The role of occupational exposure in the development of latex hypersensitivity

Abstract

Professionals in a healthcare setting use latex gloves on a daily basis, primarily to prevent transmission of microbial and viral organisms to and from patients and specimens. Repeated exposure to latex proteins (through direct skin contact or mucous membrane absorption) leads to the formation of circulating latex-specific antibodies and increases the risk of sensitisation. Among all known risk groups, healthcare workers have the highest risk to develop latex hypersensitivity. Early detection of antibodies or predisposing factors (e.g. atopy or impaired skin barrier function), could assist in the identification and management of risk groups and limit possible sensitisation. An experimental group with high occupational latex exposure is compared to a control group with low or no occupational latex exposure at Tygerberg Hospital, Cape Town. A questionnaire was completed by all subjects to obtain a thorough history of past and present latex exposure and to identify other risk factors. A complete physical examination was done to evaluate clinical signs and symptoms of risk factors and latex hypersensitivity. Atopy was evaluated by means of the United Kingdom's Diagnostic Criteria for Atopy, personal and lor family history of atopy, haematogram and total serum IgE analyses. Latex-specific IgE antibodies were measured immunometrically. Skin prick tests were performed on subjects with negative in vitro results, but with predefined clinical symptoms suggestive of latex hypersensitivity. An