Latex allergy risk management and harm prevention

Reproduced with permission from Dr. Valerie Olsen and the College of Physicians and Surgeons of Saskatchewan (CPSS). View the original article on the CPSS website. 

Latex allergy is an immunological reaction, either cell-mediated or IgE-mediated, to certain proteins found in natural rubber latex. Repeated environmental or occupational exposure can lead to sensitization and potentially life-threatening allergic reactions. Reactions are triggered by direct touch, skin contact or mucosal surface contact, or through inhalation of airborne particles.

While latex allergy is fairly rare in the general population, the prevalence among health care workers is reported to be as high as 17%. It is also higher among individuals with other allergies, or with medical conditions, such as spina bifida, which necessitate repeated interventions or procedures. Several health regions and facilities throughout the country have undertaken initiatives and developed policies and procedures to eliminate occupational exposure to latex for their employees.

Although there is no legislation or policy that regulates latex use in private health facilities and offices, an awareness of latex allergy and latex allergy disability, and an understanding of the potential consequences for both patients and staff, might lead physicians to consider using alternatives to latex. There is also an expectation that physicians should make accommodations for patients with disabilities, which in some cases might include modifications in the office environment for latex-sensitive patients.

It is recommended that physicians take steps to create latex-safe environments to minimize the risk of preventable harm to their office personnel and their patients.

Creating a latex-safe environment

• Use latex-free products such as gloves, supplies and equipment in the office or clinic.  This includes tourniquets, stethoscopes, blood pressure cuffs, dressing materials and adhesives, exercise bands, condoms, balloons, gloves and other personal protective equipment (PPE). (Stretchy rubber products contain the highest concentration of allergenic proteins due to the type of vulcanization process used in manufacturing them).
• Use alternative materials such as nitrile or vinyl gloves.
• Replace latex-containing toys in waiting rooms.
• Post notices in the office indicating that it is a latex-free environment and advising against introducing latex products.
• Identify patients with a known or suspected latex allergy and indicate that clearly on their charts.
• Ask patients about latex allergies at the time of booking appointments and procedures.
• Discuss latex concerns and options with patients.
• Follow up with allergic patients to determine the efficacy of the latex safety measures in the facility.
• Educate staff and colleagues in the facility about latex allergy and symptoms and the appropriate response in the case of a severe latex reaction.
• Ensure the facility has an available emergency cart which includes an anaphylaxis kit.

While it is not mandated that private offices make such accommodations, we recognize that physicians are committed to the well-being of their patients, and additionally have a responsibility to maintain a safe workplace for their staff.  An awareness of the risks associated with latex products in the healthcare environment can help when making improvements toward achieving these objectives.

Further information about latex allergy can be found in the following resources:

https://allergyasthmanetwork.org/allergies/latex-allergy/

https://www.osha.gov/latex-allergy

https://www.ccohs.ca/oshanswers/diseases/latex.html

https: //www.cdc.gov/niosh/docs/97-135/default.html

Dr. Valerie Olsen is Senior Medical Advisor with the Quality of Care Department at the College of Physicians and Surgeons of Saskatchewan (CPSS). Her specialty is general surgery.