Medication Summary

Latex allergies are best treated with patient education to avoid further exposure. Even HCWs may be poorly informed about latex allergy risk factors, clinical syndromes, and preventive approaches.^[26]Type I reactions are treated as any other systemic allergic reaction. The cornerstones of treatment are epinephrine and H1 antihistamines. Systemic corticosteroids and H2 blockers may be useful. Please see articles on Anaphylaxis, Angioedema, and Asthma for details of therapy. No specific immunotherapy has been shown to be effective.

Type IV reactions (localized contact dermatitis) are unlikely to require ED treatment. They can be treated with topical steroids and patient education to avoid further exposures.

All patients with type I latex allergy should carry a subcutaneous epinephrine kit at all times.

Follow-up

Gawchik SM. Latex allergy. Mt Sinai J Med. 2011 Sep-Oct. 78(5):759-72. [QxMD MEDLINE Link].
Geier J, Lessmann H, Mahler V, Pohrt U, Uter W, Schnuch A. Occupational contact allergy caused by rubber gloves--nothing has changed. Contact Dermatitis. 2012 Sep. 67(3):149-56. [QxMD MEDLINE Link].
Pak VM, Watkins M, Green-McKenzie J. What is the role of thiurams in allergy to natural rubber latex products?. J Occup Environ Med. 2012 May. 54(5):649-50. [QxMD MEDLINE Link].
Agarwal S, Gawkrodger DJ. Latex allergy: a health care problem of epidemic proportions. Eur J Dermatol. 2002 Jul-Aug. 12(4):311-5. [QxMD MEDLINE Link].
Feng C, Wang H. Natural rubber latex allergy among health care workers. J Allergy Clin Immunol. 2007 Jun. 119(6):1561; author reply 1561. [QxMD MEDLINE Link].
Palosuo T, Antoniadou I, Gottrup F, Phillips P. Latex medical gloves: time for a reappraisal. Int Arch Allergy Immunol. 2011. 156(3):234-46. [QxMD MEDLINE Link].
Caballero ML, Quirce S. Identification and practical management of latex allergy in occupational settings. Expert Rev Clin Immunol. 2015 Sep. 11 (9):977-92. [QxMD MEDLINE Link].
Paul A, Chabaud M, Auber F, Peycelon M, Audry G. [Latex-free hospitals: Benefits and disadvantages]. Arch Pediatr. 2015 Sep 24. [QxMD MEDLINE Link].
Ahmed SM, Aw TC, Adisesh A. Toxicological and immunological aspects of occupational latex allergy. Toxicol Rev. 2004. 23(2):123-34. [QxMD MEDLINE Link].
Jackson EM, Arnette JA, Martin ML, Tahir WM, Frost-Arner L, Edlich RF. A global inventory of hospitals using powder-free gloves: a search for principled medical leadership. J Emerg Med. 2000 Feb. 18(2):241-6. [QxMD MEDLINE Link].
Sekiya K, Watai K, Taniguchi M, Mitsui C, Fukutomi Y, Tanimoto H. Latex anaphylaxis caused by a Swan-Ganz catheter. Intern Med. 2011. 50(4):355-7. [QxMD MEDLINE Link].
Bernardini R, Catania P, Caffarelli C, et al. Perioperative latex allergy. Int J Immunopathol Pharmacol. 2011 Jul-Sep. 24(3 Suppl):S55-60. [QxMD MEDLINE Link].
Caffarelli C, Stringari G, Miraglia Del Giudice M, Crisafulli G, Cardinale F, Peroni DG. Prevention of allergic reactions in anesthetized patients. Int J Immunopathol Pharmacol. 2011 Jul-Sep. 24(3 Suppl):S91-9. [QxMD MEDLINE Link].
Dong SW, Mertes PM, Petitpain N, Hasdenteufel F, Malinovsky JM,. Hypersensitivity reactions during anesthesia. Results from the ninth French survey (2005-2007). Minerva Anestesiol. 2012 Aug. 78(8):868-78. [QxMD MEDLINE Link].
Gawchik SM. Latex allergy. Mt Sinai J Med. 2011 Sep-Oct. 78 (5):759-72. [QxMD MEDLINE Link].
Thong BY, Yeow-Chan. Anaphylaxis during surgical and interventional procedures. Ann Allergy Asthma Immunol. 2004 Jun. 92(6):619-28. [QxMD MEDLINE Link].
Ahmed DD, Sobczak SC, Yunginger JW. Occupational allergies caused by latex. Immunol Allergy Clin North Am. 2003 May. 23(2):205-19. [QxMD MEDLINE Link].
Occupational Safety and Health Administration. Latex Allergy. US Department of Labor. Available at http://www.osha.gov/SLTC/latexallergy/index.html. Accessed: June 28, 2013.
Wu M, McIntosh J, Liu J. Current prevalence rate of latex allergy: Why it remains a problem?. J Occup Health. 2016 May 25. 58 (2):138-44. [QxMD MEDLINE Link].
Dorevitch S, Forst L. The occupational hazards of emergency physicians. Am J Emerg Med. 2000 May. 18(3):300-11. [QxMD MEDLINE Link].
Fein JA, Selbst SM, Pawlowski NA. Latex allergy in pediatric emergency department personnel. Pediatr Emerg Care. 1996 Feb. 12(1):6-9. [QxMD MEDLINE Link].
Galindo MJ, Quirce S, Garcia OL. Latex allergy in primary care providers. J Investig Allergol Clin Immunol. 2011. 21(6):459-65. [QxMD MEDLINE Link].
Schottler J, Vogel LC, Sturm P. Spinal cord injuries in young children: a review of children injured at 5 years of age and younger. Dev Med Child Neurol. 2012 Dec. 54(12):1138-43. [QxMD MEDLINE Link].
