Percutaneous Reactivity to Natural Rubber Latex Proteins Persists in Health-Care Workers Following Avoidance of Natural Rubber Latex

Details

• Personal Author:
  Amin HS ; Arif SAM ; Bernstein DI ; Biagini, Raymond E. ; Hamilton, Robert G. ; Smith AM ; Yeang HY
• Description:
  Background: long-term avoidance of natural rubber latex [Hevea brasiliensis (Hev b)] is currently recommended for health-care workers (HCWs) with established natural rubber latex (NRL) allergy. Percutaneous sensitivity to eight Hev b NRL allergens was evaluated in HCWs in 2000. To date, no studies have evaluated the longitudinal effects of NRL avoidance on percutaneous sensitivity to NRL allergens. Objective: the aims of this study were to evaluate changes in percutaneous reactivity to non-ammoniated latex (NAL) and NRL allergens in HCWs 5 years after a recommendation to avoid NRL and to evaluate factors that predict the persistence of in vivo sensitivity to NAL and NRL allergens. Methods: skin prick testing was performed with NAL, seven NRL allergens (Hev b 1, 2, 3, 4, 6.01, 7.01, and 13), and recombinant Hev b 5 (rHev b 5) in 34 HCWs who were initially evaluated in 2000 for occupationally related NRL allergy. Serial 10-fold dilutions of NAL and NRL allergens were employed in skin testing. Sera from the HCWs were assayed for latex and enhanced latex (rHev b 5-enriched allergosorbent)-specific IgE antibodies using the ImmunoCAP assay. Results: the prevalence of work-related symptoms significantly decreased between 2000 and 2005 with avoidance of NRL (P<0.05). A 100-fold reduction in percutaneous sensitivity to Hev b 2 and Hev b 7 was less likely in those with prior history of systemic reactions to NRL (P=0.0053), reported history of reaction to cross-reactive foods (P=0.014), continued local reactions to NRL gloves (P<0.0001), or high NRL glove exposure since the initial study (P=0.0075). The diagnostic sensitivity and specificity of the latex-specific IgE serology was 54% and 87.5%, respectively, in comparison with NAL skin tests. The addition of rHev b 5 to the ImmunoCAP (enhanced latex) allergosorbent altered the diagnostic sensitivity and specificity of the ImmunoCAP to 77% and 75%, respectively. Conclusion: while symptoms may resolve quickly with NRL avoidance therapy, detectable IgE indicating continued sensitization remains beyond 5 years, and thus continued avoidance of NRL should be recommended. [Description provided by NIOSH]
• Subjects:
  Hazardous Substances Health Personnel Hypersensitivity Occupational Health Safety Skin Skin Diseases Workplace
• Keywords:
  Allergic-dermatitis Allergic-disorders Allergic-reactions Biological-systems Health-care-personnel Health-hazards Health-protection Skin-diseases Skin-disorders Skin-exposure Skin-irritants Skin-sensitivity Statistical-analysis Statistical-quality-control Work-environment Worker-health

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• ISSN:
  0954-7894
• Document Type:
  Text
• Genre:
  Journal Article
• Place as Subject:
  Maryland ; Ohio ; OSHA Region 3 ; OSHA Region 5
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DART - Division of Applied Research and Technology
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Volume:
  37
• Issue:
  9
• NIOSHTIC Number:
  nn:20032604
• Citation:
  Clin Exp Allergy 2007 Sep; 37(9):1349-1356
• Contact Point Address:
  Andrew M. Smith, Department of Internal Medicine, Division of Allergy/Immunology, University of Cincinnati, 231 Albert Sabin Way, ML 0563, Cincinnati, OH 45267-0563
• Email:
  sa6@email.uc.edu
• Federal Fiscal Year:
  2007
• Peer Reviewed:
  True
• Source Full Name:
  Clinical and Experimental Allergy
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:1afe7084e4b5cd104ddc050baf609b459f21aad7911cb3c889a9793ad86384df3327bc9244e118a3352b4b6e01d85839753151d32074f1c7daa1a038a862ed88
• Download URL:
  https://stacks.cdc.gov/view/cdc/186518/cdc_186518_DS1.pdf
• File Type:
  [PDF - 120.91 KB ]