NIOSH Alert on Work-Related Latex Allergy Recommends Steps to Reduce Exposures

Contact: Fred Blosser (NIOSH) (202) 260-8519
Date: June 23, 1997

The National Institute for Occupational Safety and Health (NIOSH), part of the Centers for Disease Control and Prevention (CDC) in the U.S. Department of Health and Human Services, today recommended ways to protect workers from allergic reactions due to job-related exposures to natural rubber latex in gloves and other products.

Latex allergy can result from repeated exposures to proteins in natural rubber latex through skin contact or inhalation. Reports of work-related allergic reactions to latex have increased in recent years, especially among employees in the growing health-care industry, where latex gloves are widely used to prevent exposure to infectious agents.

At least 7.7 million people are employed in the health-care industry in the U.S. Once sensitized, workers may go on to experience the effects of latex allergy. Studies indicate that 8 percent to 12 percent of health-care workers regularly exposed to latex are sensitized, compared with 1 percent to 6 percent of the general population, although total numbers of exposed workers are not known.

Symptoms include skin rash and inflammation, respiratory irritation, asthma, and in rare cases shock. In some instances, sensitized employees have experienced reactions so severe that they impeded the worker's ability to continue working in their current job.

Wherever feasible, NIOSH recommends the selection of products and implementation of work practices that reduce the risk of allergic reactions. Employee education about latex allergy and monitoring of allergy symptoms also are recommended. The recommendations, which are voluntary, are contained in a NIOSH Alert requesting the assistance of employers, workers, and occupational health professionals in preventing work-related latex allergic reactions. Evolving technology for manufacturing latex products and improvements in methods for measuring exposures may lead to changes in the recommendations in the future, NIOSH noted.

"NIOSH's recommendations highlight practical ways to protect workers in many industries, including the nation's dedicated health- care employees," said Health and Human Services Secretary Donna E. Shalala. "These are clear, basic precautions to prevent exposures that can impair workers' health, disrupt careers that represent years of training and hard work, and burden employers in growing sectors of our economy."

"The NIOSH recommendations provide a sensible public-health blueprint that can be used for determining appropriate safeguards in different work settings," said CDC Director David Satcher, M.D., Ph.D.

The NIOSH Alert reminds health care workers and employers that appropriate protection is necessary when handling infectious materials, as specified in CDC guidelines for preventing exposure of health-care workers to the human immunodeficiency virus and the Hepatitis B virus. If latex gloves are chosen as appropriate protection, they should be reduced-protein, powder-free latex gloves, NIOSH suggests. Powder used as a lubricant in some gloves can increase exposure to the allergy-causing proteins in natural latex through skin contact and inhalation.

The Alert also says that:

• Non-latex gloves are recommended for tasks (such as food preparation, routine housekeeping, and maintenance) that are not likely to involve contacts with infectious materials such as blood.
• Workers at high risk of allergic reaction should be screened periodically to detect symptoms early and control or eliminate latex exposure.
• Appropriate work practices should be followed. For example, workers should wash their hands with a mild soap and dry thoroughly after removing latex gloves. Areas contaminated with latex-containing dust should be identified and cleaned, and ventilation filters and vacuum bags used in those areas should be changed frequently.
• Workers should be provided with education programs and training materials about latex allergy.
• Workers showing symptoms of latex allergy should consult a doctor experienced in treating the problem, and workers with a known allergy should avoid latex exposures, wear a medical alert bracelet, and follow their doctor's advice for dealing with allergic reactions.

"NIOSH has worked closely with our partners in business, labor, and the health community in developing these recommendations and will continue to work with them closely to disseminate the recommendations widely in the many workplaces affected by latex allergies," said NIOSH Director Linda Rosenstock, M.D., M.P.H.

In the health care industry, workers at risk of latex allergy from ongoing latex exposures include physicians, nurses, aides, dentists, dental hygienists, operating room employees, laboratory technicians, and housekeeping personnel. Workers who use latex gloves less frequently, such as law enforcement personnel, ambulance attendants, fire fighters, food service employees, painters, gardeners, housekeeping personnel outside the health care industry, and funeral home employees, also may develop latex allergy. Workers in factories where natural rubber latex products are manufactured or used also may be affected.

The amount of exposure needed to sensitize individuals to natural rubber latex is not known, but reductions in exposure to latex proteins have been reported to be associated with decreased sensitization and symptoms. People at increased risk for developing latex allergy include workers with ongoing latex exposure, persons with a tendency to have multiple allergic conditions, and persons with spina bifida. Latex allergy also is associated with allergies to certain foods such as avocados, potatoes, bananas, tomatoes, chestnuts, kiwi fruit, and papaya.

NIOSH was created under the Occupational Safety and Health Act of 1970 and became part of CDC in 1973. CDC, the nation's prevention agency, is responsible for translating scientific research into effective public health programs. NIOSH is the only federal institute mandated to conduct research and train professionals in workplace safety and health.

Copies of NIOSH Alert: Preventing Allergic Reactions to Latex in the Workplace, Publication No. DHHS (NIOSH) 97-135, are available by calling the NIOSH toll-free information number, (1-800-356-4674) Further information about NIOSH research is available from the toll-free information number and on the NIOSH home page on the World-Wide Web, http://www.cdc.gov/niosh/homepage.html.