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. 2001 Jun;58(6):386–391. doi: 10.1136/oem.58.6.386

Sensitisation to natural rubber latex: an epidemiological study of workers exposed during tapping and glove manufacture in Thailand

N Chaiear 1, S Sadhra 1, M Jones 1, P Cullinan 1, I Foulds 1, P Burge 1
PMCID: PMC1740139  PMID: 11351054

Abstract

OBJECTIVES—To estimate the prevalence of sensitisation to natural rubber latex in latex tappers and latex glove factory workers, and to relate this to airborne exposure to latex.
METHODS—Five hundred workers employed in three latex glove factories, 314 tappers, and 144 college students (control group) were studied. The workers in the glove factories were classified into three exposure groups; high, moderate, and low. Personal exposures to natural rubber latex aeroallergens were measured by immunoassay. Symptom questionnaires and skin prick tests with latex allergens (Stallergènes 1:200 w/v) and other common environmental allergens were performed. The criterion for positivity was a wheal reaction at least 3 mm in diameter greater than that to a diluent control.
RESULTS—The geometric mean (GM) concentration of latex in air was 15.4 µg/m3 for those employed in glove stripping, glove inspections, and packing of powdered gloves. The moderate exposure glove manufacturing group and the tappers had GM concentrations of 2.3 and 2.4 µg/m3 respectively, compared with United Kingdom users of latex powdered gloves,who had GM concentrations of 0.5 µg/m3. The prevalence of sensitisation to latex in the tappers and latex glove factory workers was 1.3% and 1.7% respectively. No positive cases were found among the college students. Workers who showed a positive skin prick test to latex were more likely to be atopic. Work related respiratory and dermatological symptoms were found in about 20% of each population studied, but were not related to the presence of positive latex prick tests.
CONCLUSIONS—This study suggests that in the Thai latex industries, latex sensitisation is rare despite high concentrations of airborne exposure and is less prevalent than in the healthcare sector in Europe where skin exposure is greater. 


