What is latex?
Latex is a natural substance found in many plants, but especially a tree, Hevea brasiliensis (Hev b), also called the rubber tree. Latex is transformed into different products using 2 methods:
1. 90% of latex is coagulated for transformation into certain rubber products such as tires and rubber-soled shoes.
2. 10% of latex is processed with chemical products. It is then used in casts and molds to make products such as gloves, condoms and balloons. In these cases the proteins are only lightly denatured, and more allergenic.
What are the symptoms of a latex allergy?
The symptoms depend on the mechanism of the reaction.
IgE mediated allergic reaction
When an antibody called IgE is present, reactions may include: hives (red itchy welts that appear immediately on contact with a latex product), rhinoconjunctivitis or asthma (sneezing, runny nose, itchy eyes, difficulty breathing after manipulating a product containing latex), or anaphylaxis (the combination of severe cutaneous and respiratory symptoms that may be associated with a fall in blood pressure and cause death). Certain people with this type of latex allergy may also have symptoms with specific fruits, principally bananas, avocadoes, chestnuts and kiwi.
Contact dermatitis, not involving IgE antibodies, and often associated with chemical products used in the transformation of latex, occurs 1-4 days after exposition to latex in the form of small blisters on the skin followed by dry red plaques, and crusting.
Finally, many people who regularly wear latex gloves complain of red, dry and irritated skin. Without specifically having an allergy to latex, these people are more likely to have an irritant skin eruption due to occlusion, contact with powder from the gloves, and frequent hand washing.
How does one diagnose an allergy to latex?
The signs and symptoms that a person develops in contact with latex can help the doctor make the diagnosis. Allergy skin testing with an extract of latex may be used to determine if IgE antibodies are implicated. Sometimes a blood test to detect IgE antibodies may be necessary.
What is the treatment of a latex allergy?
Avoidance of latex or rubber containing products is necessary, both at work and at home. According to the type of reaction, the doctor might prescribe an epinephrine autoinjector (eg: Epipen®) so that the patient is able to treat a severe allergic reaction in case of accidental exposition. A medical bracelet describing the latex allergy is also recommended. Certain patients keep non-latex gloves with them in case of emergencies.
Where is latex found?
The principal sources of latex are: medical gloves and rubber gloves (for dishwashing), balloons, condoms, diaphragms, bandages, pacifiers, diverse medical and dental equipment. You must always inform yourself and verify the composition of different products. Latex and rubber alternatives include vinyl, polyurethane, silicone, etc.
Can you undergo surgery if you have a latex allergy?
Yes, but you must always notify your health care professional (doctor, nurse, dentist) of your latex allergy whether for surgery or other minor medical procedures. Certain hospitals have policies that minimize latex exposure by choosing products containing little or no latex. Other establishments have particular procedures in place for operating on latex allergic patients.
Nha Uyen Nguyen-Luu, MD FRCPC
(translation: Andrew Moore, MD FRCPC)