1. Latex Allergy Loma Linda University Medical Center Murrieta Food and Nutrition Services Presented by Cindi Rafoth, RD Created by Gena Alltizer

2. What is latex? Latex is a natural product that is used to form rubber. It can also be made synthetically. Latex allergy is not caused by the natural rubber itself, but from the protein prohevein found in the rubber.

3. Latex products Latex can be found in gloves, catheters, rubber bands, balloons, and baby bottle nipples. The use of powdered latex gloves can cause the protein prohevein to become airborne, and consequentially cause a reaction in patients with latex sensitivity.

4. Latex Allergies There are two main types of latex allergy IgE mediated allergic reactions Cell mediated contact dermatitis

5. IgE Mediated Allergic Reactions Can be life threatening, and are of the most concern to clinicians. Mode of transmission: direct skin contact, mucosal surface contact, or inhalation. Anaphylaxis as well as any of these symptoms may occur: hives, itching, flushing, swelling, sneezing, shortness of breath, chest tightness, nausea, and dizziness.

6. Cell Mediated Contact Dermatitis Not life threatening. Skin irritation and rash are evident at the site of exposure to the latex product.

7. Latex Diet Syndrome About 40% of individuals with latex allergy also exhibit a food allergy. This is known as Latex Diet Syndrome, or Latex Fruit Syndrome. Many foods have proteins in common with latex that cause a reaction.

8. Most Common Foods Foods that most commonly cause a reaction in patients with a latex allergy are: Avocado Banana Kiwi Chestnuts

9. Most Common Foods Tree NutsBell PeppersCarrots DillFigsGrapes MangoesOreganoPassion Fruit PineappleSageTomatoes Sunflower SeedsApricotsPotatoes ApplesCeleryPapaya MelonsStrawberriesZucchini ChickpeasSoybeansRye Foods that also may cause an allergic reaction are:

10. Tree Nuts Examples of Tree Nuts: CoconutWalnutsAlmonds Macadamia Nuts CashewsHazelnuts PecansPistachiosPine Nuts

11. Cross Reactivity Pollens in the air have proteins that may cause cross reactivity when patients consume: Mugwort with Carrot, Celery, Apple, Peanut, & Kiwi Birch with Apple, Pear, Peach, Cherry, & Hazelnut Grasses (Wheat, Rice, Barley) with Potato Ragweed with Banana, & Melons

12. Interviewing the patient When a patient indicates they have a latex allergy, further questioning to determine if they have also experienced any related food allergies is necessary. Type and severity of reaction should also be determined.

13. Questions?

14. Quiz Question # 1 True or False: A patient with an IgE mediated allergy will not have an allergic reaction as long as you do not touch them with a latex product.

15. Quiz Question # 2 What is the name of the syndrome that describes patients with a latex allergy who also react to certain foods containing the same proteins?

16. Quiz Question # 3 Which of the following nuts is not considered a tree nut? (a) Pecans (b) Peanuts (c) Walnuts (d) Coconut (e) Both b. and d. (f) All of the above are tree nuts

17. Quiz Question # 4 List the four most common foods that may cause an allergic reaction in patients with latex allergy.

18. Quiz Question # 5 Which menu selection could cause an allergic reaction in a patient with latex allergy? (a) Scrambled eggs, and wheat toast with butter. (b) Harvest Salad-mixed greens, avocado, & pecans. (c) Macaroni and cheese, with baked sweet potato. (d) Turkey sandwich on sourdough, lettuce only. (e) Hummus with pita chips. (f) Both b. and e.

19. Quiz Question # 6 True or False: A patient with a latex allergy will absolutely not have a reaction from eating coconut rice.

20. References Academy of Nutrition and Dietetics Nutrition Care Manual. Latex Allergy. Retrieved Oct. 30, 2014 American Academy of Allergy, Asthma, and Immunology (2014). Latex allergy: Tips to remember. Web. Retrieved Oct. 30, 2014