Natural rubber latex allergy.
Natural rubber latex allergy was identified as an increasingly significant health care problem in the late 1980s. Though the incidence of latex allergy has decreased in the United States over the last several years, 150,000 to 1 million healthcare workers and over 15 million people worldwide still suffer from latex allergy. Natural rubber is obtained from the Hevea brasiliensis tree, a tree of the family Euphorbiacieae and also known as the "rubber tree." Through a process called "rubber tapping," latex is collected from the milky sap of this tree and is derived of 33% rubber, cis 1,4polyisoprene, 2% resin, 65% water, and proteins. Crude latex is collected in ammoniated solution to prevent microbial growth. It contains an array of cellular proteins, lipids, and amino acids, which are the allergens that induce sensitization. In manufacturing rubber, many chemicals may be added to latex such as thiurams in the vulcanization process, stabilizers, and antioxidants. Vulcanization is the chemical process by which the physical properties of natural or synthetic rubber are improved by heating rubber with sulfur. Since rubber deteriorates with aging by oxidation, antioxidants are incorporated in the final rubber products to prevent the polymer chain from degrading. Current antioxidants include thiocarbamates, diphenylamines, dihydroquinolines, and phenylenediamine, all of which are potential contact allergens. The prevalence of latex allergy is dependent on the population studied and ranges from 3% to 64% Latex sensitization in the general population varies from 5.4% to 7.6% Repeated contact with or prolonged exposure to latex containing products may result in adverse latex reactions. Patients with spina bifida or urogenital abnormalities are a particular subpopulation at risk with a prevalence 460% due to multiple surgeries early in life, resulting in frequent exposure to latex. Approximately 10 20% of healthcare workers are sensitized to latex. Exposure to rubber gloves is a frequent cause of occupational latex allergy, but contact with other types of latex containing
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