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Articles Reviewed in This Issue:
Hunt, L.W., Fransway, A.F., Reed, C.E., Miller, L.K., Jones, R.T., Swanson, M.C., & Yunginger, J.W. (1995). An epidemic of occupational allergy to latex involving health care workers. Journal of Environmental and Occupational Medicine, 37(10), 1204-1209.
Stojanovic, A., Keena. D., Kroneman, O., Rocher, L., Weidbrauk, D., & Lauter, C.B. (1998). Latex specific IgE in hemodialysis patients. Abstract 663. The Journal of Allergy and Clinical Immunology, 101(1), Part 2,161.
Vassallo, S.A., Thurston, T.A., Kim, S.H., & Todres, I.D. (1995). Allergic reaction to latex from stopper of a medication vial. Anesthesia and Analgesia, 80, 1057-1058.
National Institute for Occupational Safety and Health (NIOSH) Alert (1997, July). Preventing allergic reactions to natural rubber latex in the workplace. (DHHS (NIOSH) Publication No. 97135). Rockville, MD: DHHS.
The urgent call for universal precautions to protect against HIV and hepatitis B in the late 1980s dramatically increased the number of gloves used by health care personnel. Federal agencies never specified that glove material should be latex, noting only that there was a need for universal precautions and an "intact" barrier, yet latex glove usage became almost universal among health care workers. Ironically, by the mid-90s, the very material that was thought to be protecting health care workers had become, itself a source of illness.
Despite hundreds of reports of studies and articles since the late 1980s, largely in allergy journals (there were 36 abstracts of latex allergy-related studies presented at one meeting alone - the 1998 American Academy of Allergy, Asthma, and Immunology conference), the issue of latex allergy is widely misunderstood, even by experienced nurses and physicians. There is confusion even about the basics, for example, the distinction between "natural rubber latex" (NRL) and "latex." Technically, the term latex refers to a wide range of synthetic materials (such as in paints or carpet backing) that usually have no rubber at all, and that are not generally associated with true allergy and reactions, such as anaphylaxis. Natural rubber latex does have protein allergens capable of sensitizing and of causing a severe reaction such as anaphylaxis, and is most often referred to as latex. For this Journal Club, the term "latex" is used to mean natural rubber latex.
There is a wide range of reactions to gloves,...