Occupational allergy to natural rubber latex (NRL)

Abstract

During the 1980s and 1990s the need for protection of health care workers from HIV as well as Hepatitis B and C viruses led to an increased use of powdered natural rubber latex (NRL) examination gloves that contaminated the room atmosphere with NRL-allergens adhering to cornstarch glove powder. The NRL allergens caused type-I sensitization in up to 17% of health care personnel mainly through inhalation. In most cases the first symptom of NRL-allergy was urticaria of the hands when wearing powdered NRL gloves. Ninety percent of NRL asthma sufferers could recall having urticaria of the hands when wearing NRL gloves more than 6 months prior to developing allergic respiratory tract symptoms. Even in NRL-asthma cases confirmed by inhalation exposure up to 5% of patients had negative skin-prick-tests and no detectable specific IgE-antibodies to NRL-allergens. Patients who have been diagnosed with type-I NRL-allergy might have a lifelong risk of developing an anaphylactic shock when being exposed to NRL-containing devices such as gloves during diagnostic or therapeutic medical, surgical, or dental procedures. Negative skin-prick-tests and negative specific IgE-antibodies to NRL-allergens do not rule out a relevant sensitization to NRL. © Springer-Verlag Berlin Heidelberg 2000, 2012.