Comparing the level of dexterity offered by latex and nitrile SafeSkin gloves.
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An increase in the occurrence of latex allergy has been concurrent with the increasing use of latex gloves by laboratory and healthcare workers. In recent years nitrile gloves have been used to replace latex gloves to prevent latex allergy. Nitrile gloves offer a comparable level of protection against chemical and biological agents and are more puncture resistant. However, if manual dexterity is compromised by nitrile gloves to a greater degree than latex then this may increase the risk of sharps injuries. The Purdue pegboard test, which measures both gross and fine finger dexterity, was used to test the dexterity levels of two glove types used at HPA CEPR; Kimberly-Clark SafeSkin nitrile and latex laboratory gloves. There was a statistically significant 8.6% increase in fine finger dexterity provided by latex compared with nitrile SafeSkin laboratory gloves but no difference in gross dexterity between the glove types. There was no significant relationship between glove dexterity and age or gender. The selection of glove size was influenced by the digit length of participants. Moreover, those with longer, thinner fingers appeared to have an advantage when using nitrile SafeSkin gloves. The level of dexterity provided by latex and nitrile SafeSkin gloves for tasks on a gross dexterity level are comparable and health workers will benefit from the non-allergenic properties of nitrile. For tasks requiring fine finger dexterity nitrile SafeSkin gloves may impede dexterity. Despite this, the degree of restriction appears to have a negligible impact on safety in this study when compared with the risk of latex sensitization and subsequent allergy. In addition to glove material, working practices must also take into account glove size, fit, grip and thickness, as these factors can all influence dexterity. (+info)
Latex allergy: a follow up study of 1040 healthcare workers.
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BACKGROUND: Natural rubber latex allergy can cause skin and respiratory symptoms The aim of this study was to evaluate the prevalence and incidence of latex related symptoms and sensitisation among a large group of healthcare workers in Trieste hospitals, followed for three years before and after the introduction of powder-free gloves with low latex release. METHODS: In the years 1997-99 the authors evaluated 1040 healthcare workers exposed to latex allergen for latex related symptoms and sensitisation by means of a questionnaire, a medical examination, skin prick tests, and IgE specific antibody assay. The second evaluation was carried out in the years 2000-02, subsequent to the changeover to a powder-free environment. RESULTS: Glove related symptoms were seen in 21.8% of the nurses (227), mostly consisting of mild dermatitis: 38 (3.6%) complaining of contact urticaria and 24 (2.3%) of asthma and/or rhinitis. These symptoms were significantly related to skin prick tests positive to latex (OR = 9.70; 95% CI 5.5 to 17) and to personal atopy (OR = 2.29; 95% CI 1.6 to 3.2). Follow up was completed in 960 subjects (92.3%): 19 new subjects (2.4%) complained of itching erythema when using gloves, but none was prick positive to latex. Symptoms significantly improved and in most cases disappeared (p<0.0001). CONCLUSIONS: Simple measures such as the avoidance of unnecessary glove use, the use of non-powdered latex gloves by all workers, and use of non-latex gloves by sensitised subjects can stop the progression of latex symptoms and can avoid new cases of sensitisation. (+info)
Latex-vegetable syndrome due to custard apple and aubergine: new variations of the hevein symphony.
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An increasing number of vegetables with crossreactions to latex are being described in patients with latex-vegetable syndrome. We present two of these vegetables, custard apple linked in two previous cases with latex sensitisation, and aubergine, that had not been described up to now in patients with latex sensitisation. The diagnosis of both cases was based on the clinical history, positive skin prick test (SPT) and specific IgE to the offending vegetables, as well as to positive SPT and specific IgE levels to latex and the major fruits involved in the latex-fruit syndrome (avocado, banana, and chestnut). Further, crude extracts from latex, custard apple and aubergine, as well as the purified allergens Hev b 6.02 and Prs a 1 were used in in vitro and in vivo assays: IgE immunodetection, histamine release (HRT) and basophil activation (BAT) tests and skin prick tests. In case 1, both purified Hev b 6.02 and Prs a 1 induced positive responses in skin prick tests, high levels of basophil activation and histamine release. Specific IgE immunodetection uncovered a reactive band of 45 kd in the crude custard apple extract, which was also recognized by anti-chitinase monospecific antibodies. The serum from patient 1 also detected Prs a 1 in immunodetection. Hev b 6.02 produced positive skin responses and showed high biological activity in HRT and BAT in the case of patient 2. However, Prs a 1 was reactive neither in SPT nor in IgE immunodetection. In fact, no band was detected using the serum of patient 2 in avocado or aubergine extracts. By contrast, Prs a 1 reached high values of basophil activation and over 10% of histamine release in case 2. (+info)
Primary prevention of latex related sensitisation and occupational asthma: a systematic review.
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METHODS: Eight primary prevention intervention studies on natural rubber latex (NRL) published since 1990 were identified and reviewed. This is the largest evidence base of primary prevention studies for any occupational asthmagen. RESULTS: Review of this small and largely observational evidence base supports the following evidence statement: Substitution of powdered latex gloves with low protein powder-free NRL gloves or latex-free gloves greatly reduces NRL aeroallergens, NRL sensitisation, and NRL-asthma in healthcare workers. Evidence in support of this statement is ranked SIGN level 2+, referring to well conducted case-control or cohort studies with a low risk of confounding, bias, or chance and a moderate probability that the relationship is causal. CONCLUSION: Substitution of powdered latex gloves with low protein powder-free NRL gloves or latex-free gloves promises benefits to both workers' health and cost and human resource savings for employers. This message should be broadly disseminated beyond the hospital sector to include other healthcare settings (such as aged care facilities) as well as food service and other industries where latex gloves might be used. (+info)
Glove selection as personal protective equipment and occupational dermatitis among Japanese midwives.