Goldberg H, Aharony S, Levy Y, Sivan B, Baniel J, Ben Meir D. Low prevalence of latex allergy in children with spinal dysraphism in non-latex-free environment. J Pediatr Urol. 2015 Sep 5. [QxMD MEDLINE Link].
Poley GE Jr, Slater JE. Latex allergy. J Allergy Clin Immunol. 2000 Jun. 105 (6 Pt 1):1054-62. [QxMD MEDLINE Link].
Al-Niaimi F, Chiang YZ, Chiang YN, Williams J. Latex allergy: assessment of knowledge, appropriate use of gloves and prevention practice among hospital healthcare workers. Clin Exp Dermatol. 2013 Jan. 38(1):77-80. [QxMD MEDLINE Link].
Turner S, McNamee R, Agius R, Wilkinson SM, Carder M, Stocks SJ. Evaluating interventions aimed at reducing occupational exposure to latex and rubber glove allergens. Occup Environ Med. 2012 Dec. 69(12):925-31. [QxMD MEDLINE Link].
Liss GM, Sussman GL. Latex sensitization: occupational versus general population prevalence rates. Am J Ind Med. 1999 Feb. 35(2):196-200. [QxMD MEDLINE Link].
Marmo M, Sacerdoti C, Di Minno RM, Guarino I, Villani R, Di lorio C. Anaphylactic shock during hyperbaric oxygen therapy. Undersea Hyperb Med. 2012 Jan-Feb. 39(1):613-6. [QxMD MEDLINE Link].
Taylor JS, Erkek E. Latex allergy: diagnosis and management. Dermatol Ther. 2004. 17(4):289-301. [QxMD MEDLINE Link].
Hamilton RG, Peterson EL, Ownby DR. Clinical and laboratory-based methods in the diagnosis of natural rubber latex allergy. J Allergy Clin Immunol. 2002 Aug. 110(2 Suppl):S47-56. [QxMD MEDLINE Link].
Accetta Pedersen DJ, Klancnik M, Elms N, et al. Analysis of available diagnostic tests for latex sensitization in an at-risk population. Annals of Allergy, Asthma, & Immunology. February 2012. 108(2):94-7.
Saulnier N, Nucera E, Altomonte G, Rizzi A, Pecora V, Aruanno A. Gene expression profiling of patients with latex and/or vegetable food allergy. Eur Rev Med Pharmacol Sci. 2012 Sep. 16(9):1197-210. [QxMD MEDLINE Link].
Blanco C, Carrillo T, Ortega N, Alvarez M, Dominguez C, Castillo R. Comparison of skin-prick test and specific serum IgE determination for the diagnosis of latex allergy. Clin Exp Allergy. 1998 Aug. 28(8):971-6. [QxMD MEDLINE Link].
Bernardini R, Mistrello G, Pucci N, et al. Diagnostic value of three different latex extracts. Int J Immunopathol Pharmacol. 2007 Apr-Jun. 20(2):393-400. [QxMD MEDLINE Link].
Caballero ML, Quirce S. Identification and practical management of latex allergy in occupational settings. Expert Rev Clin Immunol. 2015. 11 (9):977-92. [QxMD MEDLINE Link].
Reunala T, Alenius H, Turjanmaa K, Palosuo T. Latex allergy and skin. Curr Opin Allergy Clin Immunol. 2004 Oct. 4 (5):397-401. [QxMD MEDLINE Link].
Liberatore K, Kelly KJ. Latex Allergy Risks Live On. J Allergy Clin Immunol Pract. 2018 Nov - Dec. 6 (6):1877-1878. [QxMD MEDLINE Link].
Food and Drug Administration. Natural rubber containing medical devices: user labeling.[Docket No. 96N-0119]. 21 CFR Part 801 Fed. Regist. 1997. 62:51021-51030.
Korniewicz DM, Chookaew N, El-Masri M, Mudd K, Bollinger ME. Conversion to low-protein, powder-free surgical gloves: is it worth the cost?. AAOHN J. 2005 Sep. 53(9):388-93. [QxMD MEDLINE Link].
Phillips VL, Goodrich MA, Sullivan TJ. Health care worker disability due to latex allergy and asthma: a cost analysis. Am J Public Health. 1999 Jul. 89(7):1024-8. [QxMD MEDLINE Link]. [Full Text].
Allmers H, Brehler R, Chen Z, Raulf-Heimsoth M, Fels H, Baur X. Reduction of latex aeroallergens and latex-specific IgE antibodies in sensitized workers after removal of powdered natural rubber latex gloves in a hospital. J Allergy Clin Immunol. 1998 Nov. 102(5):841-6. [QxMD MEDLINE Link].
LaMontagne AD, Radi S, Elder DS, Abramson MJ, Sim M. Primary prevention of latex related sensitisation and occupational asthma: a systematic review. Occup Environ Med. 2006 May. 63(5):359-64. [QxMD MEDLINE Link]. [Full Text].
Filon FL, Radman G. Latex allergy: a follow up study of 1040 healthcare workers. Occup Environ Med. 2006 Feb. 63(2):121-5. [QxMD MEDLINE Link]. [Full Text].
Yagami A, Suzuki K, Kano H, Matsunaga K. Follow-up study of latex-allergic health care workers in Japan. Allergol Int. 2006 Sep. 55(3):321-7. [QxMD MEDLINE Link].
Kelly KJ, Wang ML, Klancnik M, Petsonk EL. Prevention of IgE Sensitization to Latex in Health Care Workers After Reduction of Antigen Exposures. J Occup Environ Med. 2011 Aug. 53(8):934-40. [QxMD MEDLINE Link].
American College of Occupational and Environmental Medicine. Anaphylaxis awareness in the workplace. 2013. Available at http://www.acoem.org/anaphylaxis.aspx. Accessed: June 28, 2013.
Biagini RE, MacKenzie BA, Sammons DL, et al. Latex specific IgE: performance characteristics of the IMMULITE 2000 3gAllergy assay compared with skin testing. Ann Allergy Asthma Immunol. 2006 Aug. 97(2):196-202. [QxMD MEDLINE Link].

