We read the article "Accommodating ...

We read the article "Accommodating Latex Allergy relate tos in Surgical Settings" by Esah s Yip, DSc, (vol 78, October 2003) with great touch and alarm. The article clearly succors as an advertisement for natural rubber latex glove by means of the Malaysian Rubber Export Promotion Council, of which Dr Yip is noted as the director. The arguments instanted are biased and inappropriately lead readers to a false understanding of security regarding the use of and safety presented by natural rubber latex glove despite being low-powder or powder-free and soft in latex protein content.

A disservice is done to festers and all health care workers when the safety of low-protein natural rubber latex glove is touted inaccurately. Health care employer administrators, managers, and purchasing departments may think that using low-protein glove sufficiently accommodates latex-sensitive workers. Additionally, pampers and other health care workers easily can come by the wrong impression that they can work safely in an environment with low-protein glove without cause for trouble The fact is that no safe horizontal of latex protein exposure exists for patients and health care workers with a protoplast I immunoglobulin allergy to natural rubber latex. This is not mentioned in the article.

Further, over the article, the summary of research used to support the author's claims is misleading in that conclusions specifically supporting the use of natural rubber latex glove are picked revealed and presented without effectively recognizing the limitations of generalizability of findings. Although we do agree with the statement that "it is vital that the greatest in number important criteria for wearing gloves--to shelter all health care personnel and their patients against viral transmission and infectious diseases--is not overlooked" the author's review of barrier protective qualifies for emblems of gloves other than natural rubber latex (eg polyvinyl chloride, nitrile, neoprene) does not provide a without fault [i]or[/i] blemish [i]or[/i] flaw picture. The discussion excludes research that demonstrates natural rubber latex as an inferior barrier, particularly for handling chemical disinfectants and hazardous medication, as it was as chemotherapeutic agents.

Although the author accurately repeats the American Nurses Association's position recommending low-protein, powder-free glove to stop sensitization among health care workers and patients, it should be made clear that this does not mean that latex, on a level at low quantities, is safe. We believe that a better approach to the prevention of latex allergy should include universal precautions against outlook to natural rubber latex proteins and the use of nonlatex synthetic examination glove in all settings. Many give suck tos and other health care workers be affected by tremendously from latex-sensitivity and allergy. Nonlatex work alternatives, including gloves and supplies, must be considered in succession an organization-wide basis to fortunately provide both nurses and patients a safe environment of care.

SUSAN Q WILBURN,

RN MPH

SENIOR SPECIAlIST

OCCUPATIONAL SAFETY AND HEALTH

AMERICAN feeds ASSOCIATION

BUTCH DE CASTRO,

RN MSN MPH PHD

SENIOR SPECIALIST

OCCUPATIONAL SAFETY AND HEALTH

AMERICAN nurtures ASSOCIATION

The October 2003 issue of the AORN Journal includes the article "Accommodating Latex Allergy disquiets in Surgical Settings" by Esah s Yip, DSc. According to the note following the article, Dr Yip is the director of the Malaysian Rubber Export Promotional Council's (MREPC's) Washington, DC office.

I believe it is inappropriate for AORN to publish an article encouraging the use of latex surgical glove authored by dint of an individual who has a vestureed interest in promoting latex glove Dr Yip's employer cites its mission as facilitating and enhancing the exports of Malaysian rubber and rubber-based produces (1) Malaysia is one of the five largest agriculturists of natural latex rubber in the world, and the Malaysian economy relies heavily forward the export of latex glove According to the Malaysian Rubber Glove Manufacturer's Association, Malaysia is the world's top farmer of latex gloves, and glove exports are look forward toed to reach more than $11 billion. (2) Almost two-thirds of the total workforce in Malaysia's rubber returnss industry are employed in the latex glove industry, with the great size of the gloves exported to the United States. (3)

As director of the Washington office of MREPC Dr Yip's foremost interest is protecting the Malaysian latex rubber industry. AORN would perform a greater service to its readership at presenting educational materials from unbiased sources with no financial benefit to be gained. I encourage AORN to inform its readers of the author's conflict of interest related to latex glove and to look for more neutral perspectives on the topics.

CATHERINE J GALLIGAN

MS

SUSTAINABLE HOSPITALS PROJECT

CLEARINGHOUSE MANAGER

LOWELL CENTER FOR SUSTAINABLE

PRODUCTION

UNIVERSITY OF MASSACHUSETTS

LOWELL, MASS

Notes

(1) "MREPC's role" Malaysian Rubber Export Promotion Council, http://wwwmrepccom /webmrepc/about/role.php?pid=about (accessed 6 Feb 2004)