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Glove problems

GO U - section III

Problems With Latex allergies

The purpose of this literature review should help serve as a reference for Health Care Professionals looking for answers to the various problems associated with the routine usage of latex and rubber gloves.

Recent studies have indicated that the rapid increase in recent years in the use of gloves by medical and dental personnel is due primarily because of the concern for prevention of the Acquired Immune Deficiency Syndrome (AIDS). There may be two consequences with the increase use of gloves. First, there may be an increase in the number of medical and dental personnel who experience contact urticaria (acute or chronic allergic reaction - e.g. Contact Dermatitis) after repetitive exposure to rubber gloves. Second, there may be an increased number of unexpected anaphylactic reactions in patients who develop contact urticaria to rubber.

In January of 1988, there was a reported death at the Henry Ford Hospital, probably due to anaphylactic shock. In investigations by immunologists at the hospital, using a RAST test and the patient's own blood, they found that the patient was highly allergic to proteins found in many latex products, including surgical gloves.

Studies indicate that the hypersensitivity or allergen is believed to come from a water soluble protein which occurs naturally in the latex as obtained from the tree Hevea Brasilienses. It is heat stable and is present on the surface of the latex after it has been manufactured.

Hypersensitivity and anaphylactic reactions to latex include eczema, contact urticaria, respiratory symptoms, and shock. The studies indicate that as much as 6% of the population may be at risk to these allergens.

Additional studies, regarding the use of talcs, absorbable powders, and starches in the manufacturing of gloves or used as an agent to ease the donning of gloves are also listed. The studies clearly indicate that these substances may pose risks such as peritonitis, granuloma, adhesions, and even death.

I. Articles demonstrating hypersensitivity to latex

Systematic anaphylaxis during rectal manometry with latex balloon, by Sondheimer, headman and Bailey; The American Journal of Gastroenterology 1989; 84:No. 8 975-977

Contact urticaria and anaphylaxis to latex, by Tayloc Cassettari, Wagner and Helm; J Am Acad Dermatol 1 989; 21: 874-877

Anaphylaxis to latex during surgery, by Leynadier, Pecquet & Dry; Anesthesia 1989, 44:547-550

Severe inter-operative anaphylaxis to surgical gloves: Latex allergy, an unfamiliar condition, by Gerber, Jorg, Zbinden, Seger, Dangel; Anesthesiology 1989; 71: 800-802

Anaphylaxis produced by rubber glove contact; Case reports and immunological identification of the antigens involved, by Morales, Basomba, Carreira and A. Sastre; Clinical and Experimental Allergy 1989; 19: 425-430

Rubber anaphylaxis, by Slates; New England Journal of Medicine 1989; Vol. 320 No. 17; 1 126-1130

Hypersensitivity to natural latex, by Spaner, Dolovich, tardy Sussman & Buttoo; J Allergy Clin Immunol, 1989; 83: 1135-1137

Contact urticaria from rubber gloves, by Turjanmaa & Reunala; Dermatologic Clinics 1988; Vol. 6, No. 1

Contact urticaria & rhinitis from latex surgical gloves, by Carillo, Cuevas, Munoz, Hinojosa & Moneo; Contact Dermatitis 1986; 15: 69-72

Basophil histamine release and lymphocyte proliferation tests in latex contact urticaria, by Turjanmaa, Rasanen, Lehto, Makinen -Kiljunen Reunala; Allergy 1989; 44: 181-186

Airborne antigens from latex gloves, by Bauc Sager; Lancet April 14, 1990

II. Articles demonstrating problems with talcs, powders and starches

1. The hazards of surgical glove dusting powders, by Ellis; Sung. Gynecol. Obstet, Dec 1990: Vol. 171: 521-527

2. Granulomatous peritonitis caused by glove starch, by Michowitz, Stavorsky, Illie; Postgraduate Medical Journal, 1983, 59, 593-595

3. FDA Medical Device Reporting Summary #M122110, April 10, 1986

4. Contact urticaria due to cornstarch surgical glove powder, by Fisher; Cutis, Nov. 1986: 307-308

5. Surface powders on surgical gloves, by Tolbert, Brown; Arch. Sung.; June 1980; Vol. 1 15: 729-732

6. Life-threatening contact urticaria from glove powder, by van den Meeren; Contact Dermatitis, March 1986: 14[33: 190-191

7. Granulomatous peritonitis caused by starch glove powder, by Coder, Lander; Arch. Sung, July 1972; Vol. 105: 83-86

8. Retroperitoneal fibrosis due to starch granuloma, by Chenoweth; Urology; Feb. 1981; 18E2]: 157-159

9. Glove starch granulomatous disease, by Sugarbaker, McReynolds, Brooks; Am. J. Surgery; July 1974: Vol. 128: 3-7

10. Starch granulomatous peritonitis, by Ehrlich, Wharton, Gallager; So. Medical J.; April 1974: Vol. 67, 443446

11. Glove starch granulomatous peritonitis, by Taft, Lasersohn, Hill; Am. J. Sug.; Aug 1970: Vol. 120: 231-236

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