Recognizing the symptoms of latex allergies

In the past decade, there has been a significant increase in the number of health care professionals reporting allergic reactions to latex. Because frequent exposure to latex products can lead to increased sensitivity, health care professionals are at a higher risk of developing an allergy to latex proteins.

Here is a summary of the problems, reactions and precautions associated with latex gloves, according to CDA Endorsed Program PureLife.

Apart from health care and other occupational workers, those "at risk" for allergic reactions are patients with asthma, a history of hay fever or allergies to trees, grasses, animals, dust, molds and certain medications.

As far as materials go, natural rubber latex is a material found in many dental supplies -- mainly exam gloves. Other dental materials that contain latex include latex dams, gutta-percha, mixing bowls, orthodontic elastics, some suction tips, bite blocks and amalgam carriers.

"Generally, most people attribute any glove-related reaction to latex as an 'allergy,' when in fact there are two types of latex reactions," said Rodney Hanoon, PureLife CEO.

Adverse reactions can be classified as allergic contact dermatitis (Type IV hypersensitivity) or true latex allergy (Type I hypersensitivity). Allergic contact dermatitis is a reaction to the chemical additives used in the manufacturing of latex gloves (OSAP, 2013). These additives can also be found in nitrile and neoprene gloves. Symptoms take several hours to develop and include swelling, redness, itching and blistering/cracking of the skin.

Conversely, true latex allergy is a reaction to the latex proteins. These proteins can infiltrate the body through skin and mucosa. If lightly powdered latex gloves are used, aerosolized latex proteins can also enter the respiratory system during gloving and ungloving. Reactions can range from erythema and hives to the most severe reactions characterized by anaphylaxis.

Patients with true latex allergy (Type I hypersensitivity) require the use of nonlatex gloves, such as nitrile, neoprene or vinyl. Patients with allergic contact dermatitis (Type IV hypersensitivity) require the use of vinyl gloves, as nitrile and neoprene gloves can also contain the same chemical additives found in natural rubber latex gloves.

Latex-safety checklist

Dentists can use this checklist to assist them and their staff in providing a latex-safe facility for patients with possible or documented latex allergy:

  • Screen all patients for latex allergy (e.g., obtain their health history and provide medical consultation when latex allergy is suspected).

  • Be aware of some common predisposing conditions (e.g., spina bifida, urogenital anomalies or allergies to avocados, kiwis, nuts or bananas).

  • Be familiar with the different types of hypersensitivity -- immediate and delayed -- and the risks that these pose for patients and staff.

  • Consider sources of latex other than gloves. Dental patients with a history of latex allergy may be at risk from a variety of dental products including, but not limited to, prophylaxis cups, rubber dams and orthodontic elastics.

  • Provide an alternative treatment area free of materials containing latex. Ensure a latex-safe environment or one in which no personnel use latex gloves and no patient contact occur with other latex devices, materials and products.

  • Remove all latex-containing products from the patient's vicinity. Adequately cover/isolate any latex-containing devices that cannot be removed from the treatment environment.

  • Be aware that latent allergens in the ambient air can cause respiratory and or anaphylactic symptoms in people with latex hypersensitivity. Therefore, to minimize inadvertent exposure to airborne latex particles among patients with latex allergy, try to give them the first appointments of the day.

  • Clean all working areas contaminated with latex powder/dust frequently.

  • Change ventilation filters and vacuum bags used in latex-contaminated areas frequently.

  • Have latex-free kits (e.g., dental treatment and emergency kits) available at all times.

  • Be aware that allergic reactions can be provoked from indirect contact as well as direct contact (e.g., being touched by someone who has worn latex gloves). Hand hygiene is essential.

  • Communicate latex allergy procedures (e.g., verbal instructions, written protocols, posted signs) to other personnel to prevent them from bringing latex-containing materials into the treatment area.

  • Manage the reaction and seek emergency assistance as indicated if latex-related complications occur during or after the procedure. Follow current medical emergency response recommendations for management of anaphylaxis.

In addition to providing these tips on latex allergies, PureLife got involved with the community by sponsoring the CDA Foundation's CDA Cares Solano program on April 25-26 at the Solano County Fairgrounds. As part of its sponsorship, the company sent 440 boxes of exam gloves for volunteer dental professionals to use while they provide care at no charge to patients in need. PureLife has been the primary "glove sponsor" of CDA Cares and has given a significant amount over the last few clinics.

For more information about PureLife, visit www.purelifedental.com.