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This study was conducted to 1) evaluate the personal selection and use of protective gloves against bloodborne pathogens and management of glove selection in the workplace, 2) survey the experience with occupational dermatitis and other allergic symptoms, 3) explore the relationships between occupational dermatitis experience and glove use, and 4) determine the impact of glove selection upon occupational dermatitis among midwives. Subjects were 1,150 midwives working in Japan. Participants were selected from the members of Japanese Nursing Association and 835 responded to the survey. More than 30% of respondents wore gloves only when clients had an infectious disease, 41% reported experience of occupational dermatitis, 26% associated the dermatitis with medical glove use, and 2% had a diagnosis of latex allergy. Demographic variables that were significantly associated with occupational dermatitis included history of allergic symptoms other than due to occupational exposure, age, tenure and type of working institution. Using latex gloves during administering enema, shaving, changing pads, washing perineum, receiving newborns, suctioning, and handling waste significantly increased the risk of occupational dermatitis experience compared to not using gloves. Logistic regression analysis with backward stepwise elimination revealed glove selection management, such as availability of alternative glove types, using latex gloves for washing perineum, and using latex gloves for handling waste were significant predictors of occupational dermatitis. Occupational dermatitis is a significant issue and glove use as personal protective equipment is not standardized. Some occupational dermatitis may be preventable by managing appropriate glove selection. (+info)
Inhibition of Calotropis procera latex-induced inflammatory hyperalgesia by oxytocin and melatonin.
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The latex of the wild growing plant Calotropis procera produces inflammation of the skin and mucous membranes upon accidental exposure. On local administration it elicits an intense inflammatory response due to the release of histamine and prostaglandins that is associated with hyperalgesia. In the present study we have evaluated the anti-inflammatory and antinociceptive activity of oxytocin and melatonin against rat paw edema induced by dried latex (DL) of C procera and compared it with that against carrageenan-induced paw edema. Aqueous extract of DL of C procera or carrageenan (1%) was injected into the subplantar surface of the rat paw and the paw volume was measured at 0, 1, 2, 3, 4, 6, 10, and 24 hours. The associated hyperalgesic response and functional impairment were also evaluated concomitantly by dorsal flexion pain test, motility test, and stair climbing ability test. The inhibitory effect of oxytocin and melatonin on edema formation and hyperalgesic response was compared with dexamethasone. DL-induced edema formation was maximum at 2 hours and was associated with decreased pain threshold and functional impairment. Treatment with melatonin significantly attenuated the edematous response while both oxytocin and melatonin increased the pain threshold and improved functional parameters. Both oxytocin and melatonin significantly inhibited the hyperalgesia associated with DL-induced paw edema. Oxytocin was found to be as effective as melatonin in ameliorating the hyperalgesic response. However, it was found to be less effective than melatonin in attenuating edema formation. (+info)
Perioperative anaphylaxis from locally applied rifamycin SV and latex.
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A patient developed severe anaphylaxis during irrigation of a wound with rifamycin SV. The temporal relationship between application of rifamycin SV, the positive skin test and basophil activation test for rifamycin SV strongly supported diagnosis of anaphylaxis from the locally applied antibiotic. However, after operation the patient had two anaphylactic reactions with pruritus, urticaria and angio-oedema after routine care by a nurse, and these were probably caused by natural rubber latex. This case report has several messages. First, it is not widely appreciated that topically applied drugs and related compounds can elicit life-threatening anaphylaxis. Second, it illustrates patients can present with more than one allergy. Finally, it provides an opportunity to summarize the applications of flow cytometry-assisted quantification of in vitro activated basophils in diagnosing the cause of anaphylaxis during anaesthesia. (+info)
Follow-up study of latex-allergic health care workers in Japan.
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BACKGROUND: While many cases of latex allergy have been reported in Japanese health care workers (HCWs) since 1992, there have been no follow-up studies after removing latex from the workplace. We had previously replaced all working environment latex gloves and latex products with low-allergen or non-latex products. The purpose of the investigation was to evaluate the benefits of the latex allergy countermeasures that were taken in our hospital, and the effects of life guidance education. METHODS: We investigated 16 latex-allergic HCWs in our hospital. We gave them a detailed questionnaire and tested them by a skin prick test (SPT) with latex extract and specific IgE antibodies against latex using the Pharmacia CAP RAST system, RAST FEIA. We compared these results with earlier results from the time of diagnosis. RESULTS: According to the questionnaire, none of the HCWs had changed their work habits, though all were avoiding the use of latex products as much as possible. Of the 16 patients, 81.2% were eating foods for which cross reactivity with latex has been reported. However, the foods had not induced severe allergic symptoms. In the SPT, 62.5% of scores decreased and 81.2% of patients had decreases in specific IgE antibody levels. CONCLUSIONS: After avoiding latex products and following our educational suggestions, the patients' allergy symptoms had generally improved. This indicates that our countermeasures against latex allergy were largely successful. (+info)