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Reducing latex allergy

Study
Results
Comment

Bandolier's interest in latex goes back almost a decade, when a review of latex allergy was posted, and when the problem was not well recognised. A new study from Germany shows how tackling the problem on a national level can have a major impact [1].

Study

In Germany, a law of 1997 allowed mandated use of low-allergen, powder-free natural rubber latex gloves. The number and type of gloves purchased in Germany was provided by manufacturers. Statutory accident insurance covers almost two million German healthcare workers, and suspected occupational diseases have to be reported to the accident insurance company. Reported cases are required to have a medicolegal examination including hypersensitivity tests, with skin prick and IgE for latex allergens.

Results

Purchase of sterile and non-sterile gloves increased considerably from 1986, reaching a plateau from 1996. The proportion of gloves made of latex (powdered or unpowdered) rose, as gloves made from vinyl, polyethylene or copolymer decreased because of concerns that they were much less biodegradable, and were hazardous when incinerated.

The proportion of powdered gloves was high (above 80%) before 1996, and fell thereafter. The figures for acute care hospitals in Germany are shown in Figure 1, and the proportion of powdered gloves fell from above 80% in 1996 to about 10% by 2002. In response the incidence of latex-induced contact urticaria fell dramatically (Figure 1). There were similar falls, from over 0.3 to below 0.1 per 1000 workers in all healthcare settings.



Figure 1: Increased use of powder-free gloves and contact urticaria rates in Germany





Comment

Strengths of the study were size (two million healthcare workers), that the type and number of gloves purchased was known, that reporting occupational health problems was mandatory, with objective diagnosis. Using powder-free gloves removes air-borne allergens, and decreased latex-related contact urticaria. Simple and practical measures properly instituted make a difference. The reduction from 0.35 to 0.07 cases of contact urticaria per 1000 workers for the 1.8 million workers in the insurance scheme saves 500 people a year from lost working time and personal distress.

Reference:

  1. H Allmers et al. Decreasing incidence of occupational contact urticaria caused by natural rubber latex allergy in German health care workers. Journal of Allergy and Clinical Immunology 2004 114: 347-351.

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