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Secondhand smoke (SHS) is commonplace in South Dakota. It is casually linked to an increased incidence and severity of childhood and adult asthma; lower respiratory tract infections; symptoms of cough, wheeze, phlegm; acute and chronic otitis media; sudden infant death syndrome; cancers; prematurity; and cardiovascular disease. At this time, the development of specific allergy cannot be causally linked. As there is no risk-free level of secondhand smoke, tobacco smoking cessation is the only effective treatment and should be actively pursued at every opportunity.

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.