Media Gallery

of 0

Author

Constantine K Saadeh, MD President, Allergy ARTS, LLP; Principal Investigator, Amarillo Center for Clinical Research, Ltd

Constantine K Saadeh, MD is a member of the following medical societies: American Academy of Allergy, Asthma and Immunology, American College of Rheumatology, American Medical Association, Southern Medical Association, Texas Medical Association

Disclosure: Nothing to disclose.

Coauthor(s)

Nicole Davey-Ranasinghe, MD Rheumatologist, Allergy ARTS, LLP, Amarillo Center for Clinical Research, Ltd

Nicole Davey-Ranasinghe, MD is a member of the following medical societies: Alpha Omega Alpha, American College of Physicians, American College of Rheumatology

Disclosure: Nothing to disclose.

Specialty Editor Board

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Received salary from Medscape for employment. for: Medscape.

Matthew M Rice, MD, JD, FACEP Senior Vice President, Chief Medical Officer, Northwest Emergency Physicians of TeamHealth; Assistant Clinical Professor of Medicine, University of Washington School of Medicine Pending Approval

Matthew M Rice, MD, JD, FACEP is a member of the following medical societies: American College of Emergency Physicians, American Medical Association, National Association of EMS Physicians, Society for Academic Emergency Medicine, Washington State Medical Association

Disclosure: Nothing to disclose.

Chief Editor

Erik D Schraga, MD Staff Physician, Department of Emergency Medicine, Mills-Peninsula Emergency Medical Associates

Disclosure: Nothing to disclose.

Additional Contributors

Amy J Behrman, MD, FACOEM, FACP Professor, Department of Emergency Medicine, Medical Director, Division of Occupational Medicine, Perelman School of Medicine at the University of Pennsylvania

Amy J Behrman, MD, FACOEM, FACP is a member of the following medical societies: American College of Occupational and Environmental Medicine, American College of Physicians

Disclosure: Nothing to disclose.

Mark Louden, MD Assistant Professor of Clinical Medicine, Division of Emergency Medicine, Department of Medicine, University of Miami, Leonard M Miller School of Medicine

Mark Louden, MD is a member of the following medical societies: American College of Emergency Physicians

Disclosure: Nothing to disclose.

Jarrod D Matthei, MD, MPH Resident Physician in Occupational Medicine, Hospital of the University of Pennsylvania

Disclosure: Nothing to disclose.

Acknowledgements

Marilyn Howarth, MD Center for Excellence in Environmental Toxicology, University of Pennsylvania

Marilyn Howarth, MD is a member of the following medical societies: American College of Occupational and Environmental Medicine

Disclosure: Nothing to disclose.