title: Influence of occupational exposure to latex on the prevalence of sensitization and allergy to latex in a Swiss hospital.
abstract: BACKGROUND
  Replacement of powdered latex gloves has been recommended in order to prevent the development of latex allergy in health care workers. The conclusion that occupational exposure to latex gloves represents a risk factor for latex allergy is mainly based on studies without exposure controls. Atopy is also thought to be a risk factor for the development of latex allergy.
  
  
  OBJECTIVE
  To determine the prevalence of atopy, sensitization to latex, and symptoms following latex exposure in professionally exposed and nonexposed hospital personnel by means of a cross-sectional study.
  
  
  METHODS
  Six hundred randomly sampled individuals working in medicine and surgery departments and in surgery theaters and 300 sex- and age-matched individuals classified as administrative personnel were selected from the employee data base of the Geneva University Hospital. A questionnaire about exposure to latex and symptoms following this exposure was sent to all individuals. Skin prick test reactions and serum IgE to latex as well as standard environmental allergens were determined in both groups.
  
  
  RESULTS
  Respiratory and skin (local) symptoms but not objective tests of latex sensitization (positive skin prick test and specific IgE to latex) were significantly associated with occupational exposure to latex (p < 0.001). Only among atopics subjects was 15 years or more of occupational exposure associated with a significantly higher prevalence of local symptoms than among those who were exposed from 1 to 9 years (odds ratio: 3.2; 95% confidence interval: 1.6-6.5). Atopy was significantly associated with sensitization to latex (odds ratio: 10.3; 95% confidence interval: 4.0-26.6) but not with local symptoms. Tests of latex sensitization were both frequently positive, less frequently negative, resulting in low kappa values.
  
  
  CONCLUSIONS
  These results support the current preventive health care recommendation to replace powdered latex gloves. In atopics, increasing years of occupational exposure increase the risk of developing latex allergy. In contrast to questionnaires about local symptoms, skin prick tests and specific serum IgE to latex are of limited value in epidemiologic studies of latex allergy.
authors.affiliation: Division of Clinical Epidemiology, Division of Allergy and Immunology, University Hospital, Geneva, Switzerland.
authors.forename: B
authors.initials: B
authors.lastname: Galobardes
authors.forename: A M
authors.initials: AM
authors.lastname: Quiliquini
authors.forename: N
authors.initials: N
authors.lastname: Roux
authors.forename: P
authors.initials: P
authors.lastname: Taramarcaz
authors.forename: J C
authors.initials: JC
authors.lastname: Schira
authors.forename: M
authors.initials: M
authors.lastname: Bernstein
authors.forename: A
authors.initials: A
authors.lastname: Morabia
authors.forename: C
authors.initials: C
authors.lastname: Hauser
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D020315:Latex Hypersensitivity / Q000453:epidemiology* / Q000209:etiology; D008297:Male; D016273:Occupational Exposure / Q000009:adverse effects*; D010564:Personnel, Hospital; D015995:Prevalence; D013557:Switzerland; D013997:Time Factors