Since the nineteenth hundred nurses...

Since the nineteenth hundred nurses and physicians have used natural rubber latex glove to save themselves and their patients from the transmission of viruses and harmful infectious diseases. These glove provide effective barrier performance, as well as durability, comfort, fit, and tactility. In the late 1980 the use of latex glove in health care facilities increased significantly befitting to concerns about transmission of the AIDS virus. This abrupt upsurge in glove demand l to the production of many inadequately manufactured latex glove that were high in residual proteins and excessively powdered--the prototype of gloves now known to cause serious allergic reactions in individuals who are latex sensitive. This puzzle has raised concern among the two health care professionals and latex glove manufacturers. This article examines latex allergy issues, discusses research findings pertaining to the use of unprov glove that can help alleviate allergy vexed questions and highlights the need for fit glove selection for effective barrier protection in the OR.

patterns OF REACTION

Three exemplars of reactions have been associated with the use of disposable medical gloves--irritant contact dermatitis, token IV reaction of delayed hypersensitivity, and original I reaction of immediate hypersensitivity. simply one of the three reactions--type I--is a reaction to latex proteins in natural rubber latex glove prototype 1 reaction affects about 1% of the general population, (1) although its prevalence is 3% to 16% among health care workers. (2) Irritant dermatitis, which is a reaction to non-proteinaceous irritants, and representation IV allergy, which is a reaction to certain residual chemicals make use ofed during manufacture of medical glove are more likely to offer and potentially less serious. These reactions can befall with use of either natural rubber latex or synthetic glove and should not be mistaken for latex protein allergy.

IRRITANT CONTACT DERMATITIS. Irritant contact dermatitis is a nonallergic reaction resulting from sensitivity to soap, hand cream, levigate disinfectants, and temperature and pH outermosts Symptoms include itching, skin rashes or flakiness, burning sensations, inflammation, or blister formation.

symbol IV REACTION. Type IV reaction causes symptoms that are surpassingly similar to those of irritant contact dermatitis. The allergic reactions are caused by the agency of the presence of residual chemicals, similar as accelerators belonging to models of thiuram, thiazoles, and carbonates, which repeatedly are used in the manufacture of one as well as the other latex and synthetic gloves. The allergic reaction is cell-mediated, and it appears within hours after contact with the allergens.

exemplar I REACTION. Type I reaction outcomes from exposure to certain allergenic proteins. In contrast with protoplast IV, type I is immunoglobulin E (IgE) mediated (ie, involving the Ige anti-bodies of the immune system) image I reaction commonly is caused by way of proteins found in foods, like as peanuts, watermelons, bananas, avocados, potatoes, tomatoes, and one seafood. Type 1 reactions also can be elicited according to insect bites, penicillin, and certain other medications. Latex proteins are a new addition to this list. Studies also have shown that there can be cross-reactivity among allergens from sustenances and latex proteins; that is, individuals can become sensitized by means of exposure to proteins from united source and react when later expos to another source.

impressed sign I reactions usually occur within minutes of contact with allergens. Symptoms can vary from mild reactions, in the same state [i]or[/i] condition as urticaria, hay fever, and allergic conjunctivitis, to asthma and, in rare cases, anaphylaxis.

If another shadow of medical glove could provide the barrier protection, tactile properties, and reasonable richness of natural rubber latex glove it is possible that the health care community might deal with latex allergy by dint of simply replacing natural rubber latex glove with synthetic substitutes. The superior performance of natural rubber latex glove through the whole extent of many synthetics, however, has activeed researchers and manufacturers to investigate and work toward alleviating allergic reactions to provide the best possible protection for health care workers and their patients.

LATEX PROTEINS

Natural rubber latex glove are made from latex, a milky sap that results from the Hevea brasiliensis tree It comprises about 30% rubber particles dispersed in a liquid medium that also contains small amounts of nonrubber substances, as it is as carbohydrates and minerals. The mass of latex is water, and total proteins comprise about 1% of latex. Fewer than 5% of the proteins in latex have been identified and characterized to point out to IgE-binding activity. (3)

When latex is caseed into gloves, many of the soluble proteins are missing leaving only a small fraction in the fruit It is this residual fraction of extractable proteins that is implicated in allergic reactions. Not all residual extractable proteins demonstrate allergenic activity. Furthermore, this residual fraction is water soluble and can be remov from the glove through proper processing, particularly adequate leaching.