Self-reported hand symptoms: a role in monitoring health care workers for latex sensitization?
BACKGROUND
The use of powdered natural rubber latex (NRL) gloves increased greatly in the 1980s because of concerns about transmission of blood-borne infections and the subsequent implementation of universal precautions. The most common clinical reactions to glove use are irritant and T-cell-mediated contact dermatitis. However, IgE-mediated immediate reactions to latex have become a serious concern for health care workers (HCWs). The diagnosis of latex allergy requires a comprehensive medical history and diagnostic tests. The skin prick test is the preferred diagnostic method, although it can be time-consuming.


OBJECTIVE
To determine the role of hand symptoms reported on questionnaires in monitoring HCWs for latex sensitization.


METHODS
Questionnaires were completed by 804 HCWs at 2 hospitals. Using a positive skin prick test (SPT) result as a criterion standard of latex sensitization, the diagnostic performance of hand symptoms was evaluated.


RESULTS
Increasing latex glove use was strongly related to increasing reports of hand symptoms. Hand symptoms were highly associated with glove-related respiratory and systemic symptoms. A positive SPT result was seen in 5% of HCWs and increased with the number of hand symptoms: 0 (1.6%), 1 to 2 (3.4%), and 3 to 7 (19.0%). Participants reporting more than 2 hand symptoms were 11 times more likely to have positive SPT results compared with those with 2 or fewer hand symptoms.


CONCLUSIONS
Hand symptoms are closely associated with latex sensitization. Questionnaires should be useful in health monitoring for HCWs who use latex gloves.
Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Centers for Disease Control and Prevention, Morgantown, West Virginia, USA. mlw4@cdc.gov
Mei Lin
ML
Wang
Kevin J
KJ
Kelly
Meribeth
M
Klancnik
Edward L
EL
Petsonk
D003877:Dermatitis, Contact / Q000276:immunology; D004784:Environmental Monitoring; D006230:Hand Injuries / Q000276:immunology* / Q000378:metabolism; D006801:Humans; D007840:Latex / Q000009:adverse effects* / Q000276:immunology; D010348:Patient Care Team / Q000592:standards / Q000639:trends*; D057566:Self Report; D011795:Surveys and Questionnaires
D007840:Latex