The German experience 10 years after the latex allergy epidemic: need for further preventive measures in healthcare employees with latex allergy

Merget, R.; Kampen, V. van; Sucker, Kirsten; Heinze, Evelyn; Taeger, Dirk; Goldscheid, N.; Haufs, Michael G.; Raulf‐Heimsoth, Monika; Kromark, K.; Nienhaus, Albert; Bruening, Thomas H.

doi:10.1007/s00420-010-0533-3

Cited by 16 publications

(11 citation statements)

References 24 publications

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“…Therefore, straightforward and practical interventions that are properly carried out and maintained are good examples of successful primary prevention strategies. Nevertheless, a study by Merget et al [56] published in 2010 summarized that, 10 years after the latex allergy epidemic, a substantial number of subjects with latex allergy had ongoing mild work-related symptoms of the eyes, nose or airways, suggesting that further secondary preventive measures in health care workers with latex allergy are needed.…”

Section: Preventive Measures -Successful Avoidance Strategymentioning

confidence: 95%

The Latex Story

Raulf

2014

History of Allergy

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The milky sap of the rubber tree Hevea brasiliensis is the source of the commercial production of natural rubber latex (NRL) devices, and also represents a source of potent allergenic proteins. NRL materials were introduced in the health care field in about 1840 with the advent of technical abilities to produce suitable and flexible NRL materials for medical products, especially gloves. In the late 1980s, with the increase of transmittable diseases, particularly HIV infection, the use of NRL gloves increased dramatically. During the 1990s, NRL emerged as a major cause of clinically relevant allergy in health care workers using NRL gloves and spina bifida patients with operation on the first day. The increased recognition of NRL allergies, the enhanced research on allergen characterization and sensitization mechanisms, and education about this allergy in health care facilities combined with the introduction of powder-free gloves with reduced protein levels are all factors associated with a decline in the number of suspected cases of NRL allergies in the late 1990s. NRL allergy is a very good example of a 'new allergy' that suddenly arises with tremendous health and economic implications, and also of an allergy which becomes history in a relatively short period of time based on successful primary prevention strategies by strict allergen avoidance.

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Section: Preventive Measures -Successful Avoidance Strategymentioning

confidence: 95%

The Latex Story

Raulf

2014

History of Allergy

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“…Encouraging and even excellent results in prevention have been reported, for example, from Germany (Allmers et al, 2004), Belgium (Vandenplas et al, 2009), and Finland Reunala et al, 2004a). Secondary prevention measures (i.e., to prevent clinical allergy in sensitised individuals) are continuously also needed and carried out using largely similar principles as in primary prevention, i.e., avoiding exposure of sensitised people to NRL products (Merget et al, 2010).…”

Section: Practices In the Prevention Of Nrl Allergymentioning

confidence: 97%

“…This seems to indicate that the 'epidemic' of NRL allergy is over in many European countries as well as generally in the us (Reunala et al, 2004b;NHS Plus, Royal College of Physicians, 2008;Vandenplas et al, 2009;Niggemann, 2010;Merget et al, 2010;Kelly et al, 2011).…”

Section: Introductionmentioning

confidence: 94%

Recent research on natural rubber latex (NRL) allergy

Palosuo

2014

Chemistry, Manufacture and Applications of Natural Rubber

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“…In the group of 91 HCWs examined in the scope of the whole study (Merget et al 2010 ) , exhaled nitric oxide (eNO) was signi fi cantly correlated with the atopy status (quanti fi ed via sIgE to ubiquitous environmental allergens; sx1) (r = 0.438; p < 0.0001; Pearson). Seventy-seven of the HCWs (85%) were non-smokers and included in our evaluation.…”

Section: Characterization Of the Study Groupmentioning

confidence: 99%

“…Ninety-one health care workers (HCWs) of the mean age 43.6 years, 15% current smokers, 92% females, 67% with current sensitization to latex (positive SPT or sIgE to latex), and 66% who were atopic (positive sIgE to sx1) were examined in a our institute in the scope of a cross-sectional study to test the hypothesis that nationwide preventive measures enable HCWs with latex allergy to work without health risks about 10 years afterwards (Merget et al 2010 ) . This included physical examination, a detailed questionnaire, lung function test, skin prick test (SPT) to environmental allergens (various manufacturers) and latex (Allergopharma, Reinbek & Stallergenes, Kamp-Lintfort, Germany), and measurements of speci fi c IgE to latex and environmental allergens (sx1) (sIgE; Phadia, Uppsala, Sweden).…”

Section: Study Design and Subjectsmentioning

confidence: 99%

Comparison of Different Non-invasive Methods for Detection of Allergic Asthma

Raulf‐Heimsoth

Kampen

Heinze

et al. 2012

Advances in Experimental Medicine and Biology

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Non-invasive methods to assess inflammation of lower airways are induced sputum (IS), exhaled nitric oxide (eNO), and exhaled breath condensate (EBC). Here we focused on the assessment of airway inflammation with a panel of non-invasive methods in health care workers (HCWs) with suspected latex allergy with and without current allergic respiratory symptoms about 10 years after the latex ban in German health care facilities. Seventy-seven non-smoking subjects were examined by skin prick test and specific IgE measurements, eNO, IS, and EBC. Sensitivity, specificity, and positive and negative predicted values for relevant biomarkers were calculated using current asthma symptoms as the gold standard. Twenty-nine subjects (38%) reported ongoing asthmatic symptoms (AS). In these subjects the EBC concentrations of nitrogen oxides (NO(x); p=0.027) and leukotriene B(4) (p=0.025) were significantly higher than in subjects without AS. In addition, in the subjects with AS the numbers of eosinophils (p=0.015) and the concentrations of IL-5 (p= 0.021) in IS samples were significantly higher than in the subjects without AS. A good correlation between several inflammatory markers in IS was detected. The maximum Youden Index was reached for IS total eosinophils ≥3.5·10(4) with a test efficiency of 0.72. In conclusion, non-invasive inflammatory monitoring with EBC and IS may assist the diagnosis of allergic asthma. Self-reported current asthmatic symptoms were reflected by eosinophilic inflammation and the best parameter to support the asthma diagnosis is a total number of eosinophils ≥3.5·10(4) in IS.

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The German experience 10 years after the latex allergy epidemic: need for further preventive measures in healthcare employees with latex allergy

Abstract: Although most subjects had only mild disease, ongoing work-related symptoms of the eyes, nose or airways in a substantial number of subjects with latex allergy suggest the need for further secondary preventive measures in German healthcare.

Cited by 16 publications

References 24 publications

The Latex Story

The Latex Story

Recent research on natural rubber latex (NRL) allergy

Comparison of Different Non-invasive Methods for Detection of Allergic Asthma

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