By Dawn Merritt
*** Award-winning article: 2006 Gold Circle Award, American Society for Association Executives and The Center for Association Leadership
Gerri Rivers woke up with an itchy, red rash on her neck and face. The rash did not spread, but it was still visible and itchy after several days, so she made an appointment to see her physician.
After taking Gerri’s medical history, the physician suggested that a stethoscope could be causing the rash. Working two medical jobs – at a local blood center and as an emergency medical technician (EMT) – Gerri wore a stethoscope around her neck most of the day. The rubber tubing of the stethoscope contained latex, a known allergen. At the mention of latex, Gerri recalled that she had stopped wearing latex gloves years earlier because they irritated her hands. The doctor suspected latex allergy, gave Gerri a prescription for an EpiPen® (a self-injectable dose of epinephrine that can temporarily stop symptoms of life-threatening allergic reactions) and sent her to an allergist to confirm his diagnosis. Life as Gerri knew it had just radically changed.
What’s In That Rubber Tree Plant?
Latex allergy is a reaction to proteins in rubber tree sap, a milky fluid called latex or natural rubber latex used to manufacture products ranging from surgical gloves to helium balloons. The proteins in the sap that cause allergic reactions are called latex allergens. (Allergen is a term used to describe any substance that causes an allergic reaction.)
How does someone become allergic to latex? A person prone to developing allergies has an immune system that responds to ordinarily harmless proteins like pollen, pet dander or latex by producing an antibody called IgE. When IgE antibodies start to build up in the immune system through repeated exposure to the allergen, the person becomes sensitized to that allergen. The sensitivity builds up to the point that when the person comes in contact with latex allergens again, IgE antibodies prompt other cells to begin the chain reaction that leads to allergy symptoms like coughing, sneezing, watery eyes and shortness of breath. Sometimes the allergic reaction can be more serious – even life threatening.
In’s and Out’s of Latex Allergies
Latex allergens can get into your immune system several ways:
- Inhaling allergens: Cornstarch powder used inside latex gloves carries traces of latex allergen with it into the air (and into your lungs). Latex allergens can get airborne in lesser quantities from any product made with latex, especially latex balloons.
- Absorbing allergens externally: If you have a cut, sore or irritated area on your hands (or other body part) and touch a latex product, the allergens have an open door to your immune system.
- Absorbing allergens internally: Your tissues can absorb latex allergens when a doctor or dentist does an internal examination wearing latex gloves, when a latex injection port is inserted for use with intravenous medications or even when you get a shot – stoppers on medication vials can contain latex.
These are the most obvious exposures to latex allergens. But many people who develop latex allergy have no idea how or when they developed it.
People with other allergies are at greater risk for developing latex allergy because their bodies are predisposed to overreact to proteins such as latex. However, medical care workers who wear latex gloves every day are at the highest risk: Up to 17 percent of healthcare workers in the United States have latex allergy, compared with 1 percent of the rest of the population.
How will latex allergy appear? As either a localized allergic reaction or a systemic allergic reaction.
A localized allergic reaction is a skin reaction in the spot you touched latex. Called type IV (delayed-type) hypersensitivity, this reaction can be from the latex allergen itself or the chemical additives in rubber products. Symptoms include a red, bumpy rash and itchy skin that can lead to blisters, and symptoms may appear 24-72 hours after touching a latex product (like breaking out from poison ivy the day after a camping trip).
It’s easy to confuse a localized allergic reaction with localized irritation (contact dermatitis) – the symptoms are the same, and contact dermatitis is a common reaction to the powder inside latex gloves or friction caused by sweating inside latex gloves. However, contact dermatitis is not an allergic reaction and does not signal a sensitivity to latex allergens (or any other allergen). A localized allergic reaction signals that your body has built up latex-specific IgE antibodies and is possibly gearing up for a future systemic allergic reaction.
Systemic allergic reactions are also known as type I immediate allergic reactions. Symptoms include hives, sneezing, nasal congestion, tingling lips, tongue and throat swelling, coughing and wheezing, nausea, abdominal cramping, and facial swelling with itchy, watery eyes. Which of these symptoms a person will experience depends on how sensitive they are to latex and how much latex allergen they were exposed to.
Some people with type I latex allergy will develop anaphylaxis, an allergic reaction that involves multiple organ systems – skin, respiratory tract, gastrointestinal tract and/or cardiovascular system. At their most severe, anaphylaxis symptoms can include trouble breathing and loss of consciousness associated with a dramatic and sometimes fatal drop in blood pressure – anaphylactic shock. It’s impossible to predict whether a systemic allergic reaction will turn into anaphylaxis, so you should take all allergic reactions seriously and carry auto-injectable epinephrine.
No two people with latex allergy are alike. A run-in with a latex balloon may give one person itchy hands but cause another to stop breathing. Local allergic reactions don’t always signal the onset of systemic allergic reactions; a person could have a local allergic reaction every time he comes into contact with latex. On the other hand, a person who develops latex allergy could go straight to a systemic allergic reaction and possibly anaphylactic shock.
Although latex allergy often lasts a lifetime, a person’s level of reaction to latex may change. According to Gerri Rivers, at the height of her latex allergy simply entering a restaurant where someone had a latex balloon earlier in the day sent her to the emergency room. But after years of strict latex avoidance, Gerri can feel an allergic reaction creeping up and can remove herself from dangerous situations before anaphylaxis symptoms kick in.
Where in the World Is Latex?
Some of the places you might find latex include
- Stethoscopes and intravenous drug ports
- Rubber bands and erasers
- Scuba suits
- Handgrips on bicycles and tennis racquets
- Pacifiers and baby bottle nipples
- Fasteners on disposable diapers
- Some carpet backings and pillows
- Raincoats and boots
- Gloves for household dishwashing
People with latex allergy can also have an allergic reaction to foods that contain proteins similar to those found in latex. This reaction is called cross-reactivity and is most frequently caused by bananas, avocados, kiwi fruit and chestnuts. “So it’s important for people with latex allergy to avoid these foods,” says Jordan Fink, MD, Professor of Pediatrics and Medicine, Allergy Division, Medical College of Wisconsin.
Synthetic rubber products, including latex house paints (which don’t actually contain any latex), usually do not cause problems for latex-sensitive people.
Confirm the Diagnosis
Doctors can’t tell you how many exposures to latex allergens are needed before you become sensitive to it (and therefore are likely to have an allergic reaction). If you suspect that you have a latex allergy, make an appointment to see an allergist. Be prepared with as much medical history as possible, including where you were when you had reactions and what latex products you came into contact with. Your doctor will perform a blood test to look for latex-specific IgE antibodies in your system, which will show that your immune system has developed latex sensitivity.
Unlike tests for pollen or pet dander, a skin prick test is not normally used to detect latex allergy. According to Dr. Fink, there is no standardized skin test for latex allergy in the United States approved by the Food and Drug Administration. Some doctors will perform a skin-prick test using a latex glove to see how a patient reacts, but this type of test could be life-threatening if a person is allergic to latex.
Living Without Latex
If you’ve been diagnosed with latex allergy, the only way to prevent an allergic reaction is to avoid latex. No pills, inhaled medications or allergy shots are available to minimize symptoms. D.M.
To learn more about latex allergy, contact the American Latex Allergy Association (A.L.E.R.T, Inc.), a national nonprofit organization that connects consumers with educational materials, support groups, publications and product information on natural rubber latex allergy. Call 888.972.5378 or visit www.latexallergyresources.org.
First published: Allergy & Asthma Today, Summer 2005
Reviewed: March 2009, Laurie Ross