Latex Sensitisation Study © Priory Lodge Education Limited, 1996.

Latex Sensitisation Study

Dr E. Anne Field
Senior Lecturer and Consultant in Oral Medicine

There are increasing reports of adverse reactions to latex gloves by healthcare practitioners and it has been estimated that, in the United States alone, about 17% of healthcare workers (1.4 million people) are currently allergic to natural rubber latex (NRL) (CDC. 8-15-95). Adverse reactions range from a mild skin rash to a fatal anaphylactic shock and one recent study has reported a prevelance of allergic reactions to latex gloves among American dentists of 13.7%.

Risk groups for latex allergy have been defined as:

Children with spina bifida and urogenital abnormalities
Individuals with a history of multiple operations
Healthcare professionals who frequently don gloves
Individuals with an atopic history

More recently, associations have been described between latex allergy and allergic reaction to certain foods, especially bananas and avacados. Review of the literature suggests that a carefully prepared questionaire can identify upto 80% of the individuals at risk from latex allergy.

The number of dental health care workers (DHCWs) who present clinical symptoms of latex allergy is presently unknown and there have been no previous studies to investigate the predisposing risk factors.

This study is being carried out by:
Anne Field, Senior Lecturer and Consultant in Oral Medicine
at Liverpool University Dental Hospital
Pembroke Place
Liverpool, L3 5PS
England

Please complete the questionaire form below and contribute to this survey.
Please also indicate if you (or a colleague) have been forced to give up (or restrict) clinical practice because of problems associated with wearing latex gloves.

ALL information will be treated in utmost confidence.

Title Name Email Address

Section A: General information on glove use

A0 Please state your country of residence A1 Please state your occupation

Dentist
Dental Hygienist
Dental Nurse
Dental Technician

A2 What is your gender?

Male
Female

A3 What kind of clinical setting do you primarily work in?

Genaral Dental Practice
Hospital
Community Dental Services
Armed Forces

A4 How many years have you been involved in clinical practice?

Less than 2 years
2 - 5 years
5 - 10 years
More than 10 years

A5 Do you ROUTINELY wear gloves in your clinical practice?

If you have answered NO, please submit your questionaire now.
If you have answered YES, please continue.

A6 How many years have you been ROUTINELY been wearing protective gloves in clinical practice?

Less than 1 year
1 - 2 years
2 - 3 years
3 - 5 years
More than 5 years

A7 How many pairs of gloves are worn during an average clinical session? (session = ½ day)

1 - 5 pairs
6 - 10 pairs
10 or more pairs

A8 How many sessions during a working week would you normally wear gloves?

1 or 2 sessions
3 - 5 sessions
6 - 10 sessions

A9 What type of gloves do you ROUTINELY wear and are they powdered or non-powdered?

Type of Gloves	Powdered	Non-Powdered
Latex examination or procedure gloves
Latex Surgical Gloves
Non-Latex examination gloves (eg: plastic, vinyl)

Please say which brand you use.
If you don't know please enter 'unknown'

Section B: Latex Allergy

B1 Have you ever had skin testing for possible allergy to any latex rubber glove?
  (eg skin prick, punture or patch testing)

	Yes                               
	No                                

B2 Has a medical specialist confirmed that you have an allergy 
 to any latex rubber product?

	Yes                               
	No                                

If yes, to what specifically did the specialist say you were allergic?

Section C: Risk Factors

C1 Do you have a history of any of the following conditions?

Condition	Yes	No
Asthma
Hay Fever
Hand Eczema in Childhood (15 years of age or younger)
Hand Eczema in Adulthood (16 years of age or older)
Eczema elsewhere on body (other than hands)

C2 Do you have any FOOD allergies?

	Yes                               
	No                                

If yes, check all that apply:



Banana 
Avacado 
Kiwi Fruit 
Peach 
Papaya 

Almond 
Chestnut 
Peanut 
Tomato 
Potato 

Milk Product 
Egg 
Other

If other, please specify:  

C3 Do you have any bladder (or urinary)condition
 that requires catheterisation?

	Yes                               
	No                                

C4 Do you suffer from spina bifida?

	Yes                               
	No                                

C5 Have you ever undergone surgery under general anaesthesia?

	Yes                               
	No                                

If yes, how many times?

	1 time                            
	2 times                           
	3 times                           
	More than 3 times

Section D: Self-reported reactions to Latex

D1 Have you ever developed a reaction to latex gloves, or any other latex-containing product
(eg: household rubber gloves, balloons, condoms, rubber bands, enema tips, rubber dams) such as: chapping or cracking of hands, itching, rash, hives, itchy/watery eyes, sneezing, shortness of breath, facial swelling or anaphylaxis?

Reaction To	Yes	No
Latex Gloves
Other Latex Products

If you have answered NO to either, please  submit your questionaire now.
If you have answered YES, please continue.

Section E: Type of Latex Reaction

E1 When wearing latex gloves, or in contact with other latex products, 
have you experienced any of the following symptoms?

**Please check 'Yes' or 'No' to ALL questions in BOTH columns**
Type of Latex Reaction	Latex Gloves		Other Latex Product
Type of Latex Reaction	Yes	No	Yes	No
Chapping or cracking of hands
Rash on hands
Itching
Hives on skin (like 'nettle rash')
Runny nose/sneezing
Itchy or watery eyes
Shortness of breath (difficulty breathing)
Facial swelling
Anaphylaxis

Please answer the following question (E2), ONLY if you have experienced as adverse reaction to latex gloves. The response to this question will help us to determine the type of glove reaction you may have experienced.
If not, please submit your questionaire now

E2 Which of the following descriptions best describes the signs and symptoms 
when you wear latex gloves?



 Dryness, cracking (or fissuring) and redness of hands in areas exposed to gloves. 
Tends to be chronic problem, which improves during periods when gloves not worn.

Swelling, redness, itching, cracking and thickening of skin in area exposed to glove - 
may extend above area of the cuff. Reaction occurs 6 to 48 hours after contact with gloves and 
is always localised

Itching, hives (similar to nettle rash) on skin (local or generalised) and/or symptoms 
of hayfever (runny nose, itchy/watery eyes) and maybe wheezing or breathlessness (like asthma) 
usually occurs within 60 minutes of donning gloves

E3 How long after you started wearing latex gloves did you first 
  notice a reaction?

	Less than 1 year                  
	1 - 2 years                       
	2 - 3 years                       
	3 - 5 years                       
	More than 5 years                 

E4 Have you ever required medical treatment for any reaction associated 
  with latex gloves?

	Yes                               
	No

Thank you for your contribution to this survey

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Banana	Avacado	Kiwi Fruit	Peach	Papaya
Almond	Chestnut	Peanut	Tomato	Potato
Milk Product	Egg	Other

Dryness, cracking (or fissuring) and redness of hands in areas exposed to gloves. Tends to be chronic problem, which improves during periods when gloves not worn.
Swelling, redness, itching, cracking and thickening of skin in area exposed to glove - may extend above area of the cuff. Reaction occurs 6 to 48 hours after contact with gloves and is always localised
Itching, hives (similar to nettle rash) on skin (local or generalised) and/or symptoms of hayfever (runny nose, itchy/watery eyes) and maybe wheezing or breathlessness (like asthma) usually occurs within 60 minutes of donning gloves