Occupational asthma caused by natural rubber latex

Abstract

IgE-mediated sensitization to protein allergens of natural rubber latex (NRL) can induce immediate hypersensitivity reactions ranging from mild urticaria to life-threatening anaphylaxis after cutaneous, mucosal or visceral exposure. Elutable allergens from NRL gloves adsorb to the cornstarch powder particles, become airborne, and have the potential to cause respiratory reactions. Recent studies indicate that asthma is a frequent manifestation of NRL allergy among workers manufacturing NRL materials and among health-care providers using NRL gloves. NRL induced asthma should receive increasing attention as it can lead to permanent respiratory sequelae and occupational disability. The need for early and accurate diagnosis is outlined and the different diagnostic approaches are reviewed. Specific issues pertaining to the management of affected subjects and to the prevention of exposure to airborne NRL are discussed. Areas of future research should include: 1) further characterization of relevant NRL allergens; 2) development and validation of methods for quantitative assessment of allergen content in NRL devices and workplace environments; 3) standardization of allergen extracts used for diagnostic purposes; 4) prospective evaluation of the natural history and risk factors of NRL-induced asthma; and 5) analysis of effectiveness and cost of preventive strategies.