Latex Allergy

Washington DC allergist for latex allergies Dr. Michael KletzWhat is Latex Allergy?:

Latex allergy is a condition in which an individual has an allergic reaction when exposed to natural rubber latex.  Natural rubber latex is the milky substance that comes from the Brazilian rubber tree (scientifically referred to as Hevea brasiliensis).  This latex is collected by making cuts into the bark of the rubber tree and collecting it in pails.  This technique is called tapping and is similar to how maple syrup is collected.  The latex is then refined into rubber for commercial use.

Types of Reactions and Symptoms:

There are 2 types of allergic reactions that occur from exposure to latex:  1.) Immediate-type or Type I reaction and 2.) Delayed-type or Type IV reaction

1.)  The immediate-type reaction is the typical reaction one thinks of when thinking about an “allergic reaction.”  It is the most severe type of allergic reaction.  In this type of reaction, the person is exposed to the allergen (latex, bee venom, food, etc.), and generally within 30 minutes, the individual begins to have systemic symptoms.  Some of these symptoms may include generalized itching, hives (urticaria), wheezing, shortness of breath, abdominal cramping, throat tightening (angioedema), rapid heart rate, feeling faint, and/or drop in blood pressure.  In severe cases, anaphylaxis can occur which can be life-threatening.  It is an allergic reaction to the proteins of the natural rubber latex that causes this immediate-type allergic reaction to latex.

2.)  The delayed-type reaction is a type of allergic reaction where an individual reacts to an allergen (latex, poison ivy, chemical, etc.) about 48-72 hours after exposure.  It results in a condition called contact dermatitis, which causes a delayed skin rash that can present as redness, local swelling, and/or blistering of the skin.  The blistering is often accompanied by oozing in more severe cases.  The cause of this reaction is primarily caused by the reaction to the chemicals used in the production of natural rubber latex.  This delayed-type reaction is usually much less severe than an immediate-type reaction, however, some people can have fairly severe skin rashes as a result. of their exposure to the offending allergen.

In addition to the 2 allergic reactions listed above, natural rubber latex can also cause a non-allergic irritant contact dermatitis.  This reaction is usually less severe than the allergic contact dermatitis above.  Skin manifestations of irritant contact dermatitis usually include dry, itchy, cracked, and/or irritated skin.  The reaction is most commonly seen on the hands, but may affect skin on any part of the body.

How Common Are Latex Allergies?:

About 1-2% of the U.S. population has a latex allergy. Latex allergies, however, are much more prevalent in certain groups of individuals, some of which include: children with spina bifida, health care workers, individuals with a history of multiple surgeries, people who work in the rubber industry or have increased exposure to latex, individuals who have repeated catheterization of their bladder.

Latex allergy occurs in about 70% of children with spina bifida. The reason why this percentage is so high is that children with spina bifida not only have had multiple surgical procedures (a risk factor), but in addition, they use rubber urinary catheters ( another risk factor) which further exposes them to natural rubber.  These two factors put them at a very high risk of being sensitized to the natural rubber latex.

About 8-15% of health care providers have a latex allergy.  The increased incidence is attributable to the increased exposure to rubber medical and dental devices such as latex gloves, syringes, catheters, dental dams, etc.  Many doctor’s offices and hospitals now use non-latex gloves in order to try to reduce latex exposure to their employees. The operating room in a hospital is one place where severe latex reactions tend to occur more often due to latex gloves being put on by many individuals at roughly the same time.  The latex can also become airborne and thus inhaled, which is more likely to cause systemic reactions.

Common Latex Sources:

Some common latex products include:  “rubber” gloves, syringes, urinary catheters, condoms, dental dams, balloons, bandages, rubber bands, tourniquets used for taking blood, baby bottle nipples and pacifiers, diaphragms, elastic, and various rubber toys.   Note that not all latex products are made from natural rubber latex.  Therefore, exposure to synthetic latex products such as latex paint, usually do not cause allergic symptoms.

Routes of Latex Entry into the Body:

Skin, mucous membranes (mouth, eyes, etc.), blood, inhalation

Note:  Latex allergy patients should never blow up a balloon or rubber glove as this can cause a very serious allergic reaction which can quickly lead to anaphylaxis.

Food Connection:

Interestingly, individuals allergic to latex may also be allergic to similar proteins found in certain fruits and vegetables.  Some of these foods include:  banana, kiwi, avocado, chestnut, melons (watermelon, cantaloupe, honeydew, etc.), apple, celery, carrot, papaya, potato, and tomato..  If you are allergic to latex, you are more likely to be allergic to these foods and vice versa.

Diagnosis:

The diagnosis of latex allergy begins with a thorough history taken by an allergist.  A careful physical examination is also necessary.  If the allergist feels that a latex allergy may be the problem, then further diagnostic testing is done.  This can be done via blood tests and/or skin tests.  Black & Kletz Allergy has the expertise in diagnosing latex allergies as we have been doing in the Washington, DC, Northern Virginia, and Maryland metropolitan area for decades.  It is imperative to get diagnosed properly since individuals with latex allergy can have very serious allergic reactions if exposed to natural rubber latex.

Avoidance and Treatment:

It is important that we discuss with you how to avoid exposure to natural rubber latex.  It is also important for you to know the sources of latex and what foods to avoid.  There are also hidden sources of latex such as foods that were handled by someone wearing latex gloves.  We will educate you about how to recognize early symptoms of a latex allergy and more importantly, what you can do to treat the symptoms, if they occur.  A self-injectable epinephrine device (EpiPen, Auvi-Q, Adrenaclick, etc.) should be kept with a patient that has a latex allergy at all times.  It is also recommended that the individual wear a MedicAlert bracelet or necklace to let others know of one’s allergy.

If you think you might have a latex allergy, please call us for an appointment at any one of our 3 convenient locations in Washington, DC, McLean, VA (Tysons Corner, VA), or Manassas, VA.  Alternatively, you can click Request an Appointment and fill out the form online and we will call you within 24 hours on the next business day.  The board certified allergists at Black & Kletz Allergy are dedicated in providing quality care to you and your family in a convenient professional environment.