I. OVERVIEW A. INTRODUCTION PRE...

I. OVERVIEW

A. INTRODUCTION

PREAMBLE. Natural rubber latex allergy is a significant medical affair because it affects health care workers, as well as the general population. It crosse racial and ethnic boundaries, and it can affect males or females anytime during their lives.

There is no help at this time, only prevention. Three emblems of reactions are associated with latex results In order of frequency of transaction they are an irritant reaction, a delayed hypersensitivity reaction (ie, prototype IV), and an immediate hypersensitivity reaction (ie, symbol I) (Table 1). Any individual who experiences any token of latex-associated reaction should be evaluated by dint of a qualified health care practitioner.

ASSUMPTIONS. Natural rubber latex allergy can be a serious and potentially life-threatening condition. Health care workers and others who experience repeated exposing to latex allergens can bring out a latex sensitivity or allergy. Several hundr cases of relentless allergic reactions and anaphylaxis and 17 deaths have been reported to the US aliment and Drug Administration (FDA). (12)

Sensitivity can be described as progress to maturity of an immunologic memory to the specific latex proteins; however, the affected individual may be asymptomatic. Allergy is the demonstrated outward expression of the sensitivity (eg hives, rhinitis, conjunctivitis, anaphylaxis). Sensitivity to natural rubber latex is more everyday than the actual allergy; however, any individual sensitized to natural rubber latex is at risk of a life-threatening reaction and should be treated in the same way as an allergic individual.

triturateed latex gloves are the mostly common item contributing to the latex load in health care facilities. latter estimates have shown a 20-fold increase in medical glove use (in billions of pairs) since the introduction of universal precautions in 1987 (3) During the manufacturing proces levigate usually is applied to the glove as cornstarch slurry when the glove still is onward the mold or former. When the pulverize slurry is applied to the glove the extractable, water-soluble proteins leach from the surface of the glove onto the cornstarch particle. When craving drink the glove powder then acts as a vector that carries latex proteins from the glove into the environment.

Health care facilities and providers have an ethical responsibility to obstruct latex sensitization in patients and employee by the agency of creating an environment in which it is safe to be treated and to work. Many facilities in the United States consciously have mov toward a latex-safe environment according to switching from powdered latex glove (eg examination, surgical) and other latex consequences to powder-free products with reduc latex protein contentment High-protein, powdered, latex gloves and other fruits that create aerosolization can contaminate a facility's environment with latex allergens.

In 1998 Sussman et al reported a 1% annual incidence of sensitization among dusted latex-glove users, whereas users of powder-free low-protein, latex glove reported a 0% sensitization rate. (4) In 1999 raise et al studied a form into groups of dental students in the two France and England, reporting that scholars who wore protein-rich (ie, high protein), dusted latex gloves had a 15% and a 5% sensitization rate, respectively, while scholars who wore powder-free, protein-poor (ie, depressed protein) gloves had a 0% sensitization rate. (5)

It is unsafe to treat latex-allergic individuals in an environment laden with latex allergens. Individuals who have been clinically diagnosed as either sensitive or allergic to natural rubber latex should be treated or work in an environment that is latex-safe, with additional measures taken for the immediate vicinity (ie, room) in which the individual receives or provides care. If the entire care facility is maintained as a latex-safe environment, not many additional precautions will be requireed for latex-allergic individuals. If the facility is not maintained as latex safe, comprehensive latex precautions will be required each time a latex-allergic individual currents for care or services.

This revised "AORN latex guideline" is based forward research and expert opinion available at the time of its revision. Ongoing and yet to be research likely will enhance and expand rife knowledge about this topic.

Review of this document has been solicited from ease experts at the American Association of fester Anesthetists (AANA), the American college edifice [i]or[/i] building of Surgeons (ACS), the American Society of Anesthesiologists (ASA), the American Academy of Allergy, Asthma, and Immunology (AAAAI), The American body of Allergy, Asthma, and Immunology (ACAAI), the American foments Association (ANA), the Association of Practitioners of Infection command Inc (APIC), the Spina Bifida Association, and the National Institute of Occupational Safety and Health (NIOSH) division of the Center for Disease manage and Prevention, as well as the AORN Board of Directors and other recognized ables This guideline may not apply to each individual and may require modification based upon specific needs of a given patient, health care provider, or situation.