Latex-induced occupational asthma: time trend in incidence and relationship with hospital glove policies.
BACKGROUND
Natural rubber latex (NRL) has become as a major cause of occupational asthma (OA) in workers using NRL gloves. Few population-based studies have assessed the impact of changes in the patterns of glove usage on the incidence of NRL-induced OA.


OBJECTIVE
To characterize the time trends in incident cases of NRL-induced OA in Belgium and examine whether incidence rates were related to the types of gloves used in hospitals.


METHODS
Incident cases of NRL-induced OA were identified through a retrospective review of all claims submitted to the Workers' Compensation Board up to December 2004. Based on the results of diagnostic procedures, the diagnosis of NRL-induced OA was categorized as definite, probable, unlikely, or indeterminate. The patterns of glove usage were characterized through a questionnaire survey of Belgian hospitals.


RESULTS
A total of 298 claims for NRL-induced OA were identified, including 127 subjects with definite OA and 68 with probable OA. Categorized by the year of asthma onset, the incident cases of definite and probable NRL-induced OA markedly decreased from 1999 onwards. The use of powdered NRL gloves fell from 80.9% in 1989 to 17.9% in 2004. Powdered NRL gloves were predominantly substituted with NRL-free gloves, especially in the case of non-sterile procedures.


CONCLUSIONS
These national compensation-based data confirm that a persistent decline in the incidence of NRL-induced OA has occurred since late 1990s. This downward trend has temporally been associated with a decreasing usage of powdered NRL, further supporting a beneficial role of changes in glove policies.
Vandenplas
O
O
Fonds voor de Beroepsziekten-Fonds des Maladies Professionnelles, Brussels, Belgium.
Larbanois
A
A
Vanassche
F
F
François
S
S
Jamart
J
J
Vandeweerdt
M
M
Thimpont
J
J
D000328:Adult; D001530:Belgium; D005260:Female; D005932:Gloves, Surgical / Q000009:adverse effects*; D006801:Humans; D007840:Latex / Q000009:adverse effects; D020315:Latex Hypersensitivity / Q000453:epidemiology*; D008297:Male; D009784:Occupational Diseases / Q000453:epidemiology*; D016273:Occupational Exposure; D011208:Powders / Q000009:adverse effects; D013995:Time; D014942:Workers' Compensation
D007840:Latex; D011208:Powders