Translation: Susana Carrillo – Mi Despacho Virtual

http://www.portalesmedicos.com/traductores-medicina/midespachovirtual

LATEX ALLERGY

Latex Allergy presents an increasing incident in all the developed countries. Nowadays in Spain there is a 1% of population sensitized to this substance, very much major percentage for the identified groups at risk.

Latex of natural rubber is a milky substance that obtains of Hevea Brasiliensis tree or tree of the rubber. Once treated suitably it is used for the manufacture of many products of habitual use (zeal, condoms, globes, tires, elastic rubbers, gums of feeding-bottles, pacifiers, toys, and a length etc. up to 40.000 articles that are calculated contain it) and also in articles of sanitary use (probes, gloves, catheters, stoppers of road, connections, enemas, sticking-plaster, shiver, bandage elastic, resuscitation masks, oxygen masks, etc.). 

Situations that suppose major risk for the allergic ones are those who expose the individual to elastic objects of thin walls like globes, gloves and preservatives. Risk increases when these enter in touch with mucous (to swell globes, preservative in vaginal mucous, etc.) and when they contain powder to facilitate its use (powder in globes, gloves, cap of swimming pool, etc.).

In sanitary environment, all these products as well as the particles of latex spread in the environment from the powder of gloves, suppose a threat for the allergic patients. In addition, it is frequent in this area that the latex contacts directly with the mucous ones, corporal fluids and internal organs, so that absorption of particles is much more rapid and the most intense reaction. This situation endures, in addition, an exhibition continued to latex on the part of all the sanitary workers, who turn this way into one of most affected by this allergy. 

Other groups at risk for this allergy - patients with cleft spine and disorders urogenitals congenital, present with multiple surgeries and with long hospitalization - they develop also allergy immediately after high frequentness in hospitals.  

Persons affected by the above mentioned allergy must avoid any contact with the proteins of latex, already it is an inhalation of particles spread by air, already it is direct contact (cutaneous, mucous, ingestion). Reactions can begin within a few minutes of exhibition and until an hour after this one and can imply: 

- Cutaneous and mucous affectation (erythemas, dermatitis, nettle-rashes, edemas, conjunctivitis)

- Respiratory affectation (rinitis, asthma, respiratory difficulty)

- Widespread affectation (angioedema, anaphylaxis, anafilactic shock at risk of death).

Type of reaction will depend on level of sensitization of patient, on quantity of allergen latex that has entered in touch with this one and of the route of contact (the contact of the latex is not the same with a healthy skin that with the mucous vaginal one during a gynaecological exploration). Many patients allergic to latex can present similar reactions on having consumed certain tropical fruits (banana, kiwi, avocado) or chestnut; it is what names latex - fruit syndrome.

High prevailence of this allergy and the importance of possible reactions does indispensably to adopt following preventive basic measures in all the welfare levels: 

1. IDENTIFY PATIENTS ALLERGIC TO LATEX AND OF RISK

a. To ask always for a possible allergy to latex (not only it is necessary to investigate medicamentous allergies), specially before a manipulation of mucous or surgical intervention. Sometimes the patient does not know the above mentioned allergy, it is necessary to ask for reactions on having swelled globes, on having used gloves or preservatives, on having consumed fruits as the kiwi or banana.

b. To read plates or bracelets of warning, specially in the urgent attention, in unconscious patients and in children. 

2. ACTIONS TO PREPARE NEW SENSITIZATIONS 

a. To avoid gloves with powder, since they spread particles of latex to the environment when we withdraw them from hands. Only with this action one managed to reduce in Germany 80 % of new cases of latex allergy in sanitary personnel. 

b. To use gloves of synthetic materials (vinyl, nitrile, neoprene) adapted to every task or of latex with low content in allergenic proteins. There exist lists updated with the content in allergens of the gloves of latex. In Finland these lists consult regularly and only the low ones are acquired in allergens. This measure avoids new sensitizations. 

c. To give attention without latex from the begin to patients of risk: cleft spine, urogenital malformations, when multiple surgeries are foreseen... 

3. ACTIONS TO AVOID REACTIONS ALLERGIC TO ALREADY SENSITIVE PATIENTS

a. Specific protocols for every service (urgencies, UCI, surgery, room of childbirths, hospitalization, external consultations, sanitary transport) that meditate:

- material without latex

- free space of latex

- training to personnel 

Up to the moment there are only a few centers that have adopted specific initiatives to give a sure attention to allergic ones to latex that they allow, at the same time, to prepare new sensitizations between sanitary personnel. But they are only small actions inside a welfare net still little prepared for them. There remains hanging the challenge of improving to offer welfare safety to the whole population.

Author: Spanish Association of Allergic to Food and latex

http://www.aepnaa.org

Translation: Susana Carrillo – Mi Despacho Virtual

http://www.portalesmedicos.com/traductores-medicina/midespachovirtual