Tips to Remember:
Allergy to proteins in natural rubber latex
became a significant concern by the late 1980s. Fortunately however, the
epidemic of new cases of latex allergy appears to have crested in the 1990s.
Latex allergy appears to have originated from an increased use of latex
gloves over the past decade due to infection precaution policies that have
been instituted at health care facilities, and changes in processes used to
manufacture latex products.
What is latex?
Latex is a milky fluid produced by rubber trees (Hevea brasiliensis). Using
different methods, latex can be processed into a variety of products, such
as gloves and balloons. During manufacturing, chemicals are added to
increase the speed of curing (vulcanization) and to protect the rubber from
oxygen in the air.
Products made from blends of natural rubber
latex and other compounds are very common. In those with latex allergy,
allergic reactions are most often triggered by dipped latex products.
Products that commonly cause reactions can include gloves, balloons and
In rare instances, people who are allergic to
latex may also react to rubber bands, erasers, rubber parts of toys, various
rubber components in medical devices, rubber elastic in clothes, or feeding
nipples and pacifiers. Products molded from hard, crepe rubber, such as
soles of shoes, are unlikely to cause reactions. Almost all latex paints are
not a problem since they do not contain natural rubber latex.
Types of allergic reactions
There are two types of allergic reactions to latex. The first is
delayed-type contact dermatitis, a poison ivy-like rash that appears 12-36
hours after contact with a latex product. This most commonly appears on the
hands of people who wear latex gloves, but it may occur on other parts of
the body following contact with rubber products. The prevalence of this form
of latex allergy does not seem to be increasing. Contact dermatitis is
usually the result of sensitization to chemicals that are added during
rubber processing. While very irritating, this form of allergy is not
Immediate, or IgE antibody-mediated
allergic reactions, are potentially the most serious form of allergic
reactions to latex. Like other common forms of allergy, these reactions
occur in people who have previously been exposed to latex and have become
sensitized (latex-specific IgE antibody positive). With re-exposure,
symptoms such as itching, redness, swelling, sneezing, and wheezing may
occur. Rarely, a person will experience life-threatening symptoms. This
severe allergic reaction is called anaphylaxis, and is characterized by
symptoms such as shock, severe trouble breathing or loss of blood pressure.
If not immediately treated, it can be fatal.
The severity of the immediate reaction
depends upon the person's degree of sensitivity and the amount of latex
allergen to which the person is exposed. The greatest danger of severe
reactions occurs when latex comes into contact with moist areas of the body
or internal surfaces during surgery, because more of the allergen can
rapidly be absorbed into the body.
Latex can also become airborne and cause
respiratory symptoms. For example, latex proteins can adhere to the
cornstarch powder used in latex gloves. As powdered latex gloves are used,
the starch particles and latex allergens become airborne, where they can be
inhaled or come into contact with the nose or eyes and cause symptoms. High
concentrations of this allergenic powder have been measured in intensive
care units and operating rooms. The use of non-powdered latex gloves, or
synthetic (vinyl, nitrile) gloves reduces the risk of these reactions. The
capacity of latex products-especially gloves-to cause allergic reactions
varies enormously by brand and by production lot.
Certain groups of individuals who are frequently exposed to latex are at
high risk for developing immediate allergic reactions. Individuals with
spina bifida (a congenital problem in the development of the back) and those
with congenital urinary tract problems who need multiple surgeries seem to
have a risk of nearly 50%. Health care workers and others whose jobs require
wearing latex gloves or working around them have a risk of about 10%. Others
who may be at increased risk are those who have had many medical or surgical
procedures, resulting in repeated exposure to latex gloves. Rubber industry
workers also are at increased risk. Even in normal adults, the risk of
sensitization to latex may be as high as 6%.
People with latex allergy may also experience
an allergic reaction to some foods that contain some of the same allergenic
proteins as those in latex. This reaction, called cross-reactivity, can be
triggered by bananas, avocados, kiwi fruit, and European chestnuts.
Evaluation and treatment
The first step in treating latex allergy is awareness of the problem. Visit
your allergist/immunologist if you think you may have symptoms of latex
allergy. After taking a detailed history and examining you, your doctor will
decide whether additional diagnostic tests for latex allergy are needed. If
you are allergic to latex, you should avoid contact with natural rubber
latex products as much as possible. Inform your family, health care
professionals, employer and school personnel about your allergy. Discuss
with your physician whether you should wear a special bracelet or necklace
that notifies others of your allergy. Your doctor will also determine
whether you should carry injectable adrenalin (epinephrine) to provide
immediate, emergency treatment in case you experience a severe allergic
If you have reactions to latex, see an
allergist/immunologist. The 1990 Americans with Disabilities Act (ADA)
covers people with severe allergies to substances such as latex. If you are
otherwise qualified but can no longer work with latex in a job setting
because of your allergy, work with your employer to determine other options
and make reasonable accommodations. If you are allergic and need to wear
gloves, or are in contact with persons wearing gloves, there are several
You may try substituting synthetic (vinyl or
nitrile) gloves for latex gloves, although they may not work as well in some
situations. These work in nearly all situations where latex gloves work,
including surgery, but in some cases, they are more expensive. For
individuals with contact dermatitis reactions to latex, latex gloves made
without additional chemicals may work.
If you have significant latex allergy
respiratory symptoms from inhaling latex particles, you need to avoid areas
where powdered gloves are used frequently. Ideally, all high glove use areas
should use powder-free gloves to avoid allergic reactions. Using latex
condoms can be a severe problem for some latex-allergic people. One option
is natural skin condoms. These do not contain latex and can prevent
pregnancy, but they do not protect against viruses like HIV, which cause
AIDS, or some other sexually-transmitted diseases (STDs). Synthetic rubber
condoms, created to prevent both pregnancy and STDs, are now available.
Manufacturers are currently working to
produce latex products that contain less latex allergen. As these products
become more available, the risk of reactions in people sensitive to latex,
as well as the risk of more people developing latex allergy, should
Your allergist/immunologist can provide you
with more information on latex allergy.
Tips to Remember are created by the
Public Education Committee of the American Academy of Allergy, Asthma and
Immunology. This brochure was updated in 2003.
The content of this brochure is for
informational purposes only. It is not intended to replace evaluation by a
physician. If you have questions or medical concerns, please contact your
American Academy of Allergy,
Asthma and Immunology
555 East Wells Street
Milwaukee, WI 53202-3823
Physician Referral and
AAAAI Web site