title: Evaluating interventions aimed at reducing occupational exposure to latex and rubber glove allergens.
abstract: OBJECTIVE
  Concerns over occupational exposures to blood-borne viruses resulted in increased protective glove use; consequentially latex allergy became a hazard for some occupational groups. Interventions aimed at managing this problem included substitution measures (eg, non-powdered/non-latex gloves), but such changes may not occur simultaneously across occupational sectors. This study evaluated whether the incidence of occupational dermatoses fell after interventions aiming to reduce exposure to 'latex and rubber glove allergens' ('latex') were introduced, and whether these interventions were more effective for healthcare workers (HCWs), compared with non-HCWs.
  
  
  METHODS
  Incidence rate ratios (IRRs) comparing cases reported to EPIDERM (a UK-wide surveillance scheme) during post versus pre-intervention periods were calculated, both where 'latex' was cited and for cases associated with other exposures ('controls').
  
  
  RESULTS
  Among HCWs, cases of contact urticaria and allergic contact dermatitis (ACD) where 'latex' was cited showed significant downward trends post-intervention, with IRRs of 0.72, 95% CI; 0.52 to 1.00 and 0.47, 95% CI; 0.35 to 0.64 respectively. For HCWs, this fall in 'latex' associated ACD was significantly greater (p=0.02) than for other exposures ('controls') IRR=0.85, 95% CI; 0.57 to 1.28, and greater than that among non-HCWs (IRR 0.75, 95% CI; 0.61 to 0.93). Increases over time were seen for irritant contact dermatitis (ICD) reporting for HCWs, both for cases associated with 'latex' (IRR 1.47, 95% CI: 1.02 to 2.13) and for other exposures ('controls') IRR 1.36, 95% CI 1.06 to 1.76, but not for non-HCWs.
  
  
  CONCLUSIONS
  A reduction in overall ACD, particularly in HCWs, coincided with interventions aimed at managing workplace contact dermatoses associated with 'latex' exposure. A coincidental rise in ICD reporting is also important, both for hand care and for infection control strategies.
authors.affiliation: Centre for Occupational and Environmental Health, The University of Manchester, Oxford Road, Manchester M13 9PL, UK. susan.m.turner@manchester.ac.uk
authors.forename: Susan
authors.initials: S
authors.lastname: Turner
authors.forename: Roseanne
authors.initials: R
authors.lastname: McNamee
authors.forename: Raymond
authors.initials: R
authors.lastname: Agius
authors.forename: Stephen Mark
authors.initials: SM
authors.lastname: Wilkinson
authors.forename: Melanie
authors.initials: M
authors.lastname: Carder
authors.forename: Susan J
authors.initials: SJ
authors.lastname: Stocks
mesh_terms: D000328:Adult; D000485:Allergens / Q000009:adverse effects; D017449:Dermatitis, Allergic Contact / Q000453:epidemiology / Q000517:prevention & control*; D017453:Dermatitis, Irritant / Q000453:epidemiology; D005260:Female; D017575:Gloves, Protective; D006282:Health Personnel; D006801:Humans; D015994:Incidence; D007840:Latex / Q000009:adverse effects*; D020315:Latex Hypersensitivity / Q000453:epidemiology / Q000517:prevention & control*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000517:prevention & control*; D016273:Occupational Exposure / Q000009:adverse effects / Q000517:prevention & control*; D012408:Rubber / Q000009:adverse effects; D014581:Urticaria / Q000453:epidemiology / Q000517:prevention & control*
chemical_list: D000485:Allergens; D007840:Latex; D012408:Rubber