Keywords: natural rubber; latex; allergy; glove factory; healthcare

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Selected References

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  1. Arellano R., Bradley J., Sussman G. Prevalence of latex sensitization among hospital physicians occupationally exposed to latex gloves. Anesthesiology. 1992 Nov;77(5):905–908. doi: 10.1097/00000542-199211000-00011. [DOI] [PubMed] [Google Scholar]
  2. Axelsson I. G., Eriksson M., Wrangsjö K. Anaphylaxis and angioedema due to rubber allergy in children. Acta Paediatr Scand. 1988 Mar;77(2):314–316. doi: 10.1111/j.1651-2227.1988.tb10652.x. [DOI] [PubMed] [Google Scholar]
  3. Barbee R. A., Lebowitz M. D., Thompson H. C., Burrows B. Immediate skin-test reactivity in a general population sample. Ann Intern Med. 1976 Feb;84(2):129–133. doi: 10.7326/0003-4819-84-2-129. [DOI] [PubMed] [Google Scholar]
  4. Brehler R., Theissen U., Mohr C., Luger T. "Latex-fruit syndrome": frequency of cross-reacting IgE antibodies. Allergy. 1997 Apr;52(4):404–410. doi: 10.1111/j.1398-9995.1997.tb01019.x. [DOI] [PubMed] [Google Scholar]
  5. Chan-Yeung M., Vedal S., Lam S., Enarson D. Immediate skin reactivity and its relationship to age, sex, smoking, and occupational exposure. Arch Environ Health. 1985 Jan-Feb;40(1):53–57. doi: 10.1080/00039896.1985.10545889. [DOI] [PubMed] [Google Scholar]
  6. Cormio L., Turjanmaa K., Talja M., Andersson L. C., Ruutu M. Toxicity and immediate allergenicity of latex gloves. Clin Exp Allergy. 1993 Jul;23(7):618–623. doi: 10.1111/j.1365-2222.1993.tb00903.x. [DOI] [PubMed] [Google Scholar]
  7. Douglas R., Morton J., Czarny D., O'Hehir R. E. Prevalence of IgE-mediated allergy to latex in hospital nursing staff. Aust N Z J Med. 1997 Apr;27(2):165–169. doi: 10.1111/j.1445-5994.1997.tb00933.x. [DOI] [PubMed] [Google Scholar]
  8. Estlander T., Jolanki R., Kanerva L. Dermatitis and urticaria from rubber and plastic gloves. Contact Dermatitis. 1986 Jan;14(1):20–25. doi: 10.1111/j.1600-0536.1986.tb01147.x. [DOI] [PubMed] [Google Scholar]
  9. Grzybowski M., Ownby D. R., Peyser P. A., Johnson C. C., Schork M. A. The prevalence of anti-latex IgE antibodies among registered nurses. J Allergy Clin Immunol. 1996 Sep;98(3):535–544. doi: 10.1016/s0091-6749(96)70087-8. [DOI] [PubMed] [Google Scholar]
  10. Heese A., Peters K. P., Stahl J., Koch H. U., Hornstein O. P. Häufigkeit und Zunahme von Typ-I-Allergien gegen Gummihandschuhe bei Zahnmedizinstudenten. Hautarzt. 1995 Jan;46(1):15–21. doi: 10.1007/s001050050201. [DOI] [PubMed] [Google Scholar]
  11. Heese A., van Hintzenstern J., Peters K. P., Koch H. U., Hornstein O. P. Allergic and irritant reactions to rubber gloves in medical health services. Spectrum, diagnostic approach, and therapy. J Am Acad Dermatol. 1991 Nov;25(5 Pt 1):831–839. doi: 10.1016/s0190-9622(08)80977-2. [DOI] [PubMed] [Google Scholar]
  12. Jaeger D., Kleinhans D., Czuppon A. B., Baur X. Latex-specific proteins causing immediate-type cutaneous, nasal, bronchial, and systemic reactions. J Allergy Clin Immunol. 1992 Mar;89(3):759–768. doi: 10.1016/0091-6749(92)90385-f. [DOI] [PubMed] [Google Scholar]
  13. Kibby T., Akl M. Prevalence of latex sensitization in a hospital employee population. Ann Allergy Asthma Immunol. 1997 Jan;78(1):41–44. doi: 10.1016/S1081-1206(10)63370-4. [DOI] [PubMed] [Google Scholar]
  14. Konrad C., Fieber T., Gerber H., Schuepfer G., Muellner G. The prevalence of latex sensitivity among anesthesiology staff. Anesth Analg. 1997 Mar;84(3):629–633. doi: 10.1097/00000539-199703000-00031. [DOI] [PubMed] [Google Scholar]
  15. Lagier F., Vervloet D., Lhermet I., Poyen D., Charpin D. Prevalence of latex allergy in operating room nurses. J Allergy Clin Immunol. 1992 Sep;90(3 Pt 1):319–322. doi: 10.1016/s0091-6749(05)80009-0. [DOI] [PubMed] [Google Scholar]
  16. Lundberg M., Wrangsjö K., Johansson S. G. Latex allergy from glove powder--an unintended risk with the switch from talc to cornstarch? Allergy. 1997 Dec;52(12):1222–1228. doi: 10.1111/j.1398-9995.1997.tb02527.x. [DOI] [PubMed] [Google Scholar]
  17. Maso M. J., Goldberg D. J. Contact dermatoses from disposable glove use: a review. J Am Acad Dermatol. 1990 Oct;23(4 Pt 1):733–737. doi: 10.1016/0190-9622(90)70283-n. [DOI] [PubMed] [Google Scholar]
  18. Moneret-Vautrin D. A., Beaudouin E., Widmer S., Mouton C., Kanny G., Prestat F., Kohler C., Feldmann L. Prospective study of risk factors in natural rubber latex hypersensitivity. J Allergy Clin Immunol. 1993 Nov;92(5):668–677. doi: 10.1016/0091-6749(93)90009-5. [DOI] [PubMed] [Google Scholar]
