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Latex allergy has become a major problem nationally and in South Dakota. It manifests itself with a range of presentations including anaphylaxis, asthma, allergic rhinitis, and contact urticaria. This is an immunoglobulin E mediated disease. Healthcare workers, spina bifida patients, and others with a high exposure to latex are at the greatest risk of developing this allergy. In South Dakota, 1,170 healthcare workers are likely afflicted. Diagnosis is mainly by a history of symptoms with exposure. Confirmatory allergy testing is now available. Avoidance of latex products is essential and is the main treatment. This predominantly will involve the patient, co-workers and healthcare providers using non-latex gloves. Patients must be identified in their records and with MedicAlerts. As do patients with other allergies, they may also need medical care involving epinephrine, bronchodilators, corticosteroids and antihistamines. Physicians have a dual role in latex allergy--recognizing it in patients and, potentially, being patients themselves.

With the emergence of the acquired immunodeficiency syndrome (AIDS) epidemic and the practice of protecting health-care workers from all body fluids, the use of rubber gloves has increased, as has occupational allergy to latex among health-care workers. During 1991, 49 Mayo Medical Center employees sought assessment and treatment of rhinitis, conjunctivitis, contact urticaria, contact dermatitis, asthma, or eczema thought to be related to exposure to latex. Most of these persons had a history of atopy and worked in areas where rubber gloves were used and changed frequently. Of the 49 subjects, 34 had positive results of skin tests to latex products, and the sera from 19 of 35 persons tested contained increased latex-specific IgE antibodies. Employees with sensitivity to latex (and co-workers in the immediate areas) should use vinyl gloves and should notify their own health-care providers of their sensitization. Changes in job assignment may be necessary for some persons.