title: Effect of reduced exposure on natural rubber latex sensitization in health care workers.
abstract: BACKGROUND
  Knowledge about the long-term course of allergy or sensitization to natural rubber latex (NRL) is insufficient.
  
  
  OBJECTIVE
  To investigate the long-term effect of preventive measures on sensitization variables in health care workers who had been diagnosed as having NRL allergy (NRLA) or NRL sensitization (NRLS) without clinical symptoms.
  
  
  METHODS
  Repeated follow-up investigations, skin prick tests, and NRL specific IgE serum antibodies were performed in 88 health care workers-33 with NRLA and 55 with NRLS. All workers had been instructed to avoid NRL exposure. At the workplace, powder-free NRL gloves for all other employees were gradually introduced. Re-evaluations were done at 14 +/- 3.7 (N = 86) and 38 +/- 4.0 (N = 78) months after the first examination.
  
  
  RESULTS
  At the last follow-up, a loss of skin prick test reactivity to NRL was observed in 1 of 29 subjects with NRLA (3.4%) and 16 of 35 with NRLS (45.7%) with previous skin test reactions (P < .001). Among those subjects who demonstrated a kU/L level (CAP class) equal to or greater than class I to NRL at the initial examination, NRL-specific IgE was absent at the last follow-up in 8 (32.0%) of 25 subjects with NRLA and 14 (38.9%) of 36 with NRLS. At the final examination, we could no longer demonstrate sensitization to NRL by any method in 24 (27.3%) of 88 health care workers. Complete loss of NRL sensitization was less frequent in subjects with NRLA than in those with NRLS (1 of 33 or 3.0% vs 23 of 55 or 41.8%; P < .001).
  
  
  CONCLUSIONS
  Implementation of simple preventive measures lowers markers of sensitization to NRL quickly in many health care workers with NRLA or NRLS.
authors.affiliation: Klinik und Poliklinik für Dermatologie und Allergologie, Ludwig-Maximilians-Universität, München, Germany. Franziska.Rueff@lrz.uni-muenchen.de
authors.forename: Franziska
authors.initials: F
authors.lastname: Ruëff
authors.forename: Pia
authors.initials: P
authors.lastname: Schöpf
authors.forename: Karin
authors.initials: K
authors.lastname: Putz
authors.forename: Bernhard
authors.initials: B
authors.lastname: Przybilla
mesh_terms: D000328:Adult; D005260:Female; D017575:Gloves, Protective / Q000009:adverse effects*; D006801:Humans; D006969:Hypersensitivity, Immediate / Q000276:immunology / Q000517:prevention & control*; D007073:Immunoglobulin E / Q000097:blood; D020315:Latex Hypersensitivity / Q000276:immunology / Q000517:prevention & control*; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000517:prevention & control*; D010564:Personnel, Hospital; D011446:Prospective Studies; D012882:Skin Tests
chemical_list: D007073:Immunoglobulin E