  19. Nutter A. F. Contact urticaria to rubber. Br J Dermatol. 1979 Nov;101(5):597–598. doi: 10.1111/j.1365-2133.1979.tb11893.x. [DOI] [PubMed] [Google Scholar]
  20. Orfan N. A., Reed R., Dykewicz M. S., Ganz M., Kolski G. B. Occupational asthma in a latex doll manufacturing plant. J Allergy Clin Immunol. 1994 Nov;94(5):826–830. doi: 10.1016/0091-6749(94)90149-x. [DOI] [PubMed] [Google Scholar]
  21. Pecquet C., Leynadier F., Dry J. Contact urticaria and anaphylaxis to natural latex. J Am Acad Dermatol. 1990 Apr;22(4):631–633. doi: 10.1016/0190-9622(90)70086-w. [DOI] [PubMed] [Google Scholar]
  22. Roberts D. M. The incidence of atopy in a working population. J Soc Occup Med. 1987 Winter;37(4):106–110. doi: 10.1093/occmed/37.1.106. [DOI] [PubMed] [Google Scholar]
  23. Sri-akajunt N., Sadhra S., Jones M., Burge P. S. Natural rubber latex aeroallergen exposure in rubber plantation workers and glove manufacturers in Thailand and health care workers in a UK hospital. Ann Occup Hyg. 2000 Mar;44(2):79–88. [PubMed] [Google Scholar]
  24. Swanson M. C., Bubak M. E., Hunt L. W., Yunginger J. W., Warner M. A., Reed C. E. Quantification of occupational latex aeroallergens in a medical center. J Allergy Clin Immunol. 1994 Sep;94(3 Pt 1):445–451. doi: 10.1016/0091-6749(94)90199-6. [DOI] [PubMed] [Google Scholar]
  25. Tarlo S. M., Wong L., Roos J., Booth N. Occupational asthma caused by latex in a surgical glove manufacturing plant. J Allergy Clin Immunol. 1990 Mar;85(3):626–631. doi: 10.1016/0091-6749(90)90103-b. [DOI] [PubMed] [Google Scholar]
  26. Tomazic V. J., Shampaine E. L., Lamanna A., Withrow T. J., Adkinson N. F., Jr, Hamilton R. G. Cornstarch powder on latex products is an allergen carrier. J Allergy Clin Immunol. 1994 Apr;93(4):751–758. doi: 10.1016/0091-6749(94)90255-0. [DOI] [PubMed] [Google Scholar]
  27. Tomazic V. J., Withrow T. J., Fisher B. R., Dillard S. F. Latex-associated allergies and anaphylactic reactions. Clin Immunol Immunopathol. 1992 Aug;64(2):89–97. doi: 10.1016/0090-1229(92)90185-q. [DOI] [PubMed] [Google Scholar]
  28. Turjanmaa K. Incidence of immediate allergy to latex gloves in hospital personnel. Contact Dermatitis. 1987 Nov;17(5):270–275. doi: 10.1111/j.1600-0536.1987.tb01476.x. [DOI] [PubMed] [Google Scholar]
  29. Turjanmaa K., Laurila K., Mäkinen-Kiljunen S., Reunala T. Rubber contact urticaria. Allergenic properties of 19 brands of latex gloves. Contact Dermatitis. 1988 Nov;19(5):362–367. doi: 10.1111/j.1600-0536.1988.tb02953.x. [DOI] [PubMed] [Google Scholar]
  30. Turjanmaa K., Palosuo T., Alenius H., Leynadier F., Autegarden J. E., André C., Sicard H., Hrabina M., Tran T. X. Latex allergy diagnosis: in vivo and in vitro standardization of a natural rubber latex extract. Allergy. 1997 Jan;52(1):41–50. doi: 10.1111/j.1398-9995.1997.tb02544.x. [DOI] [PubMed] [Google Scholar]
  31. Vandenplas O., Delwiche J. P., Depelchin S., Sibille Y., Vande Weyer R., Delaunois L. Latex gloves with a lower protein content reduce bronchial reactions in subjects with occupational asthma caused by latex. Am J Respir Crit Care Med. 1995 Mar;151(3 Pt 1):887–891. doi: 10.1164/ajrccm/151.3_Pt_1.887. [DOI] [PubMed] [Google Scholar]
  32. Wrangsjö K., Osterman K., Van Hage-Hamsten M. Glove-related skin symptoms among operating theatre and dental care unit personnel (I). Interview investigation. Contact Dermatitis. 1994 Feb;30(2):102–107. doi: 10.1111/j.1600-0536.1994.tb00572.x. [DOI] [PubMed] [Google Scholar]
  33. Wrangsjö K., Osterman K., van Hage-Hamsten M. Glove-related skin symptoms among operating theatre and dental care unit personnel (II). Clinical examination, tests and laboratory findings indicating latex allergy. Contact Dermatitis. 1994 Mar;30(3):139–143. doi: 10.1111/j.1600-0536.1994.tb00694.x. [DOI] [PubMed] [Google Scholar]
  34. Yassin M. S., Lierl M. B., Fischer T. J., O'Brien K., Cross J., Steinmetz C. Latex allergy in hospital employees. Ann Allergy. 1994 Mar;72(3):245–249. [PubMed] [Google Scholar]
  35. Zuskin E., Mustajbegovic J., Kanceljak B., Schachter E. N., Macan J., Budak A. Respiratory function and immunological status in workers employed in a latex glove manufacturing plant. Am J Ind Med. 1998 Feb;33(2):175–181. doi: 10.1002/(sici)1097-0274(199802)33:2<175::aid-ajim9>3.0.co;2-x. [DOI] [PubMed] [Google Scholar]

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