Latex allergy from glove powder--an unintended risk with the switch from talc to cornstarch?
The present study aimed to investigate to what extent glove powders of different origins and brands bind and release latex allergens. One mineral talc and five cornstarch powders were used. The allergenic material was sap of Hevea brasiliensis. The powders were incubated together with the natural rubber latex sap, and four series of experiments were performed. The talc showed the highest tendency to bind isotope-labeled proteins. When incubated with a latex allergen solution, it reduced free allergen from 100 to 2 units/ml compared to a reduction to 70-98 units/ml for the cornstarch powders. In contrast to the nonstable binding of allergen to cornstarch, the binding to talc was irreversible. The allergen bound to talc was allergenically intact and, when incubated with serum, reduced the concentration of free IgE antibody to latex to 10% of the initial level. Mineral talc had a high capacity to bind latex allergens firmly. In contrast, cornstarch captured the latex allergen, but the binding seemed less pronounced and was unstable. The replacement of talc by cornstarch as glove-donning powder has coincided with the rapid increase in latex allergy. Mineral talc is heavy and only transiently airborne. Could this difference between talc and cornstarch in latex-allergen-binding pattern and the tendency of the latter to be airborne play an important role in the bioavailability of latex allergen and thus in the epidemic of latex sensitization.
Lundberg
M
M
Department of Clinical Immunology, Karolinska Hospital, Stockholm, Sweden.
Wrangsjö
K
K
Johansson
S G
SG
D000485:Allergens / Q000276:immunology*; D005932:Gloves, Surgical; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology; D007073:Immunoglobulin E / Q000032:analysis; D007840:Latex / Q000276:immunology*; D011208:Powders; D011852:Radioallergosorbent Test; D013213:Starch; D013627:Talc
D000485:Allergens; D007840:Latex; D011208:Powders; D013627:Talc; D007073:Immunoglobulin E; D013213:Starch