Prevalence and Patterns of Latex Glove Allergy among Healthcare Workers in a Tertiary Care Center In South India - A Cross-Sectional Study

Abstract

Background: Latex glove allergy and its impact on healthcare workers (HCWs) have been studied in many countries, but the data is scarce from developing countries. Objectives: We wanted to estimate the prevalence and patterns of latex glove allergy among HCWs and to study the factors associated with it. Materials and Methods: We conducted a cross-sectional study among 1088 HCWs of a tertiary care center in South India with the screening questionnaire adopted from “Allergy and Asthma network.” Skin prick test, patch test, and serum total immunoglobulin E (IgE) were performed only in consenting symptomatic HCWs. Results: The prevalence of latex glove allergy in our study subjects was 9.1% (99/1088). This includes latex protein allergy and contact dermatitis to rubber glove allergens. The most common manifestation of latex glove allergy was irritant contact dermatitis observed in 68 HCWs (68.6%). Other presentations were allergic rhinitis (40.4%), allergic contact dermatitis (17.1%), contact urticaria (11.1%), allergic conjunctivitis (6.06%), and asthma (3.03%). The risk factors associated with latex glove allergy in our study were atopy (OR = 20.51), working in both ward and operation theater (OR = 26.6), auxiliary staff (OR = 4.75), and more than ten years of hospital work experience (OR = 3.85). Conclusion: Our study reported a high prevalence of latex glove allergy. With irritant contact dermatitis being the most common manifestation in our study, HCWs at risk shall be educated on the appropriate use of gloves and hand moisturizer to prevent occupational irritant contact dermatitis (ICD). We recommend further research to address the gaps in our knowledge around latex allergy in a healthcare setting.

The origins and longevity of IgE responses as indicated by serological and cellular studies in mice and humans

“…While many allergies initially present in childhood, chronic workplace allergen exposure can result in adult sensitization, for example, as occurs in woodmill workers, fish packers, and bakers, the latter continually exposed to wheat flour, 78 , 79 , 80 presumably via inhalational exposure. Healthcare workers that use latex gloves over long time periods are also at increased risk of developing latex allergies, 81 presumably from exposure through the skin. We suggest that what we most closely approximate in mouse allergy models relying on long‐term repeated unadjuvanted allergen exposures, such as aerosolization of ovalbumin, are these chronic workplace exposures, where repeat challenge maintains a low‐level IgE response for long periods.…”

“… 137 , 138 , 139 , 143 , 148 As discussed earlier, false positives in IgE + cell fractions requires careful subsetting to avoid. 148 If “IgE + ” cells are not significantly less abundant than IgG + cells, loosely reflecting the serum antibody differential (100‐2000‐fold lower for IgE than IgG 81 ), probably there is contamination in the gate. Further, IgE + ASC show a CXCL12 homing defect, placing them at a disadvantage at seeding in bone marrow, which may suggest ASC in other tissues could equally contribute to ongoing IgE production.…”

Latex Allergy in Children

“…A recent Argentine study showed a latex sensitization prevalence of 7.96% (95% confidence interval: 3.70–14.58) among physicians in a children’s hospital [ 21 ]. Latex allergy is an emerging problem in developing countries as well: recent studies reported latex hypersensitivity in 9.1% of healthcare workers in South India [ 22 ] and in 9.2% of Turkish healthcare workers [ 23 ].…”

Toxicity reduction of natural rubber gloves using protein crosslinking technique

“…For Type IV immunologic reactions, rubber chemicals added to the rubber gloves during processing, that is, vulcanizing agents, accelerators, antioxidants, organic pigments, and glove powders, are known to be the responsible allergens. This is a delayed‐type allergy which accounts for most reactions to gloves 3–5 . Among the compounding ingredients, accelerators are considered the most important contact allergens in gloves.…”