Constance Monitto, M.D.
The Johns Hopkins Hospital, Baltimore, MD
What is latex?
Latex is a milky fluid that is produced by rubber trees. This liquid is processed to produce natural rubber latex which is blended with other compounds to make thousands of products your child may come in contact with at home, at school, and at the hospital. These include balloons, toys, pacifiers, rubber bands, bandaids, medical gloves, urinary catheters, and dental dams.
What is latex allergy?
There are two types of allergic reactions to latex. The first is a rash or contact dermatitis. This reaction occurs 12 to 36 hours after contact with a latex-containing product. It is usually due to an immune reaction to chemicals that are added to rubber during processing. It most commonly occurs in people who wear latex gloves regularly. This reaction is annoying, but not life-threatening.
The second type of allergic reaction can be much more serious. It occurs in people who were previously exposed to latex, and is due to an allergy to a natural rubber latex protein. Allergy to latex protein became much more common in the 1980's and 1990's. This is thought to be due to a change in the way that latex was processed as well as an increase in the use of latex gloves to avoid infection at that time.
When allergic children and adults are re-exposed to latex, either by contact with a latex containing product, or by breathing air that contains latex particles, they can develop symptoms such as rash or hives, itching, redness, watery eyes, swelling, sneezing, and wheezing. Rarely, a person can experience a life-threatening response known as .anaphylaxis.. This reaction can cause low blood pressure, irregular heart rhythms, and severe trouble breathing, and can be life threatening.
Risk factors for latex allergy
Your child's doctor may be concerned that she has latex allergy if she has ever had an allergic reaction following exposure to latex containing products. There are also certain diseases that are associated with latex allergy. The most common diseases associated with latex allergy are spina bifida, a congenital problem in the development of the spine, and urinary tract problems. Up to half of the children born with these diseases may develop latex allergy. This may be due to repeated exposure to latex during the multiple surgeries necessary to treat health problems related to these diseases. Because the rate of latex allergy is so high in these children, avoidance of latex-containing products is now frequently recommended to minimize the chance of sensitization.
Another group of people who are at risk for developing latex allergy are health care workers, like your doctor, and other people who wear latex gloves repeatedly at work.
Also, because some foods contain proteins that are similar to latex proteins, if your child is allergic to certain fruits and nuts (for example, bananas, avocados, kiwi, and European chestnuts), he may be more likely to develop an allergy to latex.
Diagnosis:
If your doctor is concerned that your child is latex allergic, she may refer your child to an allergist for evaluation. The allergist will perform a history and a physical examination and may decide to perform further testing.
The most common test that is performed to test for latex allergy is the RAST test. This is a blood test that measures the amount of latex-associated antibodies in your child's blood. It is an important test in diagnosing latex allergy, but it does not identify all children with the allergy.
Skin testing for latex allergy can also be done. This test involves injecting a small amount of latex protein under the skin. If your child is allergic, she will develop a raised bump at the injection site. While this test is more sensitive, it should only be performed at specialized allergy centers.
Prevention:
The most important means of preventing allergic reactions to latex-containing products involves avoiding contact with latex products as much as possible. Exposure to latex can occur when latex-containing products come in contact with a person's skin, their mucous membranes (for example, their mouth or bladder), their blood (during surgery or by their intravenous), or when they breathe in latex particles from the air. If your child has or is at risk for latex allergy you should make sure that your family members, your doctors, and your child's school, day care, and camp are all aware of his allergy.
In the hospital and the operating room precautions can be taken to avoid using latex containing products during surgery as well as at other times. Because is often difficult to know if a product does or does not contain latex just by looking at it, the Food and Drug Administration now requires labeling of natural latex rubber in all medical devices. In addition, manufacturers now make many products that can be substituted for latex containing ones (for example, vinyl or nitrile gloves, latex-free IV tubing), and some hospitals now substitute latex-free products for latex-containing ones wherever feasible.
Treatment:
While latex avoidance is the most important part of prevention and treatment, if a reaction does occur, your child may require medical attention and medicines to treat the symptoms. These may include antihistamines, steroids, and, in severe cases, epinephrine. If you know or suspect that your child is latex allergic, make sure your doctors are aware so that they can minimize your child's exposure to latex containing products, and be ready to institute treatment as quickly as possible if necessary. In addition, if your child is latex allergic they may also benefit from wearing a medic-alert bracelet and possibly having access to autoinjectable epinephrine.