substitution and the use of latex-safe devices including synthetic gloves (vinyl, synthetic polyisoprene, neoprene, nitrile, block polymers, or polyurethane) are essential for the affected patient. Accommodation in the workplace may include the use of powder-free, low-allergen NRL gloves or synthetic gloves. These preventive measures have significantly reduced the prevalence of reported reactions to NRL. Hyposensitization is not yet feasible.

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Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Section: Epidemiology and Risk Factorsmentioning

confidence: 99%

Section: Therapy: Preventionmentioning

confidence: 99%

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Latex allergy: diagnosis and management

2004

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“…Similar results were reported by other authors (55). Latex sensitization in children with shunted hydrocephalus decrease from the 5‐year interval 1995 to 2000 (56). For occupational asthma, it could be demonstrated that prevalence rates declined with the increased use of powder‐free and low‐latex gloves (57).…”

Section: At the Turning Pointmentioning

confidence: 99%

IgE-mediated latex allergy - An exciting and instructive piece of allergy history

Niggemann

2010

Pediatric Allergy and Immunology

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Natural rubber latex represents a potent allergen, which for many years had an important impact on occupational health problems but especially on certain risk groups such as spina bifida. Luckily, these problems decreased when powder-free, latex-poor gloves were introduced. Latest data show that in children with spina bifida, who grew up completely latex-free from birth on, sensitization to NRL as well as clinical relevant allergy significantly decreased. Furthermore, sensitization to aeroallergens also went down and even the prevalence of allergic diseases decreased significantly to rates of the general population. This new data clearly indicates that potent allergens (such as latex) in high-risk groups (such as spina bifida) can induce sensitization spreading, and corresponding avoidance can reverse this development. In conclusion, it can be stated that 'new' allergies can suddenly arise, there are allergen-specific risk groups, local IgE-production is also possible in the CNS, allergen avoidance can be very effective in terms of primary prevention, sensitization spreading can be made reversible by effective prevention, and finally, certain allergies can luckily become history within a relatively short period of time. Furthermore, these new findings clearly end the debate about whether patients with spina bifida have a disease-inherited risk for allergy to NRL and show that the cause is the meningi and the multiple surgical interventions - and therefore sequelae can be reversed by implementing preventive measures.

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“…But there are a lot of every day use articles, which are today accused of causing allergic reactions to NRL [84,85]. A longitudinal study on the effect of a secondary latex prophylaxis in children with a shunted hydrocephalus found that only 34%, mainly previously sensitized children had complied with both the medical and private prophylaxis thoroughly [86]. Medical prevention contributed more to the successful outcome than prevention at home.…”

Section: Effects Of Latex Prophylaxismentioning

confidence: 99%

Natural Rubber Latex Allergy in Pediatric Patients

Cremer¹,

Rihs²,

Raulf‐Heimsoth³

2008

CPR

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During the last fifteen years better hygienic standards led to an increased consumption of natural rubber latex (NRL) gloves for the protection of medical staff. At the same time case reports about an IgE-mediated allergy to NRL sometimes causing life-threatening anaphylactic reactions came up. This allergy was different from the well-known type IV reactions caused by latex additives. Health care workers and patients with multiple surgery surgeries were identified as high risk groups. For unknown reasons patients with spina bifida (SB) showed the highest prevalence of NRL-specific IgE-antibodies. A pre-existing atopy increased the risk of latex sensitization. Allergic reactions were caused mainly by medical procedures, especially surgeries, if latex gloves and other latex containing devices were used.Meanwhile some allergenic proteins in NRL (named Hev b in accordance with the rubber tree Hevea brasiliensis) could be identified. Patients in different risk groups showed distinct prevalences of sensitization to these allergens. The way of the allergen uptake (aerogen or by direct mucosal contact during surgeries) played an important role in the sensitization to different allergens. Most of the latex allergens like Hev b 1, Hev b 3, Hev b 6.02 have been totally sequenced. Since the sequence of all registrated allergens (Hev b 1 -Hev b 13) is known, it was possible to localize in Hev b 1, Hev b 5 and Hev b 6.01 several IgE binding sites as well as T cell epitopes.Cross-reacting antibodies between NRL and numerous fruit were described and for some proteins structural homologies were well characterized.For the in vitro diagnosis of NRL allergy serologic tests with improved extracts and recombinant allergens (for instance ImmunoCAP TM system) are available. NRL protein extracts for skin prick tests were difficult to standardize. The use of natural extracts in combination with recombinant latex allergens could be one possible future perspective for skin testing.The problem of NRL allergy is still not resolved but significant progress has been made in its prevention. In high risk patients like persons with spina bifida a primary prophylaxis was performed with success, but also secondary or tertiary prophylaxis allows safe operations without symptoms of NRL allergy.

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Outcome of a latex avoidance program in a high‐risk population for latex allergy – a five‐year follow‐up study

Abstract: Secondary prevention results in a decrease of specific IgE in latex-sensitized patients with hydrocephalus. This is due to medical more than home prophylaxis. Sensitization obviously occurs mainly in early childhood, thus primary prevention remains to be the main target.

Cited by 17 publications

References 45 publications

Latex allergy: diagnosis and management

Latex allergy: diagnosis and management

IgE-mediated latex allergy - An exciting and instructive piece of allergy history

Natural Rubber Latex Allergy in Pediatric Patients

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