What are the other Names of this Condition? (Also known as/Synonyms)

• Allergy to Natural Rubber (Latex)
• Natural Rubber Latex Allergy

What is Latex Allergy? (Definition/Background Information)

• Latex Allergy is a relatively rare condition that manifests as an abnormal immune reaction/response to natural latex rubber products in individuals who use them. It is observed among certain communities, such as professionals in the medical field and rubber industry workers, to a greater extent
• Natural latex is a polymer product with a distinct smell, that is made from natural latex rubber sap, water, resin, and other chemical compounds. It is highly elastic in nature and used in a variety of hospital products, textiles, and toy industries, in the manufacture of hand gloves, medical tubes, condoms, handbags, balloons, and erasers
• Exposure to latex leading to Latex Allergy, typically occurs from direct physical (skin) contact. A severe form of allergy may also occur from inhaling latex powder dust. Reaction to the allergens can take place immediately, or after a few hours following exposure. The condition may be mild, moderate, or severe
• It is important to note that synthetic rubber (not based on any component of latex) products are not known to cause Latex Allergy; but, almost all cases occur from the use of natural rubber latex. In many individuals, Natural Rubber Latex Allergy develops slowly over a period, presenting mild symptoms during the initial stages; thus, recognizing them early, may prevent a full-blown condition from forming later
• The following 3 forms of Latex Allergy are described in the medical literature:
  • IgE mediated type: This form of Latex Allergy can be severe and life-threatening. It occurs within a few minutes to hours of contact of latex with skin and mucus membranes, or on inhaling dust coming off a latex  product. It is usually preceded by contact dermatitis in 80% of the cases. The condition is also called type I hypersensitivity Latex Allergy
  • Cell-mediated type (or type IV cell-mediated contact dermatitis): The allergic reaction occurs to certain other added chemical compounds in the product and not to natural rubber latex. The reaction can take place after 1-3 days of exposure and manifests as skin signs and symptoms. It is not known to be life-threatening and this form is self-limiting. It is also called type IV hypersensitivity Latex Allergy
  • Irritant contact dermatitis due to latex exposure: It is not strictly termed as a form of allergy, but the condition may forewarn about Latex Allergy potentially developing into the future. It manifests as a skin rash within 12-24 hours of skin contact
• Numerous signs and symptoms of the allergic reaction may be noted including runny nose, hives, sneezing, and breathing difficulties. In some individuals, Latex Allergy may lead to an anaphylactic shock, which is a medical emergency
• Latex Allergies are generally diagnosed by conducting a physical examination, assessing the symptoms, and via an antibody blood test or a skin-prick test
• Anti-allergic medications form the first line of treatment for mild Latex Allergies. However, in the case of a severe allergic reaction (anaphylaxis), epinephrine or adrenaline injections are recommended
• The prognosis of Latex Allergy is generally good with adequate treatment, although some individuals have it lifelong. Awareness of such allergies and avoidance of specific products made from natural rubber is the best form of prevention

Who gets Latex Allergy? (Age and Sex Distribution)

• Latex Allergies can occur in both children and adults (more cases are noted in adults). Individuals of any age (infants, young and old children and adults) may be affected
• No gender preference is noted and both males and females are affected
• All racial and ethnic groups are equally vulnerable to the condition

What are the Risk Factors for Latex Allergy? (Predisposing Factors)

Even though rare, Latex Allergies are frequently observed in certain high-risk groups. Such high-risk groups include:

• Children with spina bifida: Reports indicate that between 50-60% of the children born with spina bifida, a rare congenital malformation disorder affecting the spinal cord, may be allergic to naturally-derived rubber latex
• Children, who undergo multiple surgeries (over 6-10 numbers) for congenital disorders from an early age, including those undergoing frequent hospitalization and prolonged treatment
• Medical community: Personnel belonging to the healthcare field have an elevated risk following long-term exposure to medical products. It is reported that Latex Allergy incidence rate among medical workers is about 10-15%. The healthcare products made from latex may include the following:
  • Medical (surgical) gloves
  • Medical tubes; catheters, intravenous infusion tubes and pumps
  • Dental dams
  • Syringes and stethoscopes
  • Dialysis filters
  • Diaphragms
  • Tourniquets, bandage, dressings, and adhesive tapes
  • Medical masks (for oxygen, anesthesia delivery)
  • Walking aid (crutches) and wheel chair pads and cushions
• Industrial workers in the rubber extraction and process industry; up to 10% of the workers may be affected
• Individuals who regularly wear skin-tight clothing and footwear made from natural rubber latex for prolonged periods, such as those belonging to the fashion industry
• A higher prevalence of Latex Allergy may also be seen among cleaning and housekeeping personnel, painters, polishers, lab technicians, etc.
• Children with certain allergic conditions, such as contact dermatitis, on exposure to latex are at an increased risk 

Other risk factors for Latex Allergy may include:

• Family history of an associated allergy
• Having one form of allergy puts one at risk for other forms too
• Using any of the following natural rubber products:
  • Household gloves, mattresses, shower curtains, floor mats
  • Feeding bottles and nipples, pacifiers
  • Toy items such as rubber balls, balloons, molded toys, erasers
  • Condoms
  • Handbags, shoes and slippers, elastic hair bands, rubber bands
  • Vehicular tires
  • Paint coatings, glues
• Healthcare providers examining patients (mouth, rectum, vagina, genitalia) using medical gloves can place both parties at risk

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases one’s chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others.

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider.

What are the Causes of Latex Allergy? (Etiology)

An allergic reaction occurs in an individual with Latex Allergy, because the immune system recognizes certain substances (such as proteins) in natural rubber latex as being dangerous and harmful to the body.

• The exposure may occur from use of gloves for various purposes, wearing latex clothing, playing with rubber toys, blowing up balloons, inhalation of latex glove powder (containing certain proteins that result in severe reactions), or as occupational hazard from rubber-related industry work
• Contact with natural rubber latex (protein) results in the production of antibodies, specifically immunoglobulin E (IgE). The next time the individual is exposed to the substance, the antibodies that are circulating in blood causes an antibody-antigen reaction
• This results in the production of histamine and other chemical messengers, which cause the symptoms seen during an allergic reaction
• The extent of exposure that triggers an allergy may not be significantly large. Sometimes, mild or minor contact with latex (allergen) is sufficient to trigger Latex Allergy

In some cases, a severe allergic reaction termed as anaphylaxis may occur, which is a medical emergency that requires immediate medical attention.

What are the Signs and Symptoms of Latex Allergy?

The signs and symptoms of Latex Allergy may start to appear within a few minutes, to a couple of hours, after the individual has been exposed to the substance. Depending on the level of sensitivity and quantum of exposure, the symptoms may be mild or severe. A severe allergic reaction is a medical emergency.

The common signs and symptoms of Latex Allergy may include:

• Itching of skin
• Urticaria (hives), skin rashes, or eczema
• Coughing, sneezing
• Runny or stuffy nose
• Shortness of breath (trouble breathing), wheezing, asthma-like symptoms
• Watery eyes, redness, and irritation
• Irritation of the throat
• Nausea

Generally, not all episodes of allergy will be of the same severity. In some individuals, the most severe symptom caused by Latex Allergy is anaphylaxis. It may occur from inhaling latex allergen dust.

• Anaphylaxis (sometimes called an anaphylactic shock) is a life-threatening, whole-body allergic reaction
• During anaphylaxis, tissues in various body parts release histamine and other messenger chemicals, which causes swelling of the throat and other symptoms
• Swelling of the throat is especially dangerous as this can cause shortness of breath. If the swelling is not reduced soon, then there is a possibility that the individual could die from a lack of sufficient oxygen
• It can also result in a bluish skin, weak pulse, and decreased blood pressure (hypotension)

How is Latex Allergy Diagnosed?

The diagnosis of Latex Allergy may involve the following:

• Physical examination, assessment of symptoms, and medical history evaluation (history of allergies in the family)
• Radioallergosorbent (RAS) test; to determine the specific allergy-causing substance
• Skin-prick (allergy) test:
  • For this test, tiny amounts of certain substances are placed on the skin and a moderately sharp needle is lightly scraped through the test substance. This is done on the  forearm, upper arm, or back
  • After 15-20 minutes, if the spot where the chemical was injected swells, or if there is redness noticed, then this indicates that the individual may be allergic to the substance
  • Sometimes the suspected antigen is injected intradermally, as in a TB skin test
• Blood test to detect antibodies (antibody test)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis.

What are the possible Complications of Latex Allergy?

The complication of Latex Allergy is associated with the allergic reaction itself and it depends on the severity of the reaction. It may include:

• Anaphylactic shock/reaction that may be life-threatening
• Development of chronic conditions including occupational asthma due to continued exposure to latex
• Associated food allergy which is seen in nearly 50% of the individuals with Latex Allergy, called latex-food syndrome, that makes it difficult to enjoy a variety of common fruits and vegetables such as kiwis, bananas, avocados, and chestnuts, and some other fruits
• Having one form of allergy can make the individual prone to other allergy types
• In severe reactions, a tracheostomy may have to be performed during an emergency situation

How is Latex Allergy Treated?

The treatment of Latex Allergy may be undertaken in the following manner:

• Avoidance of natural rubber latex products; using suitable alternatives made of artificial latex or other materials
• In case of contact with the allergic substance, wash the affected area immediately with water
• Application of anti-itch, over-the-counter creams that contain hydrocortisone can provide relief from pain and itching sensation
• Anti-allergic medication for mild reactions; antihistamine therapy, that is prescribed by the allergy physician or over the counter
• Symptomatic treatment; use of decongestants, or intranasal steroid sprays
• In the case of anaphylaxis (severe allergic reaction), epinephrine or adrenaline is immediately administered. Those with a history of anaphylaxis must inform all healthcare providers and are strongly suggested to wear a device to alert any caretakers during emergencies
• Breathing support as necessary, control asthma symptoms and low blood pressure
• Immunotherapy, in case of severe allergies, for long-term tolerance development

How can Latex Allergy be Prevented?

The best way to prevent Latex Allergy is to avoid the allergen products. Additionally, the following factors may be considered:

• Check product labels; educate oneself on items that potentially contain the allergenic substance
• Parents must be watchful and avoid inadvertently give their child natural rubber latex toys or feeding bottles, if they are known to be allergic to the same
• Hospitals may use non-latex medical products or low-protein latex products (Eg. nitrile gloves - safety gloves made of synthetic rubber)
• If Latex Allergy is due to an occupational exposure, then the occupation or job-related tasks or habits may have to be suitably changed/modified
• Long-term latex usage may cause an occupation-associated allergy; inform others at work, request using alternatives to latex products among team members and colleagues
• Use alternative materials, where possible
• Studies have shown that breastfeeding children for 4-6 months or over, can help build their body immunity and make them less prone to allergies
• Appropriate maternal diet during pregnancy can help build stronger resistance (against allergies) in children
• Washing hands with soap and water, in case of contact with an allergen, especially before eating
• Generating public awareness on various allergies

In case the child or adult is susceptible to an anaphylactic shock (high-risk individuals) from Latex Allergy, the following should be considered:

• Being watchful of triggers and avoiding them
• Wearing medical alert information bracelets or suitable devices
• Carry auto-injector epinephrine or adrenaline medications such as EpiPen, Anapen, or Twinject. Since the condition may recur, it is advised to carry 2 doses (2 pens)
• Supervise children on how to self-administer the injection, if required
• If child is prone to anaphylactic reaction, then information (preferably written instructions) should be given to day care, school authorities accordingly
• Adults should inform their spouses, colleagues, and friends, about the condition, in case of a future emergency

What is the Prognosis of Latex Allergy? (Outcomes/Resolutions)

• The prognosis of Latex Allergy depends on the severity of the signs and symptoms, but it is generally good with appropriate treatment. However, some individuals may have it for the rest of their lives
• In some cases, the allergic reaction may be severe, causing anaphylaxis. This is a medical emergency that can lead to a respiratory failure. It requires an immediate treatment of the condition. In such cases, the prognosis is guarded and it depends on whether immediate medical assistance is provided

Additional and Relevant Useful Information for Latex Allergy:

• Individuals with Latex Allergy are more at risk for experiencing reactions to certain plant foods that contain latex tree sap proteins. This condition is called latex-food syndrome or latex-fruit allergy. These plant products include tomatoes, avocados, carrots, apples, kiwis, potatoes, papayas, soy, pineapples, bananas, etc.
• In some individuals with Latex Allergy, alternative or substitute non-latex products produced at the same manufacturing facility are still known to cause an allergy