Control of airborne latex by use of powder-free latex gloves,☆☆,,★★

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Abstract

Objective: Our objective was to assess airborne latex allergen exposure in the workplace of a hospital laboratory technician with occupational latex sensitization and repeated anaphylactic episodes from this. Her allergic manifestations had cleared only when coworkers changed to powder-free latex gloves. Therefore a laboratory still using powdered latex gloves was selected for comparative airborne latex sampling. Design: The design was a survey. Setting: We used a hospital hematology laboratory, and a biochemistry laboratory was used for comparison. Participants: The index case with latex allergy is described. An average of 10 employees worked on the day shift in the same laboratory, and 10 employees worked in the biochemistry laboratory studied. Main outcome measure: Airborne latex allergen levels obtained by high airflow area sampling were compared in the laboratory using powder-free latex gloves and in the laboratory using powdered latex gloves. Results: Levels were below the level of detection (<0.02 ng/m3 of latex allergen) in the laboratory using powder-free latex gloves but ranged from 39 to 311 ng/m3 in the laboratory using powdered gloves. Conclusions: Airborne latex allergen is produced with use of powdered latex gloves. Such usage by coworkers may provoke respiratory and anaphylactic response to latex in sensitized subjects. Use of powder-free gloves by coworkers may enable such patients to continue work in their trained profession and may prevent measurable airborne latex exposure. Affected patients, however, still need to avoid direct latex contact. (J ALLERGY CLIN IMMUNOL 1994;93:985-9.)

Section snippets

CASE REPORT

A 28-year-old female hematology laboratory technician was seen in December 1990 with a 2-year history of contact dermatitis while using latex gloves at work. In addition to the eczematous response on her hands, she also noted contact urticaria. In May 1988 she had had an anaphylactic episode while gloving at work and again experienced anaphylaxis in February 1989 during cesarean section. This occurred within minutes of contact with gloves used by the surgeon. Since then she has used vinyl

Air sampling

Area air samplers (Quan-Tec-Air, Inc., Rochester, Minn.) were used to collect air samples from a hospital biochemistry laboratory and from the hematology laboratory of the patient described. Area samplers were operated 6 hours a day, from about 9 AM to 3 PM at a flow rate of 3 L/sec. Airborne particles were collected onto polytetrafluoroethylene filters that were changed each day.

The index case air sampling was conducted in a combined blood bank/hematology laboratory, a 2400-square-foot area.

DISCUSSION

Our findings suggest this patient had inhaled latex–induced anaphylaxis when coworkers used powdered latex gloves. A change to powder-free latex glove use in her environment, while she used nonlatex gloves, was associated with clearing of symptoms. She was therefore able to continue working normally in this environment. The lack of measurable airborne latex in her current environment by area sampling supports our hypothesis that latex becomes airborne from powdered latex gloves and not from

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From The Department of Medicine, University of Toronto, Ontario, and The Mayo Clinic and Foundation, Rochester, Minn.

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Supported, in part, by the Ontario Allergy Society Research Fund.

Reprint requests: S. Tarlo, The Asthma Centre, Toronto Western Division of the Toronto Hospital, EC4-008, 399 Bathurst St., Toronto, Ontario, Canada M5T 2S8.

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