What is the cause of Natural Rubber Latex Allergy?

Due to the demand for healthcare workers need to protect themselves against the risk of cross-infection from blood-borne pathogens (such as HIV and Hepatitis B), and an unprecedented demand for natural rubber latex gloves, the number of healthcare workers with NRL allergy increased.

What is Natural Rubber Latex?

Natural rubber latex (NRL) is a milky fluid obtained from the Hevea brasiliensis tree, which is widely grown in South East Asia, and other countries. NRL is an integral part of thousands of everyday consumer and healthcare items and, like many other natural products, contains proteins which may cause some individuals to develop an allergy.

Who is most at risk?

Around 1-6 % of the general population is thought to be potentially sensitised to NRL, and those most at risk include:

• Healthcare workers
• Individuals undergoing multiple surgical procedures
• Individuals with a history of certain food allergies
• Individuals with atopic allergic disease
• Individuals exposed to NRL on a regular basis e.g. workers in the car mechanics, catering and electronics trades

However, not all sensitised individuals develop the symptoms of an NRL allergy.

Are all latex allergies the same?

There are two types of allergy related to natural rubber latex.

The first of these allergies is caused by the natural proteins, and the second is due to the chemicals used to convert the NRL to a usable item. These allergies are respectively referred to as ‘Type I’ and ‘Type IV’.

If you have experienced an irritant reaction when using products made from natural rubber latex (known as irritant contact dermatitis), you are not actually suffering from a true allergy.

What is a ‘Type IV’ allergy?

A Type IV allergy to NRL means that you have mostly reacted to the chemicals used in the manufacturing process. The chemicals most likely to cause a reaction are thiurams, dithiocarbamates and mercaptobenzothiazoles (MBT).

This allergy is a delayed hypersensitivity reaction, and tends to occur 6 – 48 hours post-exposure. If you have this type of allergy, the symptoms include: a red, itchy, scaly rash, often localised to the area of use (wrists and forearms with glove use, for instance). It can, however, spread to many other areas.

If you are diagnosed with a Type VI allergy, you ought to seek occupational health or medical advice, and avoid the specific chemicals in the future.

What is a ‘Type I’ allergy?

This type of allergy is an immediate allergic reaction to NRL proteins and is potentially life threatening; deaths have occasionally been reported due to latex allergies.

Symptoms for a Type I allergy include:

• Urticaria (hives)
• Hay fever-type symptoms,
• Asthma
• Anaphylaxis: a condition where there is a severe drop in blood pressure leading to possible loss of consciousness or severe breathing difficulty, this is rather rare, though.

There is no cure for NRL allergy, but medications are available to treat symptoms and obviously, the best way to manage the allergy is to avoid cause.

How can I avoid NRL if I am allergic?

To avoid an allergic reaction try to avoid NRL altogether. The best ways to ensure this are:

• Avoiding contact with NRL gloves or products where possible
• Use a Medic-Alert bracelet, which states a natural rubber latex allergy
• Informing employers and healthcare providers of your NRL allergy
• Avoid areas where the inhalation of powder from NRL gloves worn by others or from balloon displays may occur

How is NRL used?

Gloves are the single most widely used device containing natural rubber latex. It has been recommended by institutes such as the Health and Safety Executive (HSE) that they be used wherever a risk assessment identifies them as a necessity.

This is the case in occupations where there is a risk of blood-borne pathogen transmission and body fluid contact, for example, in surgery, catering, domestic services, motor industry and hairdressing.

NRL is the safest choice of material, provided the worker and/or patient are not sensitised to this. If a person is sensitised to NRL proteins, NRL-free gloves and equipment must be used.

Which products contain NRL?

There are many medical and consumer products that contain natural rubber latex. Examples of products containing NRL include:

Medical Equipment:

• Anaesthesia masks
• Blood pressure cuffs
• Catheters
• Dental dams
• Electrode pads
• Endotracheal tubes
• Examination and Surgical gloves
• Injection ports
• Intravenous tubing
• Oral and Nasal airways
• Rubber aprons
• Stethoscopes
• Surgical masks
• Syringes
• Tourniquets
• Wound drains

Consumer Items:

• Adhesives
• Baby teats
• Balloons
• Calculator/remote control buttons
• Carpets
• Condoms
• Contraceptive cap
• Erasers
• Hot water bottles
• Rubber bands
• Shoe soles
• Sports equipment (e.g. hand grips and gym mats)
• Stress balls
• Swimming cap and goggles
• Tyres
• Underwear elastic
• Washing-up gloves

Why use NRL?

NRL is the most cost-effective material, which for the majority of the population is not a clinical risk. It has many benefits which are yet to be equalled by other materials and is the safest form of protection available.