1. LATEX ALLERGY

2. OBJECTIVES At the conclusion of the Self-Learning Packet, the learner will be able to: 1.Define Latex Allergy. 2.Identify individuals at risk for Latex Allergy. 3.Summarize the incidence and pathophysiology of Latex Allergy. 4.List the signs of Latex Allergy. 5.Identify items that contain latex vs. latex free items. 6.State practical steps to take in providing care to latex sensitive patients. 7.Identify signs and symptoms of potential latex sensitivity in the health care worker. 8.State the steps in reporting and evaluating health problems associated with latex use.

3. LATEX ALLERGY THE PROBLEM An estimated 8% to 17% of health care workers are allergic to latex. Anaphylactic reactions to latex can be fatal. Health care worker exposure to latex has increased dramatically since the institution of Standard (Universal) Precautions. Due to the increased demand for gloves, inexperienced manufacturers are now producing latex gloves that contain varying amounts of latex protein,

4. LATEX ALLERGY DEFINITION Latex Allergy is a reaction caused by extreme sensitivity to latex rubber. Latex is a natural elastic product that comes from the Brazilian rubber tree. Latex is used in many products in healthcare and home. Latex is harmless for most people, but for others it can cause problems ranging from mild skin reactions to life-threatening problems. Manufacturers add chemicals and preservatives in the process of making latex gloves.

5. LATEX ALLERGY HOW DO REACTIONS OCCUR? Latex Allergy begins when your immune system mistakes the proteins in latex for a harmful invader. Latex proteins enter the body through skin, mucous membranes, intravascularly, or by inhalation. Cornstarch powder which is used in gloves is a carrier of the protein. Because proteins can be airborne for hours after putting on or removing gloves, this allergen can be inhaled or settle on clothing, skin or mucous membranes. Your immune system responds by building up latex fighting antibodies. These antibodies produce chemicals which cause allergy symptoms.

6. LATEX IS EVERYWHERE HEALTH-CARE (Hospitals, Dental Offices, etc.) - Gloves (Main cause of allergy in hospital) - Catheters - Blood Pressure Cuffs/Stethoscopes - Tourniquets - Injection Ports/ Rubber Tops on Vials - Masks - Keofeed Tubes - Bandages HOME - Gloves - Balloons - Carpet Backing - Condoms and Diaphragms - Rubber Bands - Beach Toys/Rafts - Handgrips on Rackets and Tools

7. LATEX ALLERGY WHO’S AT RISK Anyone routinely exposed to latex is at risk. Patients whose care requires regular exposure to latex - Spina Bifida - Chronic Urinary/Renal Problems Health-Care Workers - Doctors/Nurses - Dentists/Hygienists - Laboratory Personnel - Any individual who wears latex gloves routinely. People who work with latex - Work in latex plants - Make latex gloves People with history of allergies to avocados, bananas and eczema

8. LATEX ALLERGY WHAT ARE THE SIGNS? MILD REACTION - Redness where contact with latex has occurred - Skin rash - Hives - Swelling of face and hands - Runny nose - Itchy nose/watery eyes ANAPHYLACTIC REACTION - Wheezing - Decrease in Blood Pressure - Increased Heart Rate - Flushed face - Swelling of the throat

9. LATEX ALLERGY MAKING THE DIAGNOSIS PAST REACTIONS TO LATEX - Allergic symptoms after coming into contact with latex HISTORY OF ALLERGIES - History of multiple allergies - History of eczema - History of food allergies to kiwis/bananas BLOOD TEST - RAST immunoassay (radioallergosorbent testing) measures the serum level of latex- specific IgE.

10. DO YOU HAVE A PROBLEM WITH LATEX? IF YOU NOTICE: Skin irritation with glove use Hives related to latex gloves Sinus congestion and wheezing associated with the use of latex gloves NOTIFY YOUR MANAGER! The manager will: Have you complete an Employee Medical Referral Form Refer you to Employee Health for Evaluation

11. DO YOU HAVE A PROBLEM WITH LATEX? EMPLOYEE HEALTH WILL: Examine effected areas Take a focused clinical history Request completion of the “Latex Survey” form Test: IGE and RAST test for natural latex (blood) Request reasonable accommodations at the work site Communicate outcome to manager

12. DO YOU HAVE A PROBLEM WITH LATEX? WHEN RESULTS ARE AVAILABLE, the employee will be: Notified of results Reasonably accommodated Educated regarding risks for latex reactions Educated to recognize signs and symptoms of allergic response Educated regarding ways to avoid latex at home and work. IF THE RESULTS ARE POSITIVE: Advise follow-up with Allergist Manager will participate with Employee Health and the employee to provide reasonable accommodations

13. LATEX ALLERGY PROTECTING YOURSELF AVOID CONTACT WITH LATEX - Know GBMC’s policies regarding latex - Contact Employee Health - Avoid latex items and use non-latex alternatives such as silicone or vinyl - Wear a medic alert bracelet or tag LEARN WHAT HOUSEHOLD AND MEDICAL ITEMS CONTAIN LATEX - Use non-latex gloves - Use powderless gloves BE PREPARED FOR SEVERE REACTIONS - Carry Epinephrine Auto-Injector or quick-acting oral antihistamine at all times

14. CARING FOR LATEX- SENSITIVE PATIENTS Screen patients for high risk and allergy Place in private room to limit exposure Remove all latex containing items from the room prior to admission If possible, have room cleaned by a person wearing non-latex gloves Place labels on patient room and chart to notify others of allergy Maintain a latex-safe environment - Vinyl gloves - Non-latex equipment - Latex-free pharmacy protocol for drug preparation - Place a cloth barrier between the skin and blood pressure cuff or use a non-latex cuff. Schedule procedures early in the day

15. LATEX SAFE ENVIRONMENT A list of Latex Free Equipment is maintained on the GBMC Infoweb. Each clinical care unit has a Latex Free Starter Kit. Check with your unit manager for location. To order Latex Free Products send a Latex Free Order Sheet to General Stores.