Analysis of available diagnostic tests for latex sensitization in an at-risk population

Details

• Personal Author:
  Accetta Pedersen DJ ; Elms N ; Hoffmann RG ; Kelly KJ ; Klancnik M ; Kurup VP ; Wang, Mei Lin
• Description:
  Background: Lack of a Food and Drug Administration (FDA)-approved skin testing reagent for latex allergy in the United States requires reliance on patient history and serologic assays for diagnosis. Objective: To determine the diagnostic sensitivity, specificity, and predictive values of an FDA-cleared antilatex IgE serology test and an enzyme-linked immunosorbent assay (ELISA) with various sources of latex protein antigens in an at-risk but unselected population of health care workers. Methods: Health care workers underwent duplicate latex and serologic testing for latex specific IgE with the CAP assay and ELISA from June 1, 1998, through December 31, 2002. Logistic regression with receiver operating characteristic curve analysis determined the values, resulting in 98% and 99% specificity for the CAP assay and ELISA, respectively. Results: Results of paired skin and serologic tests were available for 792 participants. Forty duplicate skin test results (5%) were positive. For the CAP assay, sensitivity was 35%; specificity, 98%; positive predictive value, 48.3%; and negative predictive value, 96.6%. ELISA demonstrated similar results. Multivariable logistic regression yielding a 98% or 99% specificity for the various ELISAs demonstrated that the adjusted odds of a positive skin test result significantly increased with positive CAP assay and ELISA results using a powdered glove extract. Conclusions: The performance of the FDA-cleared antilatex IgE serologic test for latex allergy has much lower sensitivity than previously reported. This finding confirms that this serologic test should be used only for patients with a history of latex allergy and not for screening the population with a low prevalence of latex sensitization. [Description provided by NIOSH]
• Subjects:
  Biological Assay Diagnosis Enzymes Hazardous Substances Health Care Facilities Workforce And Services Health Personnel Hypersensitivity Occupational Health Personal Protective Equipment Safety Skin

  More +
• Keywords:
  Allergens Allergic-reactions Allergies Analytical-models Bioassays Diagnostic-tests Enzyme-activity Gloves Health-care-personnel Health-hazards Health-protection Immunological-tests Mathematical-models Medical-equipment Medical-personnel Medical-screening Proteins Reagents Sensitivity-testing Sensitization Serological-techniques Skin-tests Surveillance Synthetic-rubbers

  More +
• ISSN:
  1081-1206
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Journal Article
• Place as Subject:
  OSHA Region 3 ; OSHA Region 5 ; West Virginia ; Wisconsin
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  DRDS - Division of Respiratory Disease Studies
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  94-97
• Volume:
  108
• Issue:
  2
• NIOSHTIC Number:
  nn:20040473
• Citation:
  Ann Allergy Asthma Immunol 2012 Feb; 108(2):94-97
• Contact Point Address:
  Kevin J. Kelly, MD, Division of Allergy and Clinical Immunology, Medical College of Wisconsin, 9000 W Wisconsin Ave, #440, Milwaukee, WI 53266
• Email:
  kjkelly@mcw.edu
• Federal Fiscal Year:
  2012
• Peer Reviewed:
  True
• Source Full Name:
  Annals of Allergy, Asthma and Immunology
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:edb222d4096d5ffe2a9d2754e7be9cf5d698c8fa0236f3d9904aaf16ef36a09dd2fda29966845e74ef7acf4a27fda78bc1723a1ba63b58c3606b476cfdbecf9e
• Download URL:
  https://stacks.cdc.gov/view/cdc/193314/cdc_193314_DS1.pdf
• File Type:
  [PDF - 765.01 KB ]