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Editor—The recent report by Smedleyet al 1 is useful in measuring the prevalence and risk factors for latex allergy within a United Kingdom environment, and providing an up to date review of this problem.
The paper highlights the high frequency of symptoms in healthcare staff but suggests a low frequency of confirmed type I latex allergy. Those who only read the abstract might be misled into considering that the frequency is much lower (two of 372 responders). The frequency among those tested with symptoms was 3% (one of 33) and one person without symptoms was positive on testing (4%; 1/26).
Within the Argyll and Clyde region health surveillance has been performed on staff working in areas with exposure to glutaraldehyde. Such staff also use gloves to protect them from blood and body fluids. A recent audit of the results of health surveillance over the past 5 years identified seven cases of type I latex allergy (confirmed by specific IgE radio allergosorbent test (RAST)) in a workforce of 226 nurses (3% prevalence). The frequency of reported skin symptoms was higher (6% at the last health surveillance) but other causes were also identified (such as rosacea, seborrheic eczema, irritant dermatitis, and type IV allergy to colophony, formaldehyde, and rubber accelerators).
The findings confirm a low frequency of type I latex allergy and support the view that highly intensive health surveillance is not justified. One of the seven healthcare workers identified noted an allergic reaction after eating a sandwich bought from the hospital canteen which had been handled by a member of the catering staff who was wearing latex gloves. Healthcare workers with type I latex allergy can be exposed to latex proteins away from their own work area by such actions or from the continued use of powdered gloves in other areas. This emphasises the need for an organisational approach to this issue. Organisational action to reduce the incidence of this allergy should have priority including the use of non-powdered latex gloves where exposure to blood and body fluids is a risk for those without allergy, the provision of non-latex gloves for those identified with type I allergy and early assessment of those with symptoms related to glove use. Catering staff do not now use latex gloves in the hospital where the reaction reported here occurred.
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