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Type I allergy to natural rubber latex and type IV allergy to rubber chemicals in health care workers with glove-related skin symptoms.
Clin Exp Allergy. 2002 Mar; 32(3):441-7.CE

Abstract

BACKGROUND

It has been established that there are type I and type IV allergens in latex gloves.

OBJECTIVE

The purpose of the study was to establish the prevalence of rubber glove-induced skin symptoms among health care workers in one Italian hospital.

METHODS

Health care workers (n = 1584) were evaluated using a written questionnaire and 295 respondents with glove-induced skin symptoms were tested. We performed: skin prick test with latex glove extract and commercial latex, and environmental and food allergens; glove use test; patch tests with a rubber additive series; and RASTs.

RESULTS

Hospital employees who used or had used latex gloves at work were 1294. Three hundred and sixteen (24.4%) reported glove-induced symptoms, namely, cutaneous symptoms in all the cases and non-cutaneous symptoms in 105 subjects (8.1%). Twenty-seven of the 295 symptomatic employees tested (9.1%) were latex sensitive. Thirty-one patients (10.5%) exhibited positive patch test to rubber-related allergens. The most positive readings were obtained from the Thiuram mix and the Carba mix, with 12 and 9 positivities, respectively. The risk factors for latex skin sensitization were: a previous history of atopy and asthma; history of surgery; pre-existing hand dermatitis; work-related symptoms; and positive skin tests to common inhalant and certain foods (P < 0.05). Subjects who exhibited positive patch test were significantly more likely to have a prior hand dermatitis (P < 0.001). Of the 295 cases, 275 (93.2%) were contact dermatitis (CD), 13 (4.4%) contact urticaria (CU) (including protein CD) and 7 (2.4%) CD associated with CU.

CONCLUSIONS

Our results show a high prevalence of rubber glove-induced dermatoses among the employees in one Italian hospital. The majority of skin complaints of latex gloves are related to skin irritation rather than to allergy. The immediate allergy to latex and the delayed allergy to rubber chemicals suggest that all the health care workers with glove-related dermatitis should undergo both skin prick test and glove use test to detect type I hypersensitivity to latex, and patch test to detect type IV hypersensitivity to rubber chemicals.

Authors+Show Affiliations

Department of Medicine Clinic, Immunology and Infectious Diseases, Division of Allergy and Clinical Immunology, University of Bari, Italy. e.nettis@allergy.uniba.itNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Evaluation Study
Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

11940076

Citation

Nettis, E, et al. "Type I Allergy to Natural Rubber Latex and Type IV Allergy to Rubber Chemicals in Health Care Workers With Glove-related Skin Symptoms." Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, vol. 32, no. 3, 2002, pp. 441-7.
Nettis E, Assennato G, Ferrannini A, et al. Type I allergy to natural rubber latex and type IV allergy to rubber chemicals in health care workers with glove-related skin symptoms. Clin Exp Allergy. 2002;32(3):441-7.
Nettis, E., Assennato, G., Ferrannini, A., & Tursi, A. (2002). Type I allergy to natural rubber latex and type IV allergy to rubber chemicals in health care workers with glove-related skin symptoms. Clinical and Experimental Allergy : Journal of the British Society for Allergy and Clinical Immunology, 32(3), 441-7.
Nettis E, et al. Type I Allergy to Natural Rubber Latex and Type IV Allergy to Rubber Chemicals in Health Care Workers With Glove-related Skin Symptoms. Clin Exp Allergy. 2002;32(3):441-7. PubMed PMID: 11940076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Type I allergy to natural rubber latex and type IV allergy to rubber chemicals in health care workers with glove-related skin symptoms. AU - Nettis,E, AU - Assennato,G, AU - Ferrannini,A, AU - Tursi,A, PY - 2002/4/10/pubmed PY - 2002/9/20/medline PY - 2002/4/10/entrez SP - 441 EP - 7 JF - Clinical and experimental allergy : journal of the British Society for Allergy and Clinical Immunology JO - Clin. Exp. Allergy VL - 32 IS - 3 N2 - BACKGROUND: It has been established that there are type I and type IV allergens in latex gloves. OBJECTIVE: The purpose of the study was to establish the prevalence of rubber glove-induced skin symptoms among health care workers in one Italian hospital. METHODS: Health care workers (n = 1584) were evaluated using a written questionnaire and 295 respondents with glove-induced skin symptoms were tested. We performed: skin prick test with latex glove extract and commercial latex, and environmental and food allergens; glove use test; patch tests with a rubber additive series; and RASTs. RESULTS: Hospital employees who used or had used latex gloves at work were 1294. Three hundred and sixteen (24.4%) reported glove-induced symptoms, namely, cutaneous symptoms in all the cases and non-cutaneous symptoms in 105 subjects (8.1%). Twenty-seven of the 295 symptomatic employees tested (9.1%) were latex sensitive. Thirty-one patients (10.5%) exhibited positive patch test to rubber-related allergens. The most positive readings were obtained from the Thiuram mix and the Carba mix, with 12 and 9 positivities, respectively. The risk factors for latex skin sensitization were: a previous history of atopy and asthma; history of surgery; pre-existing hand dermatitis; work-related symptoms; and positive skin tests to common inhalant and certain foods (P < 0.05). Subjects who exhibited positive patch test were significantly more likely to have a prior hand dermatitis (P < 0.001). Of the 295 cases, 275 (93.2%) were contact dermatitis (CD), 13 (4.4%) contact urticaria (CU) (including protein CD) and 7 (2.4%) CD associated with CU. CONCLUSIONS: Our results show a high prevalence of rubber glove-induced dermatoses among the employees in one Italian hospital. The majority of skin complaints of latex gloves are related to skin irritation rather than to allergy. The immediate allergy to latex and the delayed allergy to rubber chemicals suggest that all the health care workers with glove-related dermatitis should undergo both skin prick test and glove use test to detect type I hypersensitivity to latex, and patch test to detect type IV hypersensitivity to rubber chemicals. SN - 0954-7894 UR - https://www.unboundmedicine.com/medline/citation/11940076/Type_I_allergy_to_natural_rubber_latex_and_type_IV_allergy_to_rubber_chemicals_in_health_care_workers_with_glove_related_skin_symptoms_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&amp;sid=nlm:pubmed&amp;issn=0954-7894&amp;date=2002&amp;volume=32&amp;issue=3&amp;spage=441 DB - PRIME DP - Unbound Medicine ER -