Prevalence of latex allergy among anesthesiologists: identification of sensitized but asymptomatic individuals.
BACKGROUND
Occupational exposure to natural rubber latex has led to sensitization of health-care workers. However, the prevalence of latex allergy among occupationally exposed workers in American hospitals has not been reproducibly determined. The objectives of the current study were to determine the prevalence of and risk factors for latex sensitization among a cohort of highly exposed health-care workers.


METHODS
Participants were 168 of 171 eligible anesthesiologists and nurse anesthetists working in the Department of Anesthesiology and Critical Care Medicine. A clinical questionnaire was administered, and testing was performed using a characterized nonammoniated latex reagent for puncture skin testing, a Food and Drug Administration-approved assay to quantify latex-specific immunoglobulin E antibody in serum, and, when required for clarification, a validated two-stage (contact-inhalation) latex glove provocation procedure.


RESULTS
The prevalence of latex allergy with clinical symptoms and latex sensitization without clinical symptoms was 2.4% and 10.1%, respectively. The prevalence of irritant or contact dermatitis was 24%. The risk factors identified for latex sensitization were atopy (odds ratio, 14.1; 95% CI, 1.8-112.1; P = 0.012); history of allergy to selected fruits, such as bananas, avocados, or kiwis (odds ratio, 9.8; 95% CI, 1.6-61.9; P = 0.015); and history of skin symptoms with latex glove use (odds ratio, 4.6; 95% CI, 1.6-13.4; P = 0.006).


CONCLUSIONS
The prevalence of latex sensitization among anesthesiologists is high (12.5%). Of these, 10.1% had occult (asymptomatic) latex allergy. Hospital employees may be sensitized to latex even in the absence of perceived latex allergy symptoms. These data support the need to transform the health-care environment into a latex-safe one that minimizes latex exposure to patients and hospital staff.
Department of Anesthesiology and Critical Care Medicine, and Environmental Health Sciences, Johns Hopkins University, Baltimore, Maryland, USA. rbrown@welchlink.welch.jhu.edu
R H
RH
Brown
J F
JF
Schauble
R G
RG
Hamilton
D000328:Adult; D000368:Aged; D000704:Analysis of Variance; D000776:Anesthesiology; D009783:Dermatitis, Occupational / Q000175:diagnosis / Q000453:epidemiology* / Q000473:pathology; D005260:Female; D005932:Gloves, Surgical / Q000009:adverse effects*; D006801:Humans; D007840:Latex / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012882:Skin Tests; D011795:Surveys and Questionnaires
D007840:Latex