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Latex allergy in the workplace can result in potentially serious health problems for workers, who are often unaware of the risk of latex exposure. Such health problems can be minimized or prevented by developing policies to train and educate employees and glove users on all aspects of glove use, safety & care, and procedures to prevent and react to latex allergies.
Surgical and patient examination gloves are medical devices regulated by the FDA (Food and Drug Administration). The legal definition of "medical device" encompasses several thousand health products, from simple articles such as thermometers, tongue depressors, and heating pads, to sensitive and complex devices such as pacemakers, lasers, and imaging technologies. The enactment of the Medical Device Amendments of 1976 amended the Federal Food, Drug, and Cosmetic Act (the FD&C Act) to give FDA specific authority to regulate the safety and effectiveness of medical devices.
Since 1989, FDA has received reports of 15 deaths and numerous other severe allergic reactions associated with exposure to latex. These deaths were associated with anaphylactic reactions to natural rubber latex. To determine whether there was a connection between the deaths and latex, FDA initiated research that demonstrated that antibodies from latex sensitive individuals reacted to a number of natural latex proteins. FDA used this information to inform industry and users that natural latex proteins were the source of potentially life threatening reactions to natural rubber latex-containing products.
Advice was developed for manufacturers to remove leachable proteins associated with these reactions from their finished devices. A Medical Alert was also issued to the medical community to alert health care workers to the problem of natural latex allergy, make recommendations for patient care and advice, and request health professionals to report adverse reactions to latex in medical devices.
Scientific studies and case reports have documented sensitivity to natural latex proteins found in a wide range of medical devices. Based on this information, the FDA promulgated a rule which became effective September 30, 1998 to require labeling statements on medical devices and device packaging containing natural rubber with which people come into contact. The labeling information enables users who are already sensitized to natural latex proteins to avoid exposure to natural latex proteins. It also enables users to make informed choices about the gloves and other products they may use personally and as importantly, the products they use on patients who may have sensitivity to natural latex.
The FDA also noted that manufacturers of many products, including latex exam gloves, increasingly were labeling their products as "hypoallergenic." FDA believes this term is interpreted by consumers to mean that the risk of allergic reactions to any component of the device would be minimal. This is not the case with devices containing natural rubber. The labeling regulation, therefore, prohibits use of the term "hypoallergenic" on medical devices that contain natural rubber because it incorrectly implies the device can be used safely by persons sensitive to natural latex proteins.
Although medical devices are manufactured and labeled as designated by the FDA and other regulatory authorities, policies for safe, appropriate glove use should be developed as summarized below:
Examine current procedures for exam glove use
Assess need for examination gloves
Provide alternative gloves when available
Use gloves appropriate for the task
Refrain from use of expired gloves
Buy correctly labeled products manufactured according to standards
Upon completion and implementation of these policies, information should be provided to educate and train employees in the following areas:
Identifying appropriate gloves for tasks needed
Glove labeling and storage, specifically which exam gloves contain latex
Avoid use of lotions or barrier creams under the gloves which may react with the latex or compromise the integrity of the gloves
Proper recognition of signs and symptoms of latex allergy
The need to immediately report suspected cases of reaction and/or consult a physician
Procedures for dealing with suspected as well as confirmed cases
Guidelines for exam glove use can be supplemented with the following employer and worker recommendations for preventing latex allergy in the workplace. These prevention methods are based on current knowledge and a common-sense approach to minimizing latex-related health problems. Evolving manufacturing technology and improvements in measurement methods may lead to changes in these recommendations in the future. For now, adoption of the recommendations wherever feasible will contribute to the reduction of exposure and risk for the development of latex allergy.
Employers
Latex allergy can be prevented only if employers adopt policies to protect workers from undue latex exposures. NIOSH recommends that employers take the following steps to protect workers from latex exposure and allergy in the workplace:
1. Provide workers with non-latex gloves to use when there is little potential for contact with infectious materials (for example, in the food service industry).
2. Appropriate barrier protection is necessary when handling infectious materials [CDC 1987]. If latex exam gloves are chosen, provide reduced protein, powder-free gloves to protect workers from infectious materials.
3. Ensure that workers use good housekeeping practices to remove latex-containing dust from the workplace:
Identify areas contaminated with latex dust for frequent cleaning (upholstery, carpets, ventilation ducts, and plenums).
Make sure that workers change ventilation filters and vacuum bags frequently in latex-contaminated areas.
4. Provide workers with education programs and training materials about latex allergy, including the NIOSH Alert for Preventing Allergic Reactions to Natural Rubber Latex in the Workplace and the OSHA Technical Informational Bulletin.
5. Periodically screen high-risk workers for latex allergy symptoms. Detecting symptoms early and removing symptomatic workers from latex exposure are essential for preventing long-term health effects.
6. Evaluate current prevention strategies whenever a worker is diagnosed with latex allergy.
Workers
Workers should take the following steps to protect themselves from latex exposure and allergy in the workplace:
1. Use non-latex gloves for activities that are not likely to involve contact with infectious materials (food preparation, routine housekeeping, maintenance, etc.).
2. Appropriate barrier protection is necessary when handling infectious materials [CDC 1987]. If you choose latex gloves, use powder-free gloves with reduced protein content:
Such gloves reduce exposures to latex protein and thus reduce the risk of latex allergy (though symptoms may still occur in some workers).
So-called hypoallergenic latex gloves do not reduce the risk of latex allergy. However, they may reduce reactions to chemical additives in the latex (allergic contact dermatitis).
3. Use appropriate work practices to reduce the chance of reactions to latex:
When wearing latex gloves, do not use oil-based hand creams or lotions (which can cause glove deterioration) unless they have been shown to reduce latex-related problems and maintain glove barrier protection.
After removing latex gloves, wash hands with a mild soap and dry thoroughly.
Use good housekeeping practices to remove latex-containing dust from the workplace:
Frequently clean areas contaminated with latex dust (upholstery, carpets, ventilation ducts, and plenums).
Frequently change ventilation filters and vacuum bags used in latex-contaminated areas.
4. Take advantage of all latex allergy education and training provided by your employer:
Become familiar with procedures for preventing latex allergy.
Learn to recognize the symptoms of latex allergy: skin rashes; hives; flushing; itching; nasal, eye, or sinus symptoms; asthma; and shock.
5. If you develop symptoms of latex allergy, avoid direct contact with latex gloves and other latex-containing products until you can see a physician experienced in treating latex allergy.
6. If you have latex allergy, consult your physician regarding the following precautions:
Avoid contact with latex gloves and other latex-containing products.
Avoid areas where you might inhale the powder from latex gloves worn by other workers.
Tell your employer and your health care providers (physicians, nurses, dentists, etc.) that you have latex allergy.
Wear a medical alert bracelet.
7. Carefully follow your physician's instructions for dealing with allergic reactions to latex.
Successful development and implementation of policies regarding glove use can diminish or prevent serious health conditions associated with latex allergy. Paired with prevention procedures and continuing education, safe efficient working environments will be created and maintained.
Rachelle Moxley writes about the business side of healthcare and medical management. DonTheGlove.com is the online division of Handgards Inc, a 45 year old company specializing in hand protection products. Rachelle is a frequent contributor to the website's resource centers. If you thought this article was helpful, you may explore additional articles at: www.dontheglove.com/ .
For more information about Non-Latex Gloves: Made From Third Generation Synthetic, please visit: www.dontheglove.com/syntheticgloves/ |
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