LATEX ALLERGY:

      What you need to know
      that could even save your life


      The Author:

        Michael Monheit is managing partner in the Law Offices of Herbert Monheit, a Philadelphia personal injury law firm. His area of practice concentration includes toxic torts, particularly individual exposure to latex, rubber products, medical devices, and lead paint.

        E-mail: civil@civilrights.com
        Web:         www.civilrights.com


    By Michael Monheit, Esq.

    MONG HEALTHCARE workers, especially, latex protein toxic syndrome -- popularly known as "latex allergy" -- has increased exponentially in less than a decade.

    Why? When OSHA mandated the use of latex gloves for all healthcare workers in order to prevent AIDS transmission in the early 80's, there was a large increase in the worldwide demand for these gloves. Plaintiffs in cases filed across the country have alleged that certain manufacturers rushing to supply the increased demand, resorted to faster, less refined methods of making the material necessary for thin rubber gloves. The alleged result was a higher latex protein content, and proteins are what cause an allergic reaction in those sensitive to them. These allegations will certainly be a central contest in this litigation.

    In the early '90s, up to 1,100 injuries associated with latex protein were reported (many in health care workers). In addition, 15 deaths associated with a single medical device, an NRL cuff to barium enema catheres (all manufactured by a single manufacturer), were investigated for the hypothesis that the latex had caused the deaths. Prevalence in that population was estimated at between 5% and 10%. In the general population, it hovered at 1%. Research published in 1996 shows that an estimated 17% of the healthcare population has been affected by the latex syndrome, while 6% of the general population is currently affected. In just a few years, that's a large jump in the number of sufferers.

    But what does latex allergy look like? What are its symptoms? Largely idiopathic, or differing widely from person to person, they range from a rash, or "contact dermatitis," to sinusitis/rhinitis, to chronic lesions, to anaphylactic shock which can, in turn, be fatal.

    FATAL ANAPHYLACTIC SHOCK

    WHAT DOES A potentially fatal anaphylactic shock look like? For those who have grown hypersensitive to latex through chronic exposure (including at work), 15 minutes after sufferers are exposed to latex proteins, their faces get flushed and red, their voices change and crack, they have a hard time speaking, become short of breath, start throwing up, begin to wheeze, and the skin around their necks retracts -- folding around their bones, using the accessory muscles in an effort to get air into their lungs.

    If injections of epinephrine, along with a bronco-dilator and steroids are not given quickly -- to block the histamine release that causes the cascade of potentially fatal symptoms -- they will suffocate and die.

    How is it possible for symptoms to progress from a "runny nose" and itchy hands to an allergic reaction so severe it can lead to suffocation? The answer is "powder". Latex gloves used by healthcare workers -- by dentists, doctors, nurses, lab technicians and others -- all contain a liberal amount of powder to facilitate putting them on and taking them off. Unfortunately, latex proteins bind to the powder. When the gloves are snapped on or off, powder cascades into the air (becomes aerosolized) and is inhaled by anyone present. Entering the nose, the powder-protein has a direct mucosal contact, with the potential to cause a severe reaction in those worst afflicted.

    Why don't allergic individuals simply switch to gloves made of vinyl or Nitrile? Switching doesn't help if co-workers are still wearing latex gloves and sending aerosolized proteins into the air every time they turn around. And even if everyone agrees to switch to vinyl gloves, the substance is everywhere: in I.V. tubing, ambu bags, ventilators, blood pressure cuffs, and many other medical devices (about 40,000 hospital products, in fact). At home, latex lurks in mouse pads, spatulas, carpet backing, toys, balls, balloons, racquet handles, and the family car, as well as condoms and diaphragms.

    GETTING AN ACCURATE DIAGNOSIS

    WHAT IF YOU SUSPECT that you or someone you know is allergic to latex? How do you get an accurate diagnosis? The only decisive way to know if you are allergic to natural rubber latex proteins is to be appropriately tested by an allergist, preferably someone who is well-versed in the treatment of latex allergy.

    Here is a brief list of symptoms that may mean you or someone you know is latex allergic:

    • If asthmatic, an increase in frequency and severity of asthma attacks;
    • The sudden onset of asthma, with no prior history; frequent "pink-eye," watery eyes, runny nose, sneezing or facial itching;
    • Urticaria (pale wheal), hives, or contact dermatitis after using latex or "hypoallergenic" gloves;
    • Noticeable worsening of seasonal allergies;
    • Inability to tolerate latex products (rubber balloons, condoms, envelope glue);
    • Itching or redness after gynecological procedure or intercourse with a latex condom;
    • Swelling or irritation around on in the mouth after a dental exam or procedure;
    • and anaphylaxis of unknown cause.

    One encouraging note: preventing exposure to latex can prevent the evolution of latex allergy. When more people become aware of its existence, when institutions most at risk take appropriate steps to reduce the level of latex protein in their environments, the current level of danger facing latex-allergic individuals will fall. Since the damage latex can cause includes a radical alteration of lifestyle and, in some cases, death, that would be a welcome relief to all.


    Web Law Review, Winter 1997

    Text and Photo © 1996-97, Michael Monheit, Esq.
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