With the implementation of Universal Precautions to prevent infectious diseases, the use of latex gloves has been increasing steadily. There has been an increase of reports of severe health effects associated with the use of latex rubber products. These allergic reactions are thought to be due to an immune response to latex proteins. For this reason many employers are switching to Nitrile gloves.
What are the health effects associated with latex allergy?
Irritant Contact Dermatitis
Non-allergic skin rash characterized by dry, flaky skin with papules, cracks or sores.
Allergic Skin Reactions
Immune response caused by repeated contact with an allergy-producing substance. In sensitive individuals, a rash appears within 96 hours of exposure. Skin may become dry, red, crusted and thickened with hard bumps, sores and, sometimes, blisters. Once an individual is sensitized, contact with even small amounts of the allergen may cause recurrence or worsening of the rash. Sensitization occurs more easily through already damaged skin. Workers with a pre-existing rash should not have direct contact with latex.
Immediate Allergic Reactions
Localized itching, followed by hives may occur in sensitized individuals within 5 to 60 minutes of exposure to latex. Latex allergens may be absorbed by glove powder which may become airborne causing allergic reactions to sensitive individuals. Symptoms may include: itchiness and inflammation of the eyes; eyelid swelling; runny nose; shortness of breath or asthma; dizziness and rapid heartbeat. Symptoms usually disappear without treatment within 30 minutes to 2 hours of removing the exposure.
Life-Threatening Anaphylactic Reactions
Anaphylactic reactions includes all of the above symptoms as well as low blood pressure. Anaphylactic reactions are life-threatening and require medical intervention immediately. (See Information Bulletin, Anaphylaxis - Severe Allergic Reaction)
Who is at risk of developing latex allergy?
Workers who have:
- an ongoing latex exposure.
- multiple allergic conditions.
- a personal history of hay fever and asthma.
- Spina Bifida.
- allergies to avocados, potatoes, bananas, tomatoes, chestnuts, kiwi fruit, papaya and other tropical fruit may also be at increased risk.
What should you do if you are experiencing a reaction to latex?
- Notify your OSSTF Health and Safety Representative and your supervisor.
- Fill out a WSIB Form #6.
- See your doctor promptly for referral to a specialist, diagnosis and documentation. (WSIB Form 8)
- Do not expose yourself to latex.
If you are experiencing symptoms of anaphylactic shock seek medical attention immediately.
What are the employer's responsibilities regarding the sensitized worker?
- A written accommodation policy is recommended to alleviate workers' concerns about continuing work.
- The employer must develop a policy and protocol to assess and accommodate individuals who develop a rubber or latex sensitivity.
- Once a suspected case is reported, a prompt referral to a specialist for assessment in a timely manner is essential. In the interim, non-latex gloves of the appropriate barrier quality should be provided by the employer and used by the worker.
- When a diagnosis of latex contact allergy is confirmed, the employer should accommodate the affected worker. Non-latex gloves should be provided to the sensitized worker and powderless or hypo-allergenic gloves may be provided to co-workers.
- Extremely sensitive workers may have to be reassigned to areas where no latex gloves are used because of sensitivity to airborne latex protein.
- Individuals with anaphylactic reactions should be advised to wear proper identification which warns of the serious nature of their latex allergy. Such individuals should carry their own epinephrine auto-injector (EpiPen).
- Barrier quality and allergenicity must be considered when selecting a glove.
- A current list of products which may contain latex, and possible alternatives, should be obtained from the manufacturer.
- Appropriate training should be provided to the workers about the potential health effects and risk of sensitization related to latex. Staff working in high risk areas should be targeted first.
Control of exposure to latex
Appropriate work practices should be followed:
- After removing latex gloves, workers should wash their hands with a mild soap and dry them thoroughly.
- Areas contaminated with latex dust should be identified and cleaned. Ventilation filters and vacuum bags used in those areas should be changed frequently.
- Workers at increased risk of developing latex sensitivity (i.e. those who have specific food allergies or irritants, or contact dermatitis) should be encouraged to wear impervious type (polyethylene or PVC) liners under latex gloves and where possible wear non-latex gloves (example: nitrile gloves).
- Cotton liners should not be used because of the possibility of latex particles migrating through the liners.
- No lotion or barrier cream should be used under the gloves. The ingredients may react with the latex and compromise the integrity of the gloves.
A safe alternative non-latex glove that provides the appropriate barrier quality must be provided for workers who develop an allergy to latex. Universal precautions must be used when in contact with blood, feces and any body fluid.
See: Ministry of Labour "Guidelines for Latex Glove Users" and NIOSH Alert "Latex Allergy A Prevention